Talk:Medical ultrasound

Images

This article really needs images! --WS 01:12, 31 July 2005 (UTC)

Terminology

DuBose (talk · contribs) has been changing most instances of "ultrasonography" to "sonography". According to Google, "ultrasonography" (1,890,000) is more common than "sonography" (1,490,000) and I therefore dispute that this change is necessary. Does anyone have other feelings on this matter? JFW | T@lk 14:42, 11 November 2005 (UTC)

Here is some information that favors DuBose's point of view: According to Google, "Medical ultrasonography" gets 961 hits and "Medical sonography" gets 309,000 hits. Edwardian 04:12, 15 November 2005 (UTC)

You asked me for my reasoning for preferring sonography, sonogram, etc over ultrasound as descriptive, professional terms, yet you have removed my discussion (I guess, do not see it), then ask for opinions giving only your GOOGLE numbers, a difference of only about 20%. Here is my original logic. If we are to debate this issue here, then please allow me to speak for myself. Thanks, DuBose 23:57, 11 November 2005 (UTC)

I do disagree with the term ultrasonography and ultrasound in this context. There is a historical place for ultrasound; however, ultrasound is a term of physics meaning frequencies above human hearing, you obviously know this. Ultrasound is not unique to medical imaging. Many use “ultrasound” for medical and non-medical purposes. Physical therapists use it for deep heat, dental hygienists use it to clean teeth, iron workers use it for non-destructive testing, and jewelers use it to clean rings and watches. Only sonographers use ultrasonic energy to create medical images. Sonography, sonographer, and sonographic were coined 30 years ago to specifically refer to this type of medical imaging. Ultrasonography is unnecessarily long, pretentious, and redundant because the “ultra” goes without saying. Sonography is simple and unique to the profession.

While ultrasound predates the term sonography and its derivatives, it is much more consistent with older medical nomenclature such as radiography. And while we use ultrasonic energy to create these images to refer to the technique or image as an “ultrasound” is analogous to referring to a photograph as a “light”… photographs are reflected light.

Info

Sonography, Sonographer, & Sonographic are well accepted and because they are unique to the profession are more specific to it. There are ample examples of the acceptance of these terms: ARDMS, SDMS BLS

Definitions of sonography on the Web:

• A imaging technique for visualizing the growth of ovarian follicies during infertility therapy. [www.infertilitycentral.com/fertility/infertility-glossary,6.html]
• Use of sound to form images eg ultrasound scanning [1]
• An imaging test which sends sound waves to and receives them back from an organ to create an image of that organ. [2]
• Using the reflections of high-frequency sound waves to construct an image of a body organ (a sonogram); commonly used to observe fetal growth or study bodily organs [3] -DuBose 03:14, 12 November 2005 (UTC)

I have not "removed [your] discussion ". All I have done is revert the page before a far-reaching terminology change is made. "Sonography" may be the actual performance of an ultrasound examination, but the imaging modality is still called "ultrasound", at least here in the UK. At the moment the page mentions both terms in the intro, and I think it's quite balanced.

I'm cross-posting this on the doctors' forum, to see what their views are. JFW | T@lk 01:53, 13 November 2005 (UTC)

RFC Project Clinical Medicine

I am responding to the RFC placed on Wikipedia talk:WikiProject Clinical medicine. The word "ultrasonography" is derived from the word "ultrasonic" which is commonly defined as frequencies greater than 20,000 or 30,000 Hz. If an imaging technique is using frequencies greater than 20,000 or 30,000 Hz, then it is ultrasonography. Per the article, "[t]he frequencies used for medical imaging are generally in the range of 1 to 10 MHz", so my vote is for ultrasonography. Edwardian 06:07, 13 November 2005 (UTC)

Terminology continued

The "ultra" is unnecessary. The profession coined a perfectly good and specific set of terms that work and are accepted. And if you check the history, you will find the individual who was primarily responsible for the coinage was from Great Brittan. I find the “ultra” pretentious, and a waste of ink and bandwidth. There is a historical precident for ultrasound, but language is a living thing… and it is changing in this particular profession. The largest professional organization in the world for sonographers is the Society of Diagnostic Medical Sonography. [4]DuBose 01:50, 15 November 2005 (UTC)

• Warning: I reserve the right to change my mind and/or to argue for a something different in other articles. Sorry if this seems wishy-washy. I’m researching the overall best method to index ob/gyn and childbirth articles, and I‘m not sure yet. Ultrasound is very important to obstetrics, so I want to get it right. Specifically, I reserve the right to argue for pregnancy ultrasound or prenatal ultrasound, transvaginal ultrasound, and breast ultrasound in other articles.

