Ultrasound Scan And What You Should Know About It

 

An Overview

 

Ultrasound scan is a safe and painless procedure of producing images of inside the body using sound waves. It involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body.
The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound scan does not use radiation as opposed to X-rays, CT scans and MRI. It is also non-invasive. That means there is no need to do any form of open surgery in order to have a better visualization. It captures motion pictures in real-time, and hence, can be used to visualize the inside of the body and blood flow through vessels. Conventional ultrasounds displays its images in 2D. However, recent advancements have led to the production of 3D ultrasound that may incorporate Doppler. The latter helps in visualizing blood flow.

 The ultrasound has various components: there is a console containing computer and electronics, a transducer or probe connected to the console through a cord and a visual display screen. The console is like the central processing unit of a computer, the probe is like a mouse and the visual display unit is the monitor; although they do not perform similar functions. These are the basic components. However, portable ultrasound machines can have console and monitor compressed into one.

Indications for Ultrasound

 

The ultrasound scan can be used for the heart and blood vessels, liver, spleen, kidneys, bladder, uterus, ovaries, unborn foetus, scrotum and thyroid. This list is, however, not exhaustive. Usually, the patient to be examined will be positioned lying face up. The examining table can be ti
lted to get a better exposure. The area to be examined is uncovered and a warm inert (non irritant) gel is applied on it. The transducer is subsequently maneuvered over it to visualize the structures underneath it. the gel is wiped off at the end of the examination. The probe can also be passed into the esophagus (in transesophageal echocardiogram), transrectally (to view the prostate) and transvaginally (to view the uterus).

 Misinterpretation of Ultrasound Results in Nigeria

 

The importance of the ultrasound in diagnostic medicine cannot be overemphasized. It has come a long way in aiding the physician to make a better informed diagnosis. Hence, it can be considered as a vital tool in modern day practice. This machine works best when it is in good condition, and results from it is most useful if the examination is done and interpreted by a radiologist. This seems to be the missing part in the use of ultrasound in Nigeria. Imagine a situation when the ultrasound examination is done by someone who lacks the basic knowledge of anatomy, not to talk of having the knowledge to correlate his findings with the symptoms complained by the patient, in order to arrive at a definitive diagnosis. This is the canker worm that has eaten deep into the fabric of our medical practice.

In fact, this despicable practice being practiced by medical doctors in private practice should be stopped. Seemingly, one of the reasons while these medical professionals hit so low below the belt is to cut cost: the cost of employing a radiologist or at least a another doctor or a radiographer to cover for him. As if that is not enough, some secondary and tertiary centres cannot boast of a functional ultrasound machine in Nigeria. The patient is only left with the choice of patronizing some of these quacks. In some centres, the machine continuously "breaks down" and patients are referred to the hospitals owned by the sonologists for ultrasound scan.

Meanwhile, some individuals, whose only qualification was that he watched the ultrasound probe being moved moved "back and forth" on several patients, now runs ultrasound scan. Just imagine the kind of half-baked information this individual will give to unsuspecting patients. This has in no time engineered a lot of misconceptions amongst the populace. They now see the ultrasound machine as an all-knowing machine that can diagnose anything, ranging from typhoid and malaria to a myriad of other conditions. This has led people to use their scarce resources in search of nonexistent medical conditions.

Think of a scenario where a patient walks into your hospital and demands for an ultrasound scan. And when you try to get a brief history from him, the symptoms are in conformity with gastroenteritis. Now, when you try to talk him out of the ultrasound scan, he refused your idea vehemently. How much did this patient come to the hospital with? Of course, just enough to do the scan. And if, par hazard, there was a positive finding from the scan, what will be the next line of management? He did not take that into consideration. If you refuse to do the scan, there are many road side cubicles that "can" do it. So your are seemingly forced to do it. The scan revealed nil of note. He goes home with an empty pocket and the main complaint, that could have been salvaged with the little money he had, was left unattended to. On reaching home, he tells his relatives that his condition cannot be diagnosed by an ultrasound scan; hence, there must be a spiritual component to it. And he spends his time and money running from one prayer house to another native doctor. At the end, he is left impoverished and confused.

Conclusion

 

The idea of allowing quacks to run a scan center must be discouraged. The notion that an ultrasound machine diagnosed a thousand and one conditions should be debunked.The result of a scan can only be useful when it comes from a radiologist. Where there is no Radiologist around, a qualified doctor or sonogragher should be left to handle the examination and interpretation of findings from scans. The mass media can go a long way in changing people's perception. Let us join hands and bring medical practice in Nigeria up to par with what is obtainable in the developed world.