Ultrasound Free

Ultrasound Examination of upper abdomen:-

Liver: is moderately enlarged in size, A/P diameter 118.3 mm. Hepatic parenchymal echotexture is uniform all-over. No focal hyper or hypo-echoic lesion is seen in the liver .Intrahepatic portion of IVC is normal. Portal vein is normal.  Porta-hepatis is normal. Ultrasound Physics. Read more about What is Health and Safety Issue. Wages and Benefits

Gall bladder: Normal in size and contour. Wall thickness is within normal limit. No Evidence of echogenic structures or biliary sludge is seen within the gallbladder. Intrahepatic biliary radicals and common ducts are not dilated. Internal diameter of CBD and that of portal vein are within normal limit.

Pancreas: is normal in size.  Parenchymal echotexture is homogeneous. Main Pancreatic duct not dilated.

Spleen: is normal in size. It is uniform in echotexture. No focal lesion is seen in the spleen.

Right Kidney:  Normal in size, shape & position. Cortico-medullary differentiation is normal with normal cortical echogenity. Echogenic renal sinus is normal. No evidence of hydronephrosis, mass lesion or calculus is seen.

Left Kidney: Normal in size (Bipolar length is 91.6 mm). There is a well defined hypoechoic solid mass lesion seen in the anterior cortex of left kidney near its upper pole.  It measures 33.8 mm x 21.3 mm in sag scan. The mass has pushed the upper pole calyces posteriorly. However, no evidence of hydronephrosis is seen.

No abnormality is seen in the lumen of the IVC, renal vein, and hepatic vein.No Lymphadenopathy is noted in abdomen.  

Diagnosis: SOL in the anterior cortex of left kidney near its upper pole, possibilities are –

  • RCC 
  • Inflammatory lesion.

Advice:

  • CT scan of kidneys with contrast.
  • CT guided FNAC of the SOL in left kidney.

Ultrasound Examination of Whole abdomen:- (Ultrasound Physics and Ultrasound Free )

Liver: Normal in size. Hepatic parenchymal echotexture is uniform all-over. No focal hyper or hypo-echoic lesion is seen in the liver .Intrahepatic portion of IVC is normal. Portal vein is normal.  Porta-hepatis is normal for Ultrasound Free                     

Gall bladder: Normal in size and contour. Wall thickness is within normal limit. No Evidence of echogenic structures or billary sludge is seen within the gallbladder. Intrahepatic billary radicals and common ducts are not dilated. Internal diameter of CBD and that of portal vein are within normal limit.

Pancreas: Is normal in size.  Parenchymal echotexture is homogeneous. Main Pancreatic duct not dilated.

Spleen: Is normal in size. It is uniform in echotexture. No focal lesion is seen in the spleen.

Kidneys:  Both Kidneys are normal in position, shape and size. Cortico-medullary differentiation is normal in both kidneys with normal cortical echogenity. Echogenic renal sinuses are normal on both sides. No evidence of hydronephrosis, mass lesion or calculus is seen on either side. Ureters are not dilated.

Urinary bladder: Normal in outline. No wall thickening seen. No demonstrable intravesical lesion is seen.

Aorta, IVC, and other abdominal vessels are normal. No ascites or Lymphadenopathy is noted in abdomen and pelvis.

Uterus: Is normal in size and anteverted in position.

Endometrium: Is normal in thickness and echogenicity. 

Myometrium: Is homogeneous. No focal lesion seen in the myometrium.

Left Ovary: Normal in size, volume and echogenicity.

Right Ovary: Tiny cyst area is seen within the left ovary measuring about 21.1 mm x 11.0 mm x 11.0 mm).

Cul-de-Sac: free of any fluid collection.

Ultrasound Free Comment:  Right ovarian cyst probably Retention cyst.

Urinary bladder

Urinary bladder: Well filled.  Normal in outline. Wall thickening seen. No demonstrable intravesical  lesion is seen.

Normal in outline. Wall thickening seen. No demonstrable intravesical lesion is seen.

Uterus : bulky in size. Anteverted  in position. Myometrium  inhomogenous. Endometrium  not seen. Cavity  contains  small  echogenic structure.  Cervix  dilated.

Both ovaries: Normal in size and shape. 

Cul-de-Sac:   Small  fluid collection.

Comments:   BULKY  UTERUS  WITH  INCOMPLETE ABORTION.

Ultrasound Examination of  lower abdomen:-

Urinary bladder: Normal in outline. No wall thickening seen. No demonstrable intravesical lesion is seen.Aorta, IVC, and other abdominal vessels are normal. No ascites or Lymphadenopathy is noted in abdomen and pelvis.

Uterus: appears enlarged in size  and anteverted in position.

Endometrium: Not seen. 

Myometrium: is  inhomogeneous. Cavity contains huge echogenic structure seen(placenta).

Right Ovary: appears normal in size with multiple echogenicity

Left  Ovary: appears normal

Cul-de-Sac: free of any fluid collection.

Diagnosis:  RETAINED PRODUCT OF CONCEPTION(PLACENTA).

Ultrasound Examination of Both Breast (Ultrasound Physics and Ultrasound Free )

Rt  Breast : Small hypoechoic  oval shaped mass with well defined margin is noted at the 12 “o clock position within right breast. The mass measured about 10.4mm in sag scan and 12.1mm in trans scan. Calcification is noted.within the mass with casting post acoustic shadow.Glandular patterns are normal in appearance.

Lt.Breast: No mass lesion is noted within the left breast .Glandular  patterns are also normal in appearance.

Comment ; Suggestive of Fibro adenoma within the  right breast.

Ultrasound Examination for pain in right iliac fossa:-

  • Appendix has been identified in both transverse and longitudinal scan. A/P diameter of Appendix measuring 7.1 mm in transverse scan & 8.1 mm in sag scan (Normal < 6.0 mm).
  • Appendix is swollen, Muscular wall is thickened. However, no peri appendicular collection is seen. No significant intra luminal collection is seen.
  • Liver, both kidney, gall bladder and biliary tree, spleen, urinary bladder are seen and found normal.

Diagnosis: H/O pain in right iliac fossa, fever, nausea vomiting and swollen appendix in USG is suggestive of acute appendicitis.

Ultrasound Examination of Pelvic Organs/ Left breast:-

Uterus:  Is normal in size (83.2mmX40.4mmx40.4mm) and anteverted in position.

Endometrium: Is normal in thickness (<4mm) for the phase of the cycle. 

Myometrium: Is homogeneous. No focal lesion seen in the myometrium.

Right Ovary: size:  27.9mmx21.6mmx11.1mm, Volume: 3.5ml.

Normal in size, volume and echogenicity.

Left Ovary: size:   29.3mmx12.5mmx17.8mm, Volume: 3.4ml.

Normal in size, volume and echogenicity.

Cul-de-Sac: free of any fluid collection.

Left breast:

  • The skin layer is normal. Thickness is 1.6mm in all quadrants.
  • Hypoechoic subcutaneous layer is normal in all quadrants
  • Echogenic fibroaglandular area is also normal in all quadrants except there is a small well defined anechoic cystic lesion with posterior enhancement is seen in the 12 o’clock position. It measures 5.8mmx 4.2mm in size. No septation or internal echoes seen within the cyst.
  • Retramammary layer with pectorals muscle layer are also appear normal.
  • No micro or macro calcification is noted within the breast.

Comment: Tiny left breast cyst in 12 o’ clock position

U/S Exam of Left Upper Arm Including Shoulder Joint:-

Skin is normal. Subcutaneous tissue and fat layers are normal.

Muscle: Deltoid, subscapularis, Supraspinatus, Infraspinatus, biceps muscles are noted, all are in normal in appearance.No rupture, fluid collection, or calcifications are noted within the muscle fibers or in tendons.    

Comment: Normal study at ultrasound.

TA and TR Ultrasound Examination of Prostate Gland:-

On TA Examination:

Prostate Size:  

It measures –

a) Base to apex     :  29.1 mm

b) Depth               :  34.6 mm

c) Width               :  35.5 mm

Prostate gland in Volume:  18.7 gm. (Approx)

On TR Examination:

Prostate Size: 42.5 mm x 19.5 mm x 35.3 mm

Volume: 14.62 gm (Approx)

Prostate gland is normal in size, shape and volume. It shows homogenous parenchymal echotexture all over the peripheral zone and inner gland. No localized lesion is seen in the gland. Surgical capsule is intact. The ejaculatory duct region inside the prostate gland is normal.

The seminal vesicles are not clearly visualized.

Both testes, epididymis, spermatic cord and the penile urethra are also examined and found normal in ultrasound. No periurethral calcification is noted.        

Comment: Normal study at Ultrasound.

Transvaginal (TVS) Ultrasound Examination:

TVS exam has been performed with a high frequency 6.0 MHz transducer.

Uterus:

Uterus is normal in size.

Endometrium: shows high echo. Endometrium thickness is 10.0 mm which is within normal limit at this secretary phase of her cycle.

Myometrium: There are multiple small hypoechoic nodular solid mass lesions within Myometrium of uterus both anterior and posterior Myometrium close to the fundus and a few in the fundus.  One of the lesion measures 1.8 mm size in diameter.

There is another cystic mass lesion within the cervix in its posterior wall along the endocervical canal.

Ovary:

Both ovaries are normal in size and echogenicity

Adnexae: no other abnormalities are seen in adnexae.

Pouch of Doglus: Free from any fluid collection

Comments:

  • Multiple small fibroids in uterus.
  • Nabothian cyst in the cervix.  

Ultrasound Examination of Thyroid Gland:-

Both Lobes:

There are multiple nodules with hallow around each are noted within the both lobes of the thyroid gland.

Left lobe: Largest nodule is measuring 8.0 mm x 5.3 and smallest one is measuring 5.2mmm x 3.4mm in sag scan.

Right lobe: Largest nodule is measuring 6.3 mm and smallest one is measuring is 6.2mm in sag scan.         

No calcification is noted within both lobes.

Comment: Multiple adenomas within the thyroid gland.