Abdominal ultrasound is a complex diagnostic procedure in which the liver, gallbladder and its ducts, pancreas, spleen, vessels are visualized. The study makes it possible to identify neoplasms, inflammatory diseases, concretions, cysts, and the consequences of injuries. It is performed in B-mode, additionally, Doppler ultrasound of blood vessels is performed. Together with ultrasound of the abdominal organs, the retroperitoneal space and kidneys are sometimes examined.
Abdominal ultrasound requires preparatory procedures, thanks to which the ultra sound image will be more accurate and the results more reliable. In addition to the individual training requirements reported by the doctor, there are a number of general recommendations:
- Compliance with the diet. For three days, it is worth following a diet that reduces the amount of gases in the gastrointestinal tract, since air can distort the image. Sweet carbonated water, beer, fresh pastries, legumes and milk should be excluded. In case of flatulence – start taking carminative drugs (after consulting with a doctor).
- The period of hunger. Before the examination, you need to refrain from eating for 8-12 hours. It is allowed to drink water without gas. The optimal time for scanning is in the morning, before breakfast. An exception is made for patients with diabetes mellitus, newborns, infants, and young children. For them, the minimum break is 2-4 hours.
- Cancellation of endoscopy, X-ray. Two days before the procedure, it is not necessary to perform an X-ray examination of the gastrointestinal tract with the introduction of contrast, gastroscopy and colonoscopy.
Abdominal ultrasound begins with visualization of the liver and right kidney. Their degree of echogenicity, uniformity of tissue structure, vascular pattern, clarity of contours are determined. Then the anechogenicity, the shape and lumen of the gallbladder, the location and features of the walls of the portal vein and the common bile duct are evaluated. Next, the structure of the pancreas, spleen, large veins and arteries is investigated.
During the study of the kidneys, their size, structure, contours and position are determined. The adrenal glands, retroperitoneal tissue, lymph nodes and large vessels are visualized in the retroperitoneal space. The hollow organs of the gastrointestinal tract are not studied in detail, but fluid accumulation in the small and large intestine can be detected. The following groups of pathologies are diagnosed by ultrasound:
- Liver diseases. Ultrasound detects signs of many liver diseases. Diffuse changes in tissues are observed in cirrhosis and hepatitis; focal – in tumor formations. Increased echogenicity is characteristic of fatty hepatosis, liver fibrosis.
- Diseases of the spleen. The most common secondary pathologies of the spleen as a result of systemic diseases, infections, cancer. A homogeneous increase in echogenicity is characteristic of portal hypertension, erythropoiesis disorders, and heart failure. In the pathology of lymphopoiesis and granulopoiesis, multiple myeloma, the echogenicity of the parenchyma decreases. Splenomegaly is defined as an enlargement of an organ that develops in systemic inflammatory diseases. Local changes are seen in calcifications, tumors.
- Diseases of the gallbladder. Diseases of the gallbladder diagnosed by ultrasound include kinks and constrictions, violations of bile outflow, blockage and dyskinesia of the bile ducts. In cholelithiasis, high-density echostructures are detected in the lumen of the bladder, an ultrasonic shadow behind them. A sign of chronic cholecystitis is inflammatory changes in the walls of the organ.
- Diseases of the pancreas. The main pathologies of the pancreas are pancreatitis, cysts, tumors, fat infiltration. Progressive fibrosis is manifested by a decrease in the size of the organ. Pancreatitis is a general or local enlargement of the gland, uneven contours, alternating areas of normal and increased echogenicity. With prolonged pancreatitis, calcinates are formed – bright hyperechoic inclusions. Focal changes in echogenicity are detected in cysts, tumors.
- Vascular pathologies. The most significant vascular diseases are venous thrombosis, arterial stenosis, aortic aneurysm, extravasal compression of the abdominal trunk. With thrombosis, a violation of blood flow, damage to the walls of blood vessels, a thrombus with heterogeneous echo density or a thrombus of homogeneous echogenicity is determined.
The results of sonography of abdominal organs are evaluated in combination with complaints, data from an objective examination of the patient, other instrumental and laboratory studies.
Abdominal ultrasound is a valuable diagnostic tool for detecting diseases at the preclinical stage, differentiation of inflammatory, metabolic and dystrophic changes in organs, benign and malignant neoplasms. The procedure has no contraindications, does not cause negative consequences. The disadvantage of the technique is the inability to detect functional disorders, poor quality of visualization when the patient is overweight. Compared to MRI and CT, ultrasound is a cheaper, but less informative method of diagnosis.