Ultrasound technology, and its uses, has come a long way since the 1950s

An early form of ultrasound scanning in the 1950s involved submerging a patient into a bath of water, and the probe would move around them.

The technology has since improved, allowing a portable wand to be plugged into a tablet to create real-time images of soft tissues in the body.

Ultrasound, or sonography, is a noninvasive and risk-free diagnostic medical tool. It sends high-frequency sound waves through the body, and different internal structures will send back different signals that can be turned into images.

“The way that the sound kind of bounces off different structures of the body, we're able to identify either normal anatomy or some kind of pathological process in the body,” said Julie Posey, chair of the sonography department at Owens Community College.

Ultrasound is a “relatively safe modality,” Ms. Posey said, because it doesn’t use radiation or a magnet and has no known risks.

That makes it particularly useful in pediatrics, said Thomas Win, department chair of radiology at ProMedica.

“Because ultrasound is non-ionizing radiation, it's extremely safe, essentially no side effects,” Dr. Win said. “So in the pediatric population, we like to use that almost like a first-line technique for imaging of many potential disease processes.

“It's quick, it's easy, it's well tolerated by the patient.”

Sonography has a wide range of uses in different areas of medicine. Specialties include diagnostic, cardiac, vascular, musculoskeletal, pediatric, and obstetrics.

“It's far ranging, and really is involved in just about everything we do,” Dr. Win said.

Reproductive health

People are often most familiar with ultrasounds in the context of pregnancy – OB scanning is the “bread and butter” of the field, Ms. Posey said.

She said a fetus can be seen on an ultrasound at around 5 weeks of gestation. By week 6 or 7, you can start to see its heartbeat, Dr. Win added.

Around 18 to 20 weeks, an anatomy scan will measure the cervix, identify the location of the placenta, and determine whether the pregnancy should be induced based on factors such as the amount of amniotic fluid, he said.

Looking at 3D images of a developing fetus can also help identify potential abnormalities.

Ultrasounds can also evaluate reproductive anatomy to identify any potential structural reasons for infertility. Certain probes can be inserted into the body, which gives a closer look than just scanning over the skin. A transvaginal ultrasound can look at the uterus and ovaries, while a transrectal ultrasound looks at the prostate.

With a physician’s consent and previous formal imaging, members of the public who are between 20 and 32 weeks pregnant can get free, non-diagnostic OB scans at Owens. It serves as “additional bonding time,” Ms. Posey said, "and it helps our students as well.” Go to owens.edu/snhp/ultrasounds for more details.

Internal radiology

Ultrasounds are often used to help identify characteristics of a lump or abnormality before taking a biopsy or going to a more involved scan such as a CT or MRI.

For example, if a patient feels a mass in their breast or one is found on a mammogram.

“A lump can be a cyst or can be solid. A cyst is almost always benign,” Dr. Win explained. “Ultrasounds are extremely good at differentiating: Is that abnormality filled with fluid or is it solid? If it's solid then that prompts us to go further to make a diagnosis.”

In addition to diagnosing and staging cancers, the technology can also help localize specific things in the body like pain or an infection.

“Say there's a big infection or an abscess on the patient, ultrasound is very easy to be able to localize that and help guide a needle to that location and then drain the infection,” Dr. Win said.

It can also direct where to inject a pain management medication or steroid.

Cardiology

When it comes to the heart, ultrasounds can help with several concerns such as heart failure, coronary artery disease, stroke, suspected fluid around the heart, and shortness of breath.

“You want to do the most minimally invasive test before you send them [for a catheter],” said Danielle Lycourt, a cardiac sonographer at Mercy Health St. Vincent Medical Center.

By providing quality images, she said, “we help the physicians or the cardiologists diagnose and come up with appropriate treatment plans.”

Echocardiograms often evaluate heart function for potential organ donors, both before and after operations, and even during certain procedures.

“When we do structural heart, we are in an operating room where we are helping provide images,” Ms. Lycourt said, noting that the procedure involves placing devices in the patient’s heart, such as new valves. “We provide images before they have the procedure, and then we provide some images after the valve is deployed, and then we are looking at images in the OR.”

Other uses

Cardiac sonographers also conduct transesophageal echocardiograms, in which the probe goes down through the esophagus to see the heart better, Ms. Lycourt said.

Other endoscopies are used to look at structures behind the stomach, such as the pancreas or liver.

“The endoscopic ultrasound can sort of direct a biopsy in the central portion of the abdomen, which can be very, very helpful,” Dr. Win said. “The more central it is in the body, the more risk it carries. So physicians are always looking at the best route to get to something.”

Ultrasounds may also image the kidneys, thyroid, and spleen, and help in diagnosing gallstones, blood clots, artery blockages, and acute appendicitis.

Premature infants' brains are scanned each day in the NICU to catch any potential brain bleeds or edema, which are possibilities for a neonatal.

The experts noted that improved equipment allows for clearer images and faster calculations.

“They’re always improving the technology,” Ms. Posey said, “and we're able to see things that we've never seen before.”

Contact Sarah Readdean at sreaddean@theblade.com