Tag Archives: Medical diagnostic ultrasound

More Doctors Tuned to Ultrasound’s Frequency For Diagnosis!

As ultrasound technology has advanced, it has become an increasingly valuable tool for diagnosing and treating many types of injuries and medical conditions. On Oct. 18, hundreds of medical students will come to Stanford to learn how to use it.


Laleh Gharahbaghian

Laleh Gharahbaghian, who directs the ultrasound program in the emergency department, is seeing more community physicians using ultrasound.

Norbert von der Groeben

In the public eye, ultrasound technology is probably best embodied by the big bedside machines that enable parents to catch a revelatory glimpse of their unborn babies.

Since the 1970s, however, ultrasound has become, quietly and steadily, the Swiss Army knife of health care, with an ever-expanding repertoire of functions, based on the ability of sound waves to travel through the body and bounce back when they hit something. Now the technology has been developed into a high-resolution, often pocket-sized aid for the diagnosis and treatment of many types of injuries and medical conditions.

Ultrasound’s trajectory has been mission creep of the best possible sort.

“You name the condition, and people are trying to diagnose or treat it with ultrasound,” said Pejman Ghanouni, MD, PhD, an assistant professor of radiology at the School of Medicine who employs MRI-guided, high-intensity-focused ultrasound to treat uterine fibroids. One of the main selling points of ultrasound for medical imaging and treatment is its lack of cancer-causing radiation.

Stanford has become a center of diagnostic ultrasound research, education and training. On Oct. 18, the school will host ULTRAfest, a full day of free ultrasound instruction open to any medical student in the country. Experienced clinicians from several medical specialties will serve as teachers. Last year, more than 300 medical students from the western United States participated in the event.

The School of Medicine already has incorporated ultrasound into its anatomy training for first-year students and in its patient-doctor courses for pre-clinical students. The school will soon have a complete, four-year ultrasound curriculum, which will enable students to graduate with ultrasound competency.

A laptop ultrasound scanner

A laptop ultrasound scanner.

Norbert von der Groeben

The primary goal of ULTRAfest, co-chaired by Laleh Gharahbaghian, MD, clinical associate professor of emergency medicine and director of Stanford Hospital’s emergency department ultrasound program, is to teach how ultrasound can enhance knowledge of anatomy, physiology and pathology — and, more importantly, how it can improve patient care in ways that Gharahbaghian has seen grow rapidly in the 14 years since she graduated from medical school.

“We use it for everything from head to toe and skin and organs,” she said. “It’s become an essential tool at the bedside we apply to immediately rule out — or rule in — medical conditions.”

Use in emergency medicine

Especially useful in emergency care, she said, is ultrasound’s ability “to help us find out what’s going on with a patient and to treat them appropriately with greater speed and accuracy.”

She said, “We might have a patient, for instance, who is unconscious, incoherent or not speaking a language we know, and we have no idea why the heart rate is up and the blood pressure down.”

Seeing beyond the barrier of consciousness or language is another ultrasound capability, Gharahbaghian said. “Even if a patient’s eyes are swollen shut, you can use ultrasound to quickly detect injury — to see a ruptured eye orbit or to gauge function, like pupillary activity.”

Gharahbaghian first saw this capability when the Stanford Emergency Medicine Program for Emergency Response team took along laptop-based ultrasound devices to care for people injured in the 2010 earthquake that struck Haiti. In the hardest hit areas, the earthquake destroyed most of the standing medical facilities. “In that disaster, when there was no power, when hospitals were completely collapsed and resources were limited, the ultrasound was the only radiological device the team had,” she said.

Last year, Stanford’s emergency department became the treatment center for 55 of the 200 people injured in the July 2013 crash at San Francisco International Airport of an Asiana Airlines Boeing 777. Many passengers spoke little English, and the nature of their injuries was not always immediately apparent. Seatbelts did save lives, but the violent side-to-side movement of the aircraft produced spine and rib fractures, often accompanied by seatbelt-related internal injuries caused by the unusual combination of movements in the crash. Several passengers, initially thought be only mildly injured when examined at the scene, were found, during their initial assessment with ultrasound at Stanford, to have serious internal injuries that needed quick attention.

Students at 2013 ULTRAfest.

Students and teachers at last year’s ULTRAfest.

‘I just fell in love with the technology’

Almost five years ago, a few weeks before William White started his first year of medical school at Stanford, he took a class in ultrasound. “I just fell in love with the technology,” he said, “picking up a probe and looking into the body in real time.” For the next three years, still enamored with ultrasound, White continued as a volunteer assistant for the class. Now he hopes to do a residency in emergency medicine. He is also one of the organizers of ULTRAfest, an event he believes will help ultrasound overcome the unfamiliarity many medical students have with its full range of capabilities. “This current generation is starting to get very familiar with it,” he said. “I think in the future there will be a broader acceptance — and it will be part of the standard for primary care.”

