Ultrasound, Here's What You Need to Know

Ultrasonography (USG) is an imaging procedure that uses high-frequency sound wave technology to produce images of the inner body, such as organs or soft tissues. Ultrasound can be used as a disease diagnosis tool, monitor the condition of the fetus, and as an aid during the surgical process or certain actions, such as tissue sampling (biopsy). Ultrasound technology is classified as safe, especially for pregnant women, because it does not emit radiation. There are 3 types of ultrasound that are commonly used, namely:

• External ultrasound.

This type of ultrasound uses a tool called a probe that is equipped with sensors on the tip, so that it can capture sound waves from the skin surface. External ultrasound can be used to examine abnormalities in certain body organs, such as the kidneys, liver, breast, or uterus, as well as looking at the inside of the neck and joints. In addition, external ultrasound is also usually used to monitor the condition of the fetus during pregnancy.

• Internal ultrasound.

One example of internal ultrasound is transvaginal ultrasound. This type of ultrasound is done by inserting a two-finger-sized probe through the vagina. The doctor will recommend an internal ultrasound to check the condition of pelvic area organs, such as the uterus and ovaries.

• Endoscopic ultrasound.

This type of ultrasound uses an instrument called an endoscope, which is a device shaped like a thin, long, and flexible hose equipped with a camera, lights, and ultrasound sensors at the end. This tool is inserted through the mouth to examine the upper organs, such as the esophagus to the stomach.

Indications and Contraindications to Ultrasound

The following are some of the uses of ultrasound in a number of organs, according to the types:

• Ultrasound head.

Usually done on babies to detect brain abnormalities that might occur in premature births, brain injury or bleeding, birth defects (such as hydrocephalus), and inflammation of the lining of the brain (meningitis) or inflammation of the brain. In adults, head ultrasound is used to detect the exact location of the tumor during surgery on the head region, when the skull bones have been opened.

• Neck ultrasound.

To evaluate the state of organs in the neck, such as the thyroid gland and salivary glands, neck blood vessels, and abnormalities that form in the neck, such as lumps, infections, abscesses, cysts, and tumors. In addition, ultrasound of the neck can also be used as a tool to direct the procedure of tissue sampling in the neck area (biopsy).

• Mammary Ultrasound.

Mammary or breast ultrasound serves to detect the size, location, and type of lumps in the breast, as well as a guide when taking samples of lumps in breast tissue (biopsy).

• Stomach ultrasound.

To check if there are abnormalities of the liver, kidneys, spleen, bile, and pancreas. Abdominal ultrasound can also see abnormalities such as appendicitis, hernias, and enlarged lymph nodes in the stomach. In addition, abdominal ultrasound can be used to see the flow of blood vessels in the stomach, as well as a guide when performing biopsy of tissue in the abdominal organs, or when removing fluid from the abdominal cavity in ascites.

• Pelvic ultrasound.

To detect bladder abnormalities that cause interference with urination. Specifically, pelvic ultrasound is performed by female patients to find out abnormalities in the uterus and ovaries that can cause pelvic pain, vaginal bleeding, and pelvic inflammation. Pelvic ultrasound can also help find the location of a spiral birth control, and help direct doctors when taking eggs for test tube babies. For male patients, pelvic ultrasound is performed to examine the prostate gland. Testicular ultrasound. Testicular or testicular ultrasound serves to examine testicular abnormalities such as tumor or cyst growth, undescended testes (cryptorchidism), and varicose veins in the testicular blood vessels (varicoceles) which can cause infertility.

• Ultrasound of pregnancy.

To ensure pregnancy, check fetal heart rate, condition of fetal development, estimated gestational age and time of delivery, estimated sex, amount of amniotic fluid, and blood flow to the fetus. Pregnancy ultrasound can also see abnormalities that may occur in the uterus, ovaries, cervix, and placenta, as well as to diagnose if there is an ethopic pregnancy, multiple pregnancy, congenital abnormalities in the fetus (such as Down syndrome), tumors, or miscarriages. Pregnancy ultrasound is also used to help guide the amniocentesis procedure or the process of taking a sample of amniotic fluid, if needed.

• Transvaginal ultrasound.

Transvaginal ultrasound has a function that is almost similar to pelvic ultrasound to see the state of the uterus and ovaries of female patients, but with a clearer picture. It is generally recommended to detect abnormalities in the uterus that can cause bleeding from the vagina, pelvic pain, and infertility. Transvaginal ultrasound can also see the growth of cysts and other abnormal tissue in the uterus, such as myoma. In addition, transvaginal ultrasound can also be done during pregnancy to monitor fetal heart rate, and see abnormalities in the cervix that can lead to premature birth or miscarriage.

It should be noted for patients who have a history of allergies, both to the gel that will be applied to the surface of the skin before an external ultrasound procedure, as well as allergic to sedatives that are given before the endoscopic ultrasound procedure.

