B scan ppt

8/17/2019 B scan ppt

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LOOK BEYOND AND BEHIND........OPHTHALMIC B SCANULTRASONOGRAPHY

DR. IRAM JOWHER


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CONTENTS

I. Why a class?????

II. His!"y

III. Wha is i????

I#. P"i$ci%l&s a$' %hysics

#. I$s"()&$ai!$

#I. T&ch$i*(&

#II. H!+ a $!")al sca$ l!!,s li,&????

#III. S!)& a-$!")al sca$s

I. Ul"as!$!/"a%hy i$ %&'ia"ic %ai&$s. Pi0alls

I. R&%!"i$/

II. Ca(i!$

III.

1Da$,&2


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WHY A CLASS???????


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CO3.........


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WHY????

T! c"&a& a+a"&$&ss a-!( -asics !0 US

T! &)%hasi4& !$ h& i)%!"a$c& !0

!%hhal)ic US

T! c"&a& 5 0!ll!+ sa$'a"' !%&"ai$/%"!!c!l +hil& %&"0!")i$/ !%hhal)ic US


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HISTORY.....


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6789: La44a"! S%alla$4a$i ;Ialy< 'isc!=&"&'ha -as !"i&$ h&)s&l=&s +ih h& h&l% !0s!($' +hisl&s +hil& >yi$/ i$ 'a",$&ss. This+as h& -asis !0 )!'&"$ (l"as!($'

a%%licai!$


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W!"l' +a" II: a '&=ic& -as&' !$ %i&4!&l&c"ic&&c '&=&l!%&' -y Pa(l La$/&=i$ ;@"a$c&<a-l& !0 &)ii$/ 5 "&c&i=i$/ (l"as!($'($'&" +a&" (s&' as s!$a".

68: "s '!c()&$&' (s& !0 !c(la" USGM($' a$' H(/h&s (s&' A sca$ &ch$i*(& !'&&c i$"a!c(la" ()!(".

687: @i"s (s& !0 ha$' h&l' B sca$ -yB"!$s!$ 5 +!",&"s +hich +as a%%li&''i"&cly ! h& cl!s&' li' +ih!( a +a&" -ah


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WHAT IS IT?????

s!($' %"&ss("& +ih a 0"&*(&$cy /"&a&" ha$h& (%%&" li)i !0 h()a$ h&a"i$/.

Alh!(/h his li)i =a"i&s 0"!) %&"s!$ !%&"s!$ i is a%%"!Fi)a&ly ,il!h&"4

; h&"4< i$ h&alhy y!($/ a'(ls

http://en.wikipedia.org/wiki/Soundhttp://en.wikipedia.org/wiki/Frequencyhttp://en.wikipedia.org/wiki/Humanhttp://en.wikipedia.org/wiki/Hearing_(sense)http://en.wikipedia.org/wiki/Hertzhttp://en.wikipedia.org/wiki/Hertzhttp://en.wikipedia.org/wiki/Hearing_(sense)http://en.wikipedia.org/wiki/Humanhttp://en.wikipedia.org/wiki/Frequencyhttp://en.wikipedia.org/wiki/Sound


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I is a$ ac!(sic +a=& ha c!$siss !0%a"icl&s +ihi$ h& )&'i()

@"&*(&$ci&s (s&' i$ 'ia/$!sic !%hhal)ic(l"as!($' a"& i$ h& "a$/& !0 6 MH4

Th&s& hi/h 0"&*(&$ci&s %"!'(c& sh!"&" +a=&

l&$/hs +hich all!+ /!!' "&s!l(i!$ !0)i$(& !c(la" a$' !"-ial s"(c("&s


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M(li%l& sh!" %(ls&s a"& %"!'(c&' +ih a-"i&0 i$&"=al ha all!+s h& "&("$i$/ &ch!s! -& '&&c&' %"!c&ss&' a$' 'is%lay&'.

Th& -asis !0 h& &ch! sys&) is %i&4!&l&c"ic&l&)&$ +hich is a *(a"4 !" c&"a)ic c"ysall!ca&' $&a" h& 0ac& !0 h& %"!-&


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PRINCIPLES AND PHYSICS...