That may still take some time: Fellowships that focus on ultrasound use are now only available through emergency medicine training programs, found mostly at academic medical centers like Stanford Medicine, where both basic science and clinical research is part of ultrasound’s reimagining. It also helps to have an abundance of devices: Lucile Packard Children’s Hospital Stanford has 72, still used for prenatal evaluations, but also a key part of physicians’ ability to see and treat complex cardiovascular issues.

Stanford Hospital’s 262 ultrasound devices serve an important role in emergency care, surgical treatments and postoperative care in the ICU. Ultrasound is also essential in other areas, including reproductive endocrinology and infertility, respiratory therapy, orthopaedics, anesthesia, urology, outpatient surgery, mammography, endoscopy, head and neck surgery, diagnostic radiology and cardiovascular care. Stanford’s emergency department has eight laptop-based and three handheld ultrasound devices. Ultrasound is also standard equipment at the Stanford Cancer Center, the Cath-Angio Lab and several nursing units. The Life Flight helicopter also carries ultrasound devices.

The long list of other invasive procedures made less complicated by ultrasound includes endotracheal intubation, fine needle aspiration, interventional radiology procedures, pedicle screw insertion in scoliosis surgery, prostate cancer biopsies and emergency procedures like central venous access. Ultrasound also is a much gentler and quicker screening tool for spotting artery-narrowing plaque than is coronary angiography, and for pre-operative looks at arterial issues before neck surgery.

Less costly

Ultrasound also is relatively inexpensive: Even a refurbished CT scanner with a minimum view capacity is priced at $65,000. New ones start at $90,000. Handheld ultrasounds can cost as little as $7,000; laptop-based devices range from $25,000 to $40,000.

More recently, the use of ultrasound has crossed into another part of the anatomy long thought to be immune to its imaging prowess: the lungs. In the air-filled environment of the lungs, the sound waves that are the basis of ultrasound have nothing to ping against. However, in lungs where disease has produced fluids, ultrasound has proven more accurate than a chest X-ray and faster than CT scan to diagnose common lung conditions, including pulmonary edema, pneumonia and pleural effusions.

Students at 2013 ULTRAfest

This year’s full, free day of ultrasound instruction is set for Oct. 18.

Teresa Roman-Micek

Ultrasound devices at Stanford are so highly desired that “it’s not easy to keep spares,” said Harvey Fortune, assistant director of Stanford Health Care’s clinical technology group.

Ghanouni and other Stanford physician-scientists are pushing medical ultrasound to the next level. He and his colleagues, Jaimie Henderson, MD, professor of neurosurgery, and Casey Halpern, MD, assistant professor of neurosurgery, are using high-intensity-focused ultrasound, guided by MRI, to treat essential tremor, a nervous system disorder marked by uncontrollable shaking. The ultrasound heats and destroys specific brain tissue: No anesthesia, no scalp incisions, no burr holes through the skull. Another team of Stanford physicians, which includes radiologists, neurosurgeons, oncologists and physicists, plans soon to conduct an investigatory test of this technology, available only at a handful of medical centers worldwide, to allow drugs to cross the blood-brain barrier for more targeted treatment of brain tumors.

Ultrasound is an essential part of the work of Adam de la Zerda, PhD, an assistant professor of structural biology. In collaboration with Sam Gambhir, MD, PhD, professor and chair of radiology, de la Zerda recently developed and patented a technology called photoacoustic imaging that transforms light waves into ultrasound waves. Its goal is to detect cancer with a resolution that matches CT scanning and MRI.

Quick answers for patients

Viveta Lobo, MD, who completed a fellowship in ultrasound in Stanford’s emergency department and served as an ULTRAfest co-chair, said studies have shown patients feel that doctors using bedside ultrasound spend more time at patients’ bedsides.

Studies also have shown that hospitalized patients who underwent ultrasound scanning were discharged more quickly.

Ultrasound can also provide quick answers, which patients appreciate. “I can tell someone right away that there are no gallstones, or that a woman’s baby is OK,” Lobo said. Even more crucial, she said, “we can see and treat quickly that life-threatening ectopic pregnancy or large pulmonary embolism.”

But ultrasound takes some training to master, Lobo added. “You have to know how to get good images — how to move it around obstacles, like the ribs, to see what you need to see. You have to know how to adjust the settings, just as you do in photography. Then you have to know how to interpret what you’ve seen.”

Gharahbaghian is seeing more and more community physicians, as well as those in outpatient clinics, who are using ultrasound. She hopes that trend continues. “The more we spread the news of how ultrasound helps patients in all clinical settings, the better,” she said.