Ultrasound warning

The use of special coloring agents or contrasts when performing X-rays in the digestive tract can interfere with the results of ultrasound on the stomach and pelvis, because these substances can still settle in the intestine for up to 2 days. Ultrasound scanning uses sound frequency technology that can capture images of organs in the body. However, this technology cannot pass through bones and air, so head ultrasound cannot be performed on children whose fonts have closed (age over 18 months). Factors such as excess stomach acid, obesity, and food scraps in the stomach and intestines can interfere with the results of abdominal ultrasound tests. Make sure you follow the doctor's advice before the test. For those who are undergoing certain medications, it is advisable to tell the doctor before the test is done.

Before ultrasound

The preparation depends on the type of ultrasound to be performed. Some of these include:

• Consume at least 6 glasses of water 2 hours before the action and hold to urinate for ultrasound of the pelvic area, because the bladder must be full.
• Sometimes patients can be asked to fast 8 to 12 hours before an ultrasound stomach, so that there is no leftover food in the stomach and intestines that can block sound waves. Or it can be recommended not to eat fat since the afternoon before the examination for ultrasound of the stomach if you want to see bile, liver, pancreas, and spleen
• Do not eat or drink 6-12 hours before abdominal ultrasound, especially if you want to see a clearer picture of the gallbladder.
• Avoid the use of cosmetics, such as powder or lotion on the breast before breast ultrasound, because it can affect the final result.
• For transvaginal ultrasound, the patient will be asked to empty the bladder first.

Depending on the part of the body to be examined, the hospital will provide special clothing to facilitate the ultrasound process. The patient will also be asked to remove jewelry around the area to be examined. For those who are going to undergo an endoscopic ultrasound, the doctor will give a sedative injection or spray of local anesthetic in the throat to become numb, and to avoid nausea or pain when the device is inserted.

Ultrasound Procedure

Most ultrasound procedures will take 15-45 minutes, depending on the type of ultrasound and the part of the body that needs to be examined. The inspection procedure will also be performed according to the type of ultrasound used.

• External ultrasound

The patient will lie down on the bed and the doctor will apply a lubricant gel made from latex in the area to be examined to smooth the movement of the probe. The patient will feel a cold sensation in this process. The patient may feel pain or discomfort when a part of the body is pressed. Tell your doctor if the pain worsens. For those who will do an ultrasound pregnancy test, the doctor will move the probe over the lubricated skin and see the condition of the fetus through a monitor placed next to the patient's bed. The patient can see the condition and hear the sound of the fetal pulse directly. For ultrasound baby's head, the probe will be moved in the crown that has not yet closed. Capture images of the brain and the room that contains brain fluid (ventricles) will be seen through the monitor directly. For adult head ultrasound, it can only be done during head surgery, when the skull bones have been opened, because the sound waves from the probe cannot pass through the bone. For testicular ultrasound, the doctor will smear the lubricating gel on the testis to facilitate the movement of the probe. In addition, the patient must open both thighs wide while lying down to facilitate the examination process. Special towels and straps will be placed under the scrotum and around the thigh to elevate the scrotal position. Discomfort may be felt when the probe is pressed at sensitive or painful points.

• Internal ultrasound

During transvaginal ultrasound, the patient will be asked to lie down with the pelvis slightly raised. The doctor will insert the tip of the probe that has been coated with a sterile barrier and lubricant through the vagina in order to monitor the condition of the organs around the pelvis. Monitoring can be done through a monitor placed next to the patient's bed.

• Endoscopic ultrasound

The patient will be asked to lie on his side and will be given a sedative or local anesthetic spray to relieve anxiety or pain. After that, the doctor will insert an endoscope through the patient's mouth and push it towards the esophagus to the part of the organ that needs to be examined. Just like other types of ultrasound, the image will be captured through sound waves and will be seen from a monitor located near the patient.

After ultrasound

After the doctor has finished checking, the gel that is used on the body will immediately be cleaned, and for those who are asked to hold urine before the test, patients are welcome to immediately empty the bladder. In general, patients are allowed to go home and do activities after ultrasound. But for those who are given sedatives, patients are not allowed to do activities that require concentration, such as driving a vehicle, during the first 24 hours. Patients are advised to contact family or relatives to accompany and drive him home. Usually, patients will get an ultrasound result directly. If further analysis is needed, the results will be given to the referring doctor on a daily basis. If the patient experiences certain side effects after having an ultrasound, it is recommended to consult a doctor immediately.

Side Effects of Ultrasound

Ultrasound is a safe procedure and does not cause side effects, especially external ultrasound. A possible side effect is an allergic reaction to the gel that is used. For internal ultrasound, such as transvaginal ultrasound, patients may experience discomfort when the device is inserted. For endoscopic ultrasound, patients may experience side effects such as sore throat or flatulence, but this only happens temporarily. Although rare, bleeding can occur due to endoscopic ultrasound.