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O%hhal)ic (l"as!$!/"a%hy (s&s high-

frequency sound waves

"a$s)i&' from a probe into the eye.

As h& s!($' +a=&s strike intraocularstructures

h&y a"& reected back to the probe a$'c!$=&"&' i$! a$ &l&c"ic si/$al.

Th& si/$al is s(-s&*(&$ly "&c!$s"(c&' as animage on a monitor

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As h& frequency of USG increases h&wavelength decreases a$' wavelengthof an ultrasound determines its depth oftissue penetration a$' "&s!l(i!$

Wavelength !epth of penetration of theultrasound

S! La"/&" is h& 0"&*(&$cy !0 US sh!"&" isis +a=&l&$/h shall!+&" is is %&$&"ai!$ -&&" is h& "&s!l(i!$ !0 "&s(la$ &ch!/"a%h.


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Tha2s +hy USG probes used for "cularUSG are of higher frequency#$%&'()asit needs much less tissue penetration;a$ &y& is 9. )) l!$/ !$ a=&"a/&< 5

hi/h&" "&s!l(i!$.

I$ c!$"as ultrasound probes used for purposes such as obstetrics* use lower

frequencies #$-+'() for deeper penetration into the body a$' -&ca(s&h& s"(c("&s -&i$/ i)a/&' a"& la"/&" h&y'! $! "&*(i"& h& sa)& '&/"&& !0 "&s!l(i!$


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VELOCITY Th& =&l!ciy !0 h& s!($' +a=& is

dependent on the density of themedium h"!(/h +hich h& s!($' "a=&ls.

S!($' "a=&ls faster through solids than

liquids a$ i)%!"a$ %"i$ci%l& ! ($'&"sa$'si$c& h& eye is composed of both.

Th&"& a"& ,$!+$ =&l!cii&s !0 'i&"&$c!)%!$&$s !0 h& &y& +ih s!($' "a=&li$/h"!(/h -!h a*(&!(s a$' vitreous at aspeed of $*+, meterssecond #ms) andthrough the cornea and lens at anaverage speed of $*/0$ ms

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REFLECTIVITY Wh&$ s!($' "a=&ls 0"!) !$& )&'i() !

a$!h&" )&'i() !0 'i&"&$ '&$siy %a" !0h& s!($' is "&>&c&' 0"!) h& i$&"0ac&-&+&&$ h!s& )&'ia -ac, i$! h& %"!-&.

This is ,$!+$ as a$ &ch! h& /"&a&" h&'&$siy 'i&"&$c& a ha i$&"0ac& h&s"!$/&" h& &ch! !" h& hi/h&" h&"&>&ci=iy

I$ Asca$ (l"as!$!/"a%hy a hi$ parallelsound beam is emitted which passesthrough the eye a$' i)a/&s !$& s)all aFis!0 iss(& the echoes of which arerepresented as spikes arising from a

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http://emedicine.medscape.com/article/1228447-overviewhttp://emedicine.medscape.com/article/1228447-overviewhttp://emedicine.medscape.com/article/1228447-overviewhttp://emedicine.medscape.com/article/1228447-overview


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1n 2-scan ultrasonography a$ oscillatingsound beam is emitted passing throughthe eye a$' i)a/i$/ a slic& !0 iss(& theechoes of which are represented as a

multitude of dots that together form animage on the screen.

Th& s"!$/&" h& &ch! h& -"i/h&" h& '!.

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@!" &Fa)%l& h& '!s ha 0!") h& %!s&"i!"=i"&!(s hyal!i' )&)-"a$& a"& $! as -"i/has h& '!s ha 0!") h& "&i$al )&)-"a$&.

This is =&"y (s&0(l i$ 'i&"&$iai$/ a %!s&"i!"=i"&!(s '&ach)&$ ;a -&$i/$ c!$'ii!$<0"!) a more highly reective retinaldetachment ;a -li$'i$/ c!$'ii!$< -&ca(s&

"&i$a is )!"& '&$s& ha$ =i"&!(s.


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A!LE OF ICI"ECE

Th& a$/l& !0 i$ci'&$c& !0 h& %"!-& is c"iical0!" -!h Asca$ a$' Bsca$ (l"as!$!/"a%hy.

When the probe is held perpendicular!

h& a"&a !0 i$&"&s more of the echo isreected directly back into the probetip a$' s&$ ! h& 'is%lay sc"&&$.

2#


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When held oblique ! h& a"&a i)a/&' part of the echo is reected away fromthe probe tip and less is sent to thedisplay screen.

Th& )!"& !-li*(& h& %"!-& is h&l' 0"!) h&a"&a !0 i$&"&s h& +&a,&" h& "&("$i$/&ch! a$' h(s h& )!"& c!)%"!)is&' h&

'is%lay&' i)a/&.


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"n 3-scan h& /"&a&" h& %&"%&$'ic(la"iyh& more steeply rising the spike is 0"!)-as&li$& a$' h& hi/h&" h& s%i,&.

"n 2-scan h& /"&a&" h& %&"%&$'ic(la"iythe brighter the dots !$ h& s("0ac& !0 h&a"&a !0 i$&"&s

$1


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B&ca(s& =a"i!(s %a"s !0 h& &y& a$' =a"i!(s%ah!l!/i&s a"& 'i&"&$ i$ si4& a$' sha%&($'&"sa$'i$/ his c!$c&% a$' a$ici%ai$/h& -&s %!ssi-l& 'is%lay 0!" ha &y& a"&

i)%!"a$.

P&"%&$'ic(la"iy ! h& a"&a !0 i$&"&ssh!(l' -& )ai$ai$&' ! achi&=& h&s"!$/&s &ch! %!ssi-l& 0!" ha s"(c("&

$2


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Th&"&0!"& Bsca$ sh!(l' -& %&"0!")&' !$h& !%&$ &y& ($l&ss h& %ai&$ is a s)allchil' !" has a$ !%&$ +!($'.

Li,&+is& +h&$ %&"0!")i$/ a$ (l"as!($'h"!(/h a '&$s& caa"ac as !%%!s&' ! h&$!")al c"ysalli$& l&$s )!"& !0 h& s!($' isa-s!"-&' -y h& '&$s& caa"ac!(s l&$s a$'

l&ss is a-l& ! %ass h"!(/h ! h& $&F)&'i() "&s(li$/ i$ +&a,&" &ch!&s a$'i)a/&s !$ -!h Asca$ a$' Bsca$.

$4


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@!" his "&as!$ the best images of the posterior segment are obtained whenthe probe is in contact with the sclerarather than the corneal surface*

bypassing the crystalline lens orintraocular lens implant.

PRINCIPLE O@#ELOCITY RE@LECTI#ITY

ANGLE O@ ABSORPTIO


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PRINCIPLE O@ULTRASOUND

#ELOCITY RE@LECTI#ITYANGLE O@INCIDENCE

ABSORPTION

•USG +a=& has a0"&*(&$cy

,H4.

•Wa=&l&$/h

D&%h !0%&$&"ai!$ !0h& (l"as!($'.

•La"/&" '0"&*(&$cy sh!" +a=&l&$/h shall!+

%&$&"ai!$

-&&" "&s!l(i!$

• S!($'"a=&ls

0as&"h"!(/hs!li's ha$li*(i's.

•#&l!ciy !0s!($' +a=&is '&%&$'s!$ h&'&$siy !0h& )&'ia .

•#i"&!(s69 )s•C!"$&as%&&' !066 )s

• G"&a&" h&'&$siy

'i&"&$c& ai$&"0ac&s"!$/&" h&&ch!hi/h&"h&"&>&ci=iy

• Th& s"!$/&"h& &ch! h&hi/h&" h&s%i,&

• Th& s"!$/&"h& &ch! h&-"i/h&" h&'!.

• P&"%&$'ic(la"

' %"!-& ! h&a"&a !0i$&"&s

)!"& !0 h&&ch! is

"&>&c&''i"&cly -ac,i$! h& %"!-&i%.

-"i/h&" '

s%!.

• M!"&'&$s& h&

)&'i()h& /"&a&"h& a)!($!0a-s!"%i!$.

•Bsca$sh!(l' -&%&"0!")&'!$ h& !%&$&y& ($l&ssh& %ai&$

is a s)allchil' !" hasa$ !%&$+!($'


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USE O@ INCREASING GAIN


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USE O@ DECREASING GAIