Complete abdominal ultrasound scanning protocol Copyright © 2010 The Academy of Veterinary Imaging.

The Academy of Veterinary Imaging 2409 Avenue J, Suite C Arlington, TX 76006 (800) 268-5354 opt 4 www.soundeklin.com/academy-of-imaging

Introduction This program demonstrates the scanning planes to perform and the still images to collect to archive a complete abdominal ultrasound exam. Video clips can be saved to supplement the still images. Additional images would be indicated to document any pathology encountered. Please see the Basic Abdominal Scanning Protocol CD if you are just starting to learn abdominal ultrasound. The basic exam focuses on the liver, spleen, kidneys and urinary bladder.

Directions In this program you may view the entire complete abdominal ultrasound exam from start to finish, with or without superimposed ultrasound images, or you may navigate to each organ or each individual image from the corresponding pages. You may view abdominal anatomy, probe orientation, screen orientation and image optimization by selecting the appropriate buttons. During the entire complete exam with images, the presentation will pause when an ultrasound image appears. When you are finished viewing the image, select the forward arrow button or left click the mouse to continue the exam. The ‘home’ key takes you to the table of contents. The ‘i’ key on the table of contents takes you to the title page.

Entire complete exam with images Entire complete exam without images Individual image list Organs Table of contents Abdominal anatomy Probe orientation Screen orientation Image optimization Images only

ORGANS IMAGE LIST Page: 1, 2 Right Left VD abdomen from the ventral aspect Liver Stomach Spleen Left kidney Urinary bladder Intestines GB Adrenals Right kidney Pancreas

Probe orientation Sagittal plane Reference marker points cranially Transverse plane Reference marker points to the right

Reference marker Near field Far field Screen orientation

Image optimization LOGIQ P5 LOGIQ 5 LOGIQ Book Go to: Transitions General info Depth Frequency Auto-optimize Focal points Gain Overall gain TGC LOGIQ e LOGIQ 200

General info page 1 During an abdominal ultrasound exam, the ultrasound machine settings should be changed as needed to optimize the image. However, please note, when comparing the echogenicity of different organs, all machine settings must be kept the same!!! Image optimization P5 L5 LB Le L200

General info page 2 Machine settings are most often adjusted when transitioning from one organ to another. Transitions encountered during the basic exam are listed on the ‘Transitions’ page. Within the abdominal scan, the ‘Optimize’ button will show how to typically adjust the machine when transitioning to the view in question. Transitions Image optimization P5 L5 LB Le L200

Depth Starting guidelines: Large dog: 12-14 cm Medium dog: 8-10 cm Small dogs and cats: 6-7 cm Adjust as needed throughout scan Transitions Image optimization P5 L5 LB Le L200

Frequency High frequency Better resolution Less depth Lower frequency Lower resolution Better for depth Starting points: Large dog liver: 6 MHz Small dog/cat liver: 8 MHz Transitions Image optimization P5 L5 LB Le L200

Auto optimize ‘Personal preference’ button. Adds more contrast. Try on or off. Chose the setting that looks better to you. Auto optimize must be deselected then reselected for every new structure imaged. Transitions Image optimization P5 L5 LB Le L200

Focal points Improved resolution is seen where the focal points are. Place focal points at the region of interest. Typically use: –1 focal point with cardiac scanning. –2 with abdominal scanning. Transitions Image optimization P5 L5 LB Le L200

Gain Overall gain May only adjust in beginning of exam. Perhaps may decrease when imaging the urinary bladder. TGC Compensates for beam attenuation (loss of energy as it passes through tissue). Transitions Image optimization P5 L5 LB Le L200

LOGIQ P5 Auto optimize Gain Depth TGC Focal points Frequency Image optimization Transitions

LOGIQ e Auto optimize Gain Depth TGC Focal points Frequency Image optimization Transitions

LOGIQ 5 TGC Auto optimize Gain Depth Focal points Frequency (press to toggle) Image optimization Transitions

LOGIQ Book Auto optimize Gain Depth TGC Focal points Frequency (toggle) Image optimization Transitions

LOGIQ 200 TGC Depth Gain Focal points Auto optimize Frequency Image optimization Transitions

