Abdominal ultrasound

Checklist

Each radiologist will have his or her personal preferences for imaging abdominal organs.  A common sequence of a full abdominal ultrasound examination is aorta - pancreas - liver/gallbladder - kidneys - bladder region - intestines.
As a general rule, each organ and abnormality is imaged in two directions; in most cases the transversal and sagittal directions. 

Tips for viewing stored ultrasound images: 

• Top is always the skin side 
• Use the marker on the screen to see in which region and which direction (sagittal or transversal) the structures have been imaged. 
• Fluid does not reflect sound waves, making it anechogenic (=black). If you therefore see an anechogenic structure, this could be a fluid-filled organ or fluid-filled abnormality (e.g. gallbladder, bladder, vessels, cysts, ascites).  
• Calcified structures (such as bile stones and kidney stones) may cause acoustic shadowing.  
• Compare the echo reflection pattern of the liver parenchyma with the cortex of the right kidney in order to evaluate for the presence of liver steatosis (see Pathology section).  
• Comparison with normal anatomy is useful and can help improve the identification of pathology. Examples: do the kidneys appear symmetrical or is there (mild) hydronephrosis?  Intestinal wall thickening versus normal intestinal wall (see Pathology section).