Sara Wykes

What is Diagnostic Ultrasound? Where Can You Get A Full-Body Diagnostic Ultrasound?


What is Ultrasound? It reflects Sound, which is the basis of life and even has healing powers. Not convinced? Then think of those times when you have lost yourself completely listening to good music or perhaps mesmerized by the sound created by sea waves bashing against the shore? Now may be you agree with the remarkable power of sound to provide comfort. Sound is nothing but a form of vibration, known to evoke myriad emotions. For many of us, certain sounds bring back fond memories that could send us into raptures. For some others, it could mean a recollection of sad events that have happened in their lives.

All in all, sound provides a powerful emotional trigger eliciting varied responses from all those within earshot. The simplest definition of sound – is ‘a wave with a string of compressions in the air’. When we talk, our vocal chords vibrate back and forth.

This vibration disturbs the air molecules nearby. When this disturbance hits the eardrum, the vibration is picked up by the nerves to the brain, which perceives the sound. However, human beings cannot hear all forms of sound. The human ear recognizes sounds if the vibrations per second, called as frequency, falls between 20 and 20,000 vibrations per second. This measure could vary between persons. Subsonic waves portray frequencies below audible waves. Those waves with frequencies higher than the audible range are called as ultrasonic waves. If speech is Silver, Silence is Golden. The above quote holds good especially in the case of ultrasound waves, which is being used for obtaining information about the structure and function of the human body. Ultrasound waves for imaging are generated by transducers, which convert electrical energy into sound energy. These waves are transmitted through the human body by placing the transducer over the surface of the skin.

When these sound waves travel through the human body, it is reflected back by the organs present inside, just like how a ball bounces back after hitting a wall. The sound waves, which are thus reflected, are again picked up by the same transducer. This is then transformed into visual images that provide a real time imaging of the organ being studied. The information that is obtained can then be permanently recorded on hard copy, film, videotape or both. Medical Diagnostic Ultrasound Imaging, also called ultrasound scanning or sonography, is a method of obtaining images from inside the human body through the use of high-frequency sound waves. The reflected sound wave echoes are recorded and displayed as a real-time visual image.

No radiation (x-ray) is involved in ultrasound imaging. Ultrasound is a useful way of examining many of the body’s internal organs, including but not limited to the carotid, thyroid, pancreas, liver, gallbladder, kidneys, spleen, bladder, prostate, uterus and ovaries, veins and arteries. Obstetric ultrasound refers to the specialized use of sound waves to visualize and thus determine the condition of a pregnant woman and her embryo or fetus. Because ultrasound images are captured in real time, they can show movement of internal tissues and organs and enable physicians to see blood flow and heart valve functions.

This can help to diagnose a variety of heart conditions and to assess damage after a heart attack or other illness. Someone you know has undergone an ultrasound exam. Whether it’s to get a first glimpse of a developing baby in the womb or to determine the risk of heart attack, doctors use ultrasound widely in women and men, children and seniors to gain advanced insights into the inner workings of the body. In fact, ultrasound is the most utilized form of diagnostic imaging available today. Despite today’s sophisticated, high-tech systems, ultrasound remains a science built upon the simple sound wave. By beaming high-frequency sound waves into the body, physicians can translate the “echoes” that bounce off body tissues and organs into “sound you can see,” colorful, visual images that provide valuable medical information. Heart disease, stroke, abnormalities in the abdomen or reproductive system, and more – all exhibit telltale signs that ultrasound can help to detect.

Safe, affordable and non-invasive, ultrasound is also portable. Very sick or fragile patients, for example, who might not be able to travel to a radiology lab without risking further injury, can essentially have the lab wheeled to them. That’s an important advantage when you need to conduct an exam on a grandmother who is bedridden or an incubator-bound premature baby.

For half a century now, ultrasound has been there to help families and their doctors determine what’s wrong-or not-with the body and determine the best, most effective means possible to get and stay. Clinicians have often referred to ultrasound technology as the “stethoscope of the future,” predicting that as the equipment shrinks in size, it will one day be as common at the bedside as that trusty tool around every physician’s neck.

Universal Medical Imaging Group and PH Miracle provide anyone with the opportunity to learn more about their health and offers a Full Body Medical Diagnostic Ultrasound Scan which can be combine with Full Body Thermography and 3D Bio-Electro Scan. —- http://www.phoreveryoung.com/store.html#!/Full-Body-Medical-Diagnostic-Imaging/p/44025225/category=11390124 http://universalmedicalimaging.com/ultrasound.html http://www.phmiracleliving.com/t-MedicalImaging.aspx#ultrasound