That said, in the narrow scope of this discussion (ultrasonography vs. sonography in this article), I think ultrasonography is the best term. Reasons: 1) MeSH uses ultrasonography as the subcategory head.( MeSH is NLM's controlled vocabulary used for indexing articles for MEDLINE/PubMed. MeSH terminology provides a consistent way to retrieve information that may use different terminology for the same concepts.) 2) MedlinePlus Medical Encyclopedia Topic index refers away from sonography and sonogram. 3) If this is a popularity contest between ‘sans’ ultra and ultra, then ultra wins because ultrasound is by far the most popular. Examples: a) CPT (medical procedures billing code used by U.S. Medicare, Medicaid, and other U.S. insurance companies uses ultrasound not sonography. b) American College of Radiology uses a derivative of sonography in 2 Practice Guidelines titles vs 14 for ultrasound. c) None of the goggle searches leads with sonography. See Goggle search rsults on FloNight scratch pad on User:FloNight page. --FloNight 22:56, 15 November 2005 (UTC)

Here is another article we should consider while we're at it: Medical sonology. Edwardian 06:16, 15 November 2005 (UTC)

I agree that at this time, “If this is a popularity contest between ‘sans’ ultra and ultra, then ultra wins because ultrasound is by far the most popular.” This is due to the historical nature of the term in a very new use of the technology (new in the context of the history of medicine or humans).

However, Sonography, Sonographer, Sonogram, and derivations have become legitimate terms in the English language, and should be included and not just “redirected”. If you look at the American Registry of Diagnostic Medical Sonography (http://www.ARDMS.org) you will find there are almost 50,000 certified sonographers that refer to themselves as Sonographers, not ultrasonographers. The ARDMS is accredited by the International Standards Organization (ISO), and provides certifying examinations world wide, not just for non-physicians, but also physicians.

The American Institute of Ultrasound in Medicine is the oldest professional organization for ultrasound/sonography and publishes the prestigious Journal of Ultrasound in Medicine, yet if you look at the latest table of contents for the JUM (November 1 2005, Volume 24, Issue 11; [5] ), you will find that of the 17 peer reviewed articles, eight use the term “Sonography” in the title, one uses “Ultrasonographic”, and eight use neither.

Just because "ultrasonography" may be a preferred Eurocentric term, does not mean that the term "sonography" does not exist and is not in wide use.

The purpose of an encyclopedia should not be to set language in concrete, but to record language as it is used and evolves. This should be particularly true of “Wikipedia, the free encyclopedia that anyone can edit” … a people’s encyclopedia. DuBose 22:40, 16 November 2005 (UTC)

You fully misunderstand the purpose of redirection. To create pages for every variant terminology is immensely unhelpful. At present any person who types in "sonography" will get to this page, and the word is bolded in the intro. By the way, why is the Journal of Ultrasound in Medicine still called "ultrasound"? Please stop bickering about terminology and contribute some of your professional knowledge to this resource. JFW | T@lk 00:21, 17 November 2005 (UTC)

The Journal of Ultrasound in Medicine is still called “ultrasound” because of the historical nature of the terms. The AIUM predated the coinage of the term Sonography. However, they are open minded enough to realize the evolving nature of the language, technology, and profession to now be using the term sonography in most article titles. I am not saying that that there should be a separate definition for all variations of a term, but “Sonography” has reached a status of being specific and widely used enough to be defined… gees, it is listed by the US Department of Labor! You call it “bickering”, while it is discussion and debate. If you tell me that you are the “arbiter” and no one else’s opinion matters, then I will simply quietly go away and not return. DuBose 15:40, 18 November 2005 (UTC)

Don't go away, please. I'm not an arbiter at all. That's why I asked others to give their opinion. You may be correct that in the US "sonography" is the prevalent term, but there are equal number of non-Americans worldwide who use the "outdated terminology". When an American has been to the doctor, does he go for an "ultrasound" or for a "sonogram"?

Your opinion matters. Honestly. But so does everyone else's. I would be thrilled if you could enrich some articles with common ultrasound criteria (e.g. common bile duct size in liver scans). That would be immensely helpful. JFW | T@lk 10:27, 20 November 2005 (UTC)

Pelvic Ultrasound

I disagree with recent merger of 'Pelvic ultrasound' to this page for a number of reasons:

• This is a particular application of ultrasound imaging and has no greater claim to warrant its own individual paragraph or section than the other listed applications (e.g. Obstetric ultrasound or Echocardiography).
• Other major applications of ultrasound imaging have their own pages (e.g. Obstetric or Echocardiography), so why should not Pelvic ultrasound ? I agree it was short (a stub), but its existence allowed the article to be expanded and improved.
• I think a different merger is preferable: merge of Gynecologic ultrasonography into Pelvic ultrasound
  • Pelvic ultrasound, whether trans-abdominally/vaginally/rectally, is obviously of female reproductive system, but also of bladder & other pelvic structures and so is applicable for non-gynaecological reasons and indeed in men too.
  • All Gynaecology ultrasound scans involve a Pelvic Ultrasound, but the converse is not true (not all pelvic ultrasound scans are for gynaecological reasons).
  • I would therefore propose a merge of Gynecologic ultrasonography (a term not used at all in the UK) into Pelvic ultrasound (chest/respiratory physicians don't ask for a 'Respiratory X-ray' but rather a 'Chest X-ray', nephrologists ask not for a 'Nephrology ultrasound' but a 'renal ultrasound' etc).
• If consensus agrees, then I'll place the appropriate tags on the relevant pages (following Wikipedia:Merging and moving pages procedures) for a week to notify editors.

David Ruben ^Talk 00:24, 1 February 2006 (UTC)

Errors

I have just read this entry over and had to fix a few items. One serious mistake is that the entry suggested that each image line is formed by a single transducer element of an array. This is incorrect as each line is formed by a number of elements. I have also added a couple of photographs and a couple of images. I hope this helps. Cheers! -Drickey 18:16, 15 February 2006 (UTC) PhD, Medical Physics (Ultrasound)

Nice!! Those pictures are great, esp the doppler ones. I don't suppose you could get some video or sound (of the doppler)? This could be a featured article with some more work. -Ravedave 23:27, 15 February 2006 (UTC)

Sound is a little trickier since the scanners don't record it. Let me work on it. Unfortunately the "Interpreting the echo" section looked like it was from some book written in 1965. I fixed it a bit, but it still isn't great. I changed the subtitle from "Interpreting the echo" to "Forming the image" because I didn't want confusion with "interpreting the image" as is done by a person. I removed this line "but current research on ultrasound bone imaging will make it possible with dedicated devices in the future." since the link didn't exist. It also refers to a technique that currently isn't available on any diagnostic scanner that I know about. Drickey 21:08, 16 February 2006 (UTC)

No, they're dedicated devices. A study in the Lancet a couple of years back showed that ultrasound of the calcaneus was reasonably sensitive to detect osteoporosis. More straightforward than DEXA anyway. I'm not sure how much clinical use it enjoys. JFW | T@lk 21:38, 16 February 2006 (UTC)

If I recall correctly, studies (I forget whether the one in the Lancet you are thinking of or subsequent ones) showed poor correlation of bone ultrasound measurement to actual hip fractures, compared to the current gold-standard of DEXA. David Ruben ^Talk 01:06, 17 February 2006 (UTC)

This sounds like bone densitometry which is a *non-imaging* use of ultrasound. Maybe someone was confused about this point. Rather oddly, there does not appear to be an entry for ultrasonic bone densitometry. At any rate it doesn't belong in this section. Thinking about this section, it's probably reasonable to start separate entries on three-dimensional ultrasound, and Doppler ultrasound. -DRickey

Doppler error

It is a common misconconseption that medical ultrasound uses the doppler effect to measure bloodflow in limited spatial areas. The doppler effect can only be used to measure average velocity across the entire beam, using continous-wave "pulses". Almost all velocity-measurements in use today are based on the autocorrelation technique , which offers velocity measurements with spatial resolution, thus enabling the creation of "color-flow" images, superimposed over ordinary ultrasound images. --Fredrik Orderud 20:15, 25 March 2006 (UTC)

Sorry, this last statement is incorrect, or at least not clear. The autocorrelation technique published by Kasai and used for all (or most) colour Doppler measurements is simply a fast method of determining the mean frequency (or phase) shift. It has *nothing* to do with the physics of the signal generation. A number of years ago, Philips Ultrasound built a scanner called the P700 that used true cross-correlation of the RF pulses to measure velocity. As far as I know, all current scanners use something that is arguably the Doppler shift for spectral, colour, and power Doppler. One can show that there are differences in the way that pulsed & continuous wave instruments deal with their signals, but this is not the place to discuss it. Drickey 15:10, 7 April 2006 (UTC) Daniel W. Rickey, Ph.D. Medical Physics (Ultrasound)

My point was that the "doppler sonography" discussed in the article has nothing to do with dopper shifts, and this should be made clear in the text. Velocity measurements are instead made possible by transmitting many pulses in the same direction over a very short period of time, and measuring relative movement between each pulse. Any frequency shifts encountered in processing is only a consequence of the choise of using complex demodulated data for processing. The technique is basically the same as Pulse-doppler radar. --Fredrik Orderud 17:22, 7 April 2006 (UTC)

--- Actually, we can argue that in fact what pulse-Doppler measured is also a Doppler-shift, but not of the carrier frequency like in CW Doppler. If, after the transmission of short bursts at a given pulse repetition frequency, the echoes coming back from a moving target are shifted relative to each other, on receive the repetition frequency of these echoes is different from the transmit pulse repetition frequency. This shift in frequency is in reality what pulse-Doppler is measuring, and is a function of the velocity of the target. This is I believe still a Doppler shift measurement, which is directly related to the Doppler-effect, the frequency affected by this Doppler effect being the pulse repetition frequency (and not the carrier frequency of the pulse, which has been suppressed anyway by the demodulation). 142.76.1.62 21:23, 30 March 2007 (UTC) ---

This is far too esoteric for a mention on this page. However, don't forget that many of these scanners can also operate in continuous-wave Doppler mode, which is true Doppler. The Doppler/not Doppler argument is a fun accademic discussion; I can email you a write up if you wish.Drickey 19:37, 23 February 2007 (UTC)

Dolphins?

I was just curious, does anyone think people's ideas on dolphins picking up on people's emotions with their animal echolocation might extend to ultrasonographic uses? Maybe there's research into it... I think there might be something like that with dogs too, though that might be more scent-linked. Tyciol 06:01, 19 June 2006 (UTC)

resolution

changed wikilink from resolution to Angular resolution. please change this to a different page if you know better then I do STHayden ^{[ Talk ]} 01:56, 22 August 2006 (UTC)

Angular resolution isn't quite right since in ultrasound, the distance to the object is measured. The term I use when teaching imaging physics is "spatial resolution", which is mentioned under "image resolution". However the "image resolution" page looks like it needs some work. Drickey 19:31, 23 February 2007 (UTC)

Through-transmission ultrasonography vs pulse echo

A very good and interesting article on medical ultrasonography. I have noted that through-transmission ultrasonography is not mentioned ( as used for example in quantitative ultrasound to assess bone density ). Should that be included in this article or should it be the subject of a separate article ? Dr. Imbeau 02:24, 11 October 2006 (UTC)

Through-transmission for bone-densitometry should be a separate entry since it's a very different technique.Drickey 19:21, 23 February 2007 (UTC)

External Link Should Be Removed

One of the external links is clearly not in keeping with Wikipedia's "neutral point of view" policy. It is a link to real-time, "high resolution" images of fetal development, which is basically a pro-life website.

Therapeutic applications

The section Therapeutic applications doesn't belong on this page. "Ultrasonography" refers primarily to imaging & Doppler exams. Drickey

I agree. I suggest we move the section to "Therapeutic ultrasound" and provide a link. Ultrasonography is definitely not therapeutic ultrasound. --Slashme 10:56, 17 August 2007 (UTC)

Doppler Ultrasound

The section on Doppler ultrasound is somewhat confused and misleading. Continuous wave ultrasound is used on modern ultrasound scanners, primarily for cardiac applications. The comment that the ultrasound pulse is not Doppler shifted is incorrect: the pulse is frequency-shifted, but the scanner does not use this information.

It would make sense to make a separate Doppler Ultrasound page where some of the details can be discussed.

Daniel W. RIckey Drickey 15:16, 24 September 2007 (UTC)