Abdominal ultrasound technique

Patient position. The patient can lie in a comfortable position on his back. A small pillow can be placed under the head, in case of pronounced tension of the anterior abdominal wall, a pillow can also be placed under the patient's knees.

Apply gel to your belly.

The patient is allowed to breathe calmly, however, when examining individual organs, holding the breath while inhaling is required.

Selecting a transducer: Use a 3.5 MHz transducer for adults and a 5 MHz transducer for children and thin adults. Convex or sector transducers are preferred.

Set the correct level of overall sensitivity. Begin the examination by placing the transducer centrally in the upper abdomen under the xiphoid process and ask the patient to inhale deeply and hold their breath.

Rotate the transducer to the right until the liver begins to be visualized. Adjust the sensitivity so that the image has a normal, uniform echostructure. The highly echogenic diaphragm line just behind the posterior liver should be clearly visible.

The portal and hepatic veins should be visualized as tubular structures with an anchogenic lumen. The walls of the portal vein are highly anchogenic, but the walls of the hepatic veins are practically invisible.

After you have adjusted the sensitivity of the device, slowly move the sensor from the midline to the right, stopping every centimeter and checking the image. Check at different levels. After you have examined the right side, examine the left side in the same way. In this case, the sensor should be directed in different directions in order to better localize the object and obtain more information. It is very important to examine the entire abdominal cavity: if after changing the angle of the sensor, the upper part of the liver or spleen is not visualized, it is necessary to scan through the intercostal spaces.

After these transverse scans, rotate the transducer 90 ^° and start scanning again from the xiphoid process. Locate the liver again and, if necessary, ask the patient to hold their breath while inhaling deeply to visualize it better. Make sure the sensitivity level is set correctly. If necessary, tilt the transducer toward the patient's head. Perform the examination along the intercostal spaces.

Below the ribs, hold the transducer vertically and move it toward the legs (caudally). Repeat in various vertical planes across the abdomen.

If any part of the abdomen is poorly visualized, the examination can be performed with the patient sitting or standing. If necessary, the examination can be performed with the patient lying on his side with his head raised; this is most often used when examining the kidneys and spleen. Do not hesitate to turn the patient.

It is important to visualize:

1. Aorta and inferior vena cava.
2. Liver, portal vein, hepatic veins.
3. Bile ducts and gallbladder.
4. Spleen.
5. Pancreas.
6. Kidneys.
7. Diaphragm.
8. Bladder (if full).
9. Pelvic organs.