RAD428

ULTRASOUND CASE
STUDY
:Supervisors: Students
Dr.Mohamed Emam Faris Algharras
Dr.Ahmad Nassar Thamer Alkhoiled
Rakan Alolyan
CASE STUDY 1
 Patient information's

Gender: Male
Age:33
Request: Abdominal pain
Indications: Epi-gastic pain and obstructive jaundice
 Patient preparation

.Protocol: Transverse and longitudal plane and breathing technique

Patient may be asked to eat a fat-free meal on the evening before the test and
.then to avoid eating for eight to 12 hours before the test
.Patient position: Supine with head, upper shoulder slightly elevated
Probe used: Curvilinear
Frequency: 3-5MHz
Finding/comment: A- Impacted gallbladder neck stone compressing common
.bile duct (CBD)
. B- Subsequent extrahepatic biliary obstruction
CYSTIC ORGAN
:EVALUATION(gallbladder)
Size (7-10 cm in length and 3-4 cm in transverse diameter)-1
content (stone,mud)-2
wall thickness(less than 3 mm thick)-3
Gallbladder polyps -4
Technique: Put enough gel to better visualizations to the organ
.of interest
Probe was in longitudal plane at midclavicular line and tilted
toward right lobe of the liver, clearly we could see the
gallbladder is anechoic in both fundus and body regoins except
.the neck clearly there was a classification

Gallbladder neck appears as echogenic focus with posterior -

.acoustic shadowing

We move the patient to lateral decubitus to be ensure that if -

it’s a stone classification or not ꓼ if the classification moves then
. it’s a stone because its the main characterization

Stone appears hyperechoic and its diameter was 2.81 cm due -

to that it cause an obstruction to the cystic duct and cause
.dilatation to the common bile duct (CBD)
Clearly we can see the common bile duct and the portal
. vein because the enhancement of its walls

Obviously its not normal to see the common bile duct

with this dilatation , therefore the reason for that is an
. obstruction of the cystic duct

We could be certain if it’s the common bile duct or not by

adjusting the Doppler to see if its having vascularity flow
.or not
Doppler ultrasound mode
changes sound waves of the
blood flow into different
.colors

In this scan doppler shows a

dilatation of the proximal
part of common bile duct
anterior to the portal vein,
because there is no
.vascularity in CBD
CASE STUDY 2
 Patient information's

Gender: Male
Age:77
Request: Abdominal pain
Indications: Suspected renal mass and
dysuria(burning with urination)
Prepration: patient may be asked to drink four to six
glasses of liquid about an hour before the test to fill
the bladder for better evaluation
 Patient preparation

Protocol: Transverse and longitudal plane with breathing technique

.Subcostal and intercostal scan
Patient position: Supine with head, upper shoulder slightly elevated.
Small amount of fluid to bladder is needed to identify the prostate
Probe used: Curvilinear
Frequency: 3-5MHz
Finding/comment: A-Simple and complicated cysts B- Renal stones
C-Back pressure (Hydronephrosis) D-Prostate enlargement
: SOLID ORGAN EVALUATION (kidney)
Size (10-13CM, 150-260g)-1
Parenchyma Echogenicity-2
Focal lesion (cystic,solid)-3
cystic : 1-simple (roundish, hypoechoic)
complex(hypoechoic + wall septation)-2
Renal stones-4
BackPressure changes(collection of urine the pelvis)-5
Traumatic kidney-6
Technique: Put enough gel to
better visualizations of the
.organ of interest
Probe was in longitudal plane
and place the probe in the right
lower intercostal space in the
midaxillary line
We adjust the focus and gain to
.get access through right kidney

Finding: There is a simple cyst

in the renal cortex of right
.kidney
Also, we could see a
complicated cyst with a
septation between them in
.renal cortex

No vascularity with Doppler-

mode
Clearly the complicated cyst is obviously seen
with its septation in the transverse plane. Also,
we can see a small stone the inferior portion of
.the cyst

Color Doppler generally provides no further

.advantage for the diagnosis of a simple cyst
Some complex cysts that display a central
septation may contain an artery that runs along
.the septation

The diameter of the cyst was 2.5cm x 2.39cm

The diameter of the stone was 0.20cm
In the left kidney we can identify a simple cyst superior
.to the renal cortex

The cyst diameter was 1.88cm

normal adult kidney is approximately 11 ± 1.0 cm long

(7–12), with a normal volume of 110 to 190 ml in men
and 90 to 150 ml in women

Also, we measured the long axis and short axis of the

.left kidney
Long axis = 10.9cm
Short axis = 6.44cm
The transverse plane shows the
left kidney with stone
calcification and further
,posterior acoustic shadowing

We freeze the image and

calibrate the size of the stone, it
,appears 1CM
We found an enlargement of the
prostate , which is located inferiorly to
.the urinary bladder

: Measurement of the prostate include

)height X width X depth X0.52(

In transverse view we measured the

width and depth , the width was 4cm
.and depth was 3.31cm

In longitudal view we measured the

.height of the prostate and was 4.49cm

So, to calculate the volume

4cm x 3.31cm x 4.49cm x 0.52
ml approximately 31=

Normal prostate measurements is *

3 × 3 × 5 cm approximately or a volume
.of 25 ml

is a correction coeffcient 0.52*