Ultrasound Imaging of the Right Upper Quadrant

What is Right Upper Quandrant Ultrasound Imaging?

Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound examinations do not use ionizing radiation (as used in x-rays). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.

Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

A right upper quadrant ultrasound provides pictures of the structures and organs in the liver, gallbladder, bile ducts and pancreas.

What are some common uses of the procedure?

A right upper quadrant ultrasound exam can help identify

  • gallstones.
  • bile ducts.
  • issues or concerns of the liver.
  • issues or concerns pertaining to the pancreas.

How should I prepare?

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.

You may be asked to wear a gown during the procedure.

Do not consume any food or liquids after midnight on the day prior your appointment date. This is so the gallbladder becomes distended. Eating prior to
the exam causes the gall bladder to shrink and makes it more difficult to detect small gallstones.

How does the procedure work?

In medicine, ultrasound is used to detect changes in appearance of organs, tissues, and vessels or detect abnormal masses, such as tumors.

In an ultrasound examination, a transducer both sends the sound waves and receives/records the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off of internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Small loops of the moving “real time” images may also be saved.

How is the procedure performed?

For most ultrasound exams, the patient is positioned lying face-up on an examination table that can be tilted or moved.

A clear water-based gel is applied to the area of the body being studied to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The sonographer (ultrasound technologist) or radiologist then presses the transducer firmly against the skin in various locations, sweeping over the area of interest or angling the sound beam from a farther location to better see an area of concern.

When the examination is complete, the patient may be asked to dress and wait while the ultrasound images are reviewed.

What will I experience during and after the procedure?

Most ultrasound examinations are painless, fast and easy.

After you are positioned on the examination table, the radiologist or sonographer will apply some warm water-based gel on your skin and then place the transducer firmly against your body, moving it back and forth over the area of interest until the desired images are captured. There is usually no discomfort from pressure as the transducer is pressed against the area being examined.

If scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer.

Once the imaging is complete, the gel will be wiped off your skin.

After an ultrasound examination, you should be able to resume your normal activities immediately.

Who interprets the results and how do I get them?

A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care physician or the physician who referred you for the exam, who will share the results with you. In some cases the radiologist may discuss results with you at the conclusion of your examination.

Follow-up examinations are often necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a suspicious or questionable finding needs clarification with additional views or a special imaging technique. A follow-up examination may be necessary so that any change in a known abnormality can be detected over time. Follow-up examinations are sometimes the best way to see if treatment is working or if an abnormality is stable over time.

 

What are the benefits vs. risks?

Benefits

  • Most ultrasound scanning is noninvasive (no needles or injections) and is usually painless.
  • Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
  • Ultrasound imaging does not use any ionizing radiation.
  • Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
  • Ultrasound is the preferred imaging modality for the diagnosis and monitoring of pregnant women and their unborn babies.
  • Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies and needle aspiration.

Risks

  • For standard diagnostic ultrasound there are no known harmful effects on humans.

 

 

What are the limitations of Right Upper Quadrant Ultrasound

Imaging?

 

Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique for air-filled bowel or organs obscured by the bowel. In most cases, barium exams, CT scanning, and MRI are the methods of choice in this setting.

Large patients are more difficult to image by ultrasound because greater amounts  of tissue attenuates (weakens) the sound waves as they pass deeper into the body.