Transitions Start liver Liver to splenic head (sagittal) Splenic head to body/tail of spleen Body of spleen to splenic head (tx) Splenic head (tx) to LK LK to left adrenal Left adrenal to UB UB to RK RK to right adrenal/pancreas/GI Image optimization

Start liver Image optimization Depth increase or decrease Frequency usually decrease Auto-optimize on or off Focal points (2) Gain Overall gain adjust TGC in middle or bottom levers to right Transitions Scan

Liver to splenic head (sagittal) Depth increase Frequency increase Auto-optimize on or off Focal points Gain Overall gain TGC bottom levers same or to middle Scan Image optimization Transitions

Splenic head to body/tail of spleen Depth decrease Frequency same Auto-optimize on or off Focal points move up Gain Overall gain TGC same or top levers to right Scan Image optimization Transitions

Body of spleen to splenic head (tx) Depth increase Frequency same Auto-optimize on or off Focal points move down Gain Overall gain TGC same or top levers to center Scan Image optimization Transitions

Splenic head (tx) to LK Depth decrease Frequency same or decrease Auto-optimize on or off Focal points move down Gain Overall gain TGC same Scan Image optimization Transitions

LK to left adrenal Depth decrease Frequency same or increase Auto-optimize on or off Focal points move up Gain Overall gain TGC same Scan Image optimization Transitions

Left adrenal to UB Depth varies Frequency same Auto-optimize on or off Focal points same Gain Overall gain maybe decrease TGC top levers to left Scan Image optimization Transitions

UB to RK Depth varies Frequency decrease Auto-optimize on or off Focal points same Gain Overall gain maybe increase TGC top levers to center Scan Image optimization Transitions

RK to right adrenal/pancreas/GI Depth decrease Frequency increase Auto-optimize on or off Focal points move up or down Gain Overall gain TGC same or top levers to right Scan Image optimization Transitions

Organs Liver Spleen Kidneys (Left, Right)LeftRight Adrenal glands (Left, Right)LeftRight Urinary bladder Pancreas Stomach Intestines Ovaries (Left, Right), UterusLeftRightUterus Prostate, TesticlesProstateTesticles

Individual images, page 1

Individual images, page 2

ORGANS IMAGE LIST Page: 1, 2

ORGANS IMAGE LIST Page: 1, 2 Right lateral, cranial (Right liver, diaphragm) Optimize

ORGANS IMAGE LIST Page: 1, 2 Right lateral, toward midline (GB, diaphragm)

ORGANS IMAGE LIST Page: 1, 2Midline (CVC, PV, CBD)

ORGANS IMAGE LIST Page: 1, 2 Right lateral, caudal (Caudate lobe, RK)

ORGANS IMAGE LIST Page: 1, 2 Midline to left lateral (AO, left HV, left PV, stomach)

ORGANS IMAGE LIST Page: 1, 2 Left lateral

ORGANS IMAGE LIST Page: 1, 2 Cranial (liver, diaphragm)

ORGANS IMAGE LIST Page: 1, 2 Mid (GB, PVs)

ORGANS IMAGE LIST Page: 1, 2 Caudal (CVC, HV, PV, GB)

ORGANS IMAGE LIST Page: 1, 2 IC TX LIVER

ORGANS IMAGE LIST Page: 1, 2 Optimize

ORGANS IMAGE LIST Page: 1, 2 Cranial body Optimize

ORGANS IMAGE LIST Page: 1, 2 Midbody (hilus)

ORGANS IMAGE LIST Page: 1, 2 Tail

ORGANS IMAGE LIST Page: 1, 2 Midbody (hilus)

ORGANS IMAGE LIST Page: 1, 2 Cranial body

ORGANS IMAGE LIST Page: 1, 2 Medial (poles symmetrical) LK

ORGANS IMAGE LIST Page: 1, 2Medial (renal sinus/pelvis) Optimize

ORGANS IMAGE LIST Page: 1, 2 Mid sagittal LK

ORGANS IMAGE LIST Page: 1, 2 Lateral LK

ORGANS IMAGE LIST Page: 1, 2 Mid (renal sinus/pelvis LK

ORGANS IMAGE LIST Page: 1, 2 Cranial pole LK

ORGANS IMAGE LIST Page: 1, 2 Caudal pole LK

ORGANS IMAGE LIST Page: 1, 2 To L ovary Skip

ORGANS IMAGE LIST Page: 1, 2 Mid (apex) UB Optimize

ORGANS IMAGE LIST Page: 1, 2 Mid (trigone) UB

ORGANS IMAGE LIST Page: 1, 2 Lateral to the right UB

ORGANS IMAGE LIST Page: 1, 2 Lateral to the left UB

ORGANS IMAGE LIST Page: 1, 2 Cranial UB

ORGANS IMAGE LIST Page: 1, 2 Mid UB

ORGANS IMAGE LIST Page: 1, 2 Caudal UB

ORGANS IMAGE LIST Page: 1, 2 To Uterus To Prostate To RK

ORGANS IMAGE LIST Page: 1, 2Medial(polessymmetrical) RK

ORGANS IMAGE LIST Page: 1, 2Medial (renal sinus/pelvis) Optimize RK

ORGANS IMAGE LIST Page: 1, 2 Mid sagittal RK

ORGANS IMAGE LIST Page: 1, 2Lateral RK

ORGANS IMAGE LIST Page: 1, 2 Mid (renal sinus/pelvis)

ORGANS IMAGE LIST Page: 1, 2 Cranial pole RK

ORGANS IMAGE LIST Page: 1, 2 Caudal pole RK

ORGANS IMAGE LIST Page: 1, 2 Skip To R ovary

ORGANS IMAGE LIST Page: 1, 2DUOD RK

ORGANS IMAGE LIST Page: 1, 2 GB

ORGANS IMAGE LIST Page: 1, 2 Stomach L limb panc

ORGANS IMAGE LIST Page: 1, 2 L limb panc

ORGANS IMAGE LIST Page: 1, 2Duodenum

ORGANS IMAGE LIST Page: 1, 2 GB Pylorus

ORGANS IMAGE LIST Page: 1, 2 Stomach (fundus)

ORGANS IMAGE LIST Page: 1, 2 To Ileum (cats only) Skip

ORGANS IMAGE LIST Page: 1, 2 Sagittal bowel

ORGANS IMAGE LIST Page: 1, 2Stomach Colon

ORGANS IMAGE LIST Page: 1, 2 Transverse bowel

End of scan

ORGANS IMAGE LIST Page: 1, 2 UB

ORGANS IMAGE LIST Page: 1, 2 To Testicles To RK

ORGANS IMAGE LIST Page: 1, 2 Testicles

ORGANS IMAGE LIST Page: 1, 2 Transverse feline ileum Colon

ORGANS IMAGE LIST Page: 1, 2 Sagittal feline ileum Colon

End of scan

Right lateral, cranial

Right lateral, toward midline

Midline

Right lateral, caudal RK

Midline to left lateral

Left lateral

Cranial

Caudal

Sagittal

Sagittal cranial body

Sagittal midbody (hilus)

Sagittal tail

Transverse tail

Transverse midbody (hilus)

Transverse cranial body

Transverse

Medial (poles symmetrical) LK

Medial (renal sinus/pelvis)

Mid sagittal LK

Lateral

Mid (renal sinus/pelvis LK

Cranial pole LK

Caudal pole LK

Mid (apex) and vessels UB

Mid (trigone) UB

Lateral to the right UB

Lateral to the left UB

Cranial transverse UB

Mid transverse UB

Caudal transverse UB

Medial(polessymmetrical) RK

Medial (renal sinus/pelvis)

Mid sagittal

Lateral RK

Mid (renal sinus/pelvis)

Cranial pole RK

Caudal pole RK

DUOD RK R limb pancreas

GB Pancreatic body

Stomach L limb pancreas

L PANC

Duodenum

GB Pylorus

Stomach (fundus)

Tx feline ileum Colon

Sagittal feline ileum Colon

Sagittal bowel

Transverse bowel

Stomach Colon

Testicles

Complete abdominal ultrasound scanning protocol Copyright © 2010 The Academy of Veterinary Imaging.

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Complete abdominal ultrasound scanning protocol Copyright © 2010 The Academy of Veterinary Imaging.

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