A Blog for Healthcare Consumers

Ultrasound tests use sound waves to create images of the internal organs. Abdominal ultrasounds are frequently ordered to evaluate the organs of the abdomen which include the liver, gallbladder, pancreas, kidneys, spleen, and vessels such as the aorta and IVC Below are some common indications for an abdominal ultrasound.

• Look for liver cirrhosis, infection and tumors.
• Evaluate the gallbladder for stones, inflammation (cholecystitis) for polyps or tumors of the gallbladder that may cause abdominal pain.
  
• Evaluate parts of the pancreas that are seen by ultrasound for large tumors and inflammation.
• Look for kidney stones, blockages (hydronephrosis), tumors, cysts which can cause abdominal pain.
• Look for an enlarged spleen, tumors or cysts of the spleen.
• Rule out abdominal aortic aneurysms (ballooning of the aorta).
• Check for fluid in the abdomen which can be seen in cirrhosis, infection or injury.

Abdominal ultrasounds are also used to look for pyloric stenosis in young infants (causes projectile vomiting). It is used as a guide to biopsy tumors of the liver, kidneys and other nearby tissues.

Below is a brief outline of the procedure.

1. You will be asked to fast for at least 6 hours (so the gallbladder is full - it empties if you eat before the test and makes it very hard to evaluate).
2. After you sign in, you'll be taken to the ultrasound room.
3. An ultrasound technician will perform the test.
4. Once you enter the room, you will lie down on a bed/gurney.
5. The technologist will ask you to lift up your clothing, exposing your stomach.
6. He or she will place a a warmed gel solution over the skin.
7. The technologist will use an ultrasound probe and glide it over your abdomen while taking pictures.
8. You may be asked to sit up for a part of the test to get better images of the gallbladder or kidneys.
9. The technologist may ask the Radiologist doctor to review the scan before you leave.
10. An official report is generated by the doctor in about 24-48 hours.

If you are insured abdominal ultrasounds are covered. However, for uninsured patients these tests can be quite expensive. You can expect to pay anywhere between $250 and $800 for this test.

Have you had an Abdominal ultrasound? What was it like? Please leave your comments below

Many CT scan tests require injection of IV contrast (dye). IV stands for intravenous which means the contrast is given through a vein. Generally a vein in your hand, lower arm, or near the elbow joint is used. The contrast is used to "highlight" internal organs such as the liver, kidneys, and pancreas. It helps detect and characterize tumors, infection and disease of the vessels.

Contrast scans are ordered either "with only", meaning contrast is given and then the images are taken or "with and without", which means images are taken before the contrast is administered and then immediately during or after the contrast is injected.

Into the scan room

Once you're in the CT scan room you'll be taken to a table and asked to lie down. The CT technologist may take a few images in preparation for the scan and/or do the "non-contrast" part of the scan first. That is, take images that are needed before the IV contrast injection is done.

The IV tray

Most facilities will have the IV materials on a metal tray near the CT scan machine. This will include a tourniquet, alcohol pad, IV catheter, gauze, tape, syringe with saline, and some tubing to connect to the injector (the part of the machine that injects the IV contrast - it looks like a big ray gun).

Getting the IV

Unlike a blood draw, the IV catheters used are larger and will need to stay in a vein. Larger IVs are used as the contrast is injected at a high rate. You'll be asked to straighten your arm and hand. The technologist will place the tourniquet around your upper arm or wrist.

The technologist will check for a vein, sometimes using a tapping or brushing movement across your arm. After finding a suitable vein, the technologist will clean the area with an alcohol pad and position the IV over the vein. The IV is advanced through the skin and into the vein. This might take a few tries, particulary for patients who may be dehyrated, have had multiple injections, or chemotherapy.

Once the IV is placed, a small amount of saline is sometimes injected to test it. The IV is then hooked via tubing to the injector. The table will move and the technologist will leave the room to begin the injection and scan.

The injection

The contrast will flow from the injector, through the tubing and into the IV and then the vein. You may feel a "pop" in the beginning of the injection right at the IV site. As the contrast goes into the vein you will feel the fluid rush up your arm. You shouldn't feel any pain - if you do alert the technologist immediately.

After a few seconds the contrast reaches your chest and heart and you'll feel an intense warm feeling. Some have described it as a "sunburst" or like drinking a hot cup of coffee in one gulp. You might also get a metallic taste in your mouth.

Usually the scanner begins taking pictures within 10-20 seconds after the injection begins and continues to take pictures after the injection is completed.

After the injection

The technologist will remove the IV and place a small piece of gauze with tape over the IV site. 

What about side effects?

The most common side effect of contrast is a mild allergic reaction - sneezing, coughing, asthma-like symptoms and small hives. Severe allergic reactions can lead to heart and lung failure. Contrast can also damage the kidneys. If the contrast leaks from the IV and into the tissues of the hand or arm, it can cause pain and inflammation.

These are just some of the side effects of contrast. Your local Radiology center or hospital can give you more detailed information about the risks and benefits of IV contrast.

And remember, if you've had a side effect to contrast in the past, make sure you alert the Radiology facility and your doctor in advance.

Many people get nervous about the prospect of getting into an MRI scanner. Not surprising as most MRI scan tubes are long and narrow and do not let in any natural light.

If you are claustrophobic or think you might be, here are some tips:

1. Let your doctor know.  He or she may prescribe a mild sedative to help you get through the test. If you do take one, don't forget to bring someone along to drive you home.
2. Inform the Radiology staff. The technologists who do the scanning work with patients all day and can talk you through the scan.
3. During the scan keep your eyes closed. You can ask for a towel to put over your eyes. Breath normally. If you start feeling claustrophobic during the scan, talk to the technologist and let him or her know.
4. Choose an open MRI. Open MRIs were initially designed for claustrophobic and overweight patients. You can read more about open MRI scans in this blog entry. Severely claustrophobic patients may need a sedative as well.

Keep in mind that there are a few MRI tests which won't require your entire body to go into the scanner. These include MRI scans of the foot, ankle and knee.

Do you have any tips for getting through an MRI scan? What was your experience like? Leave your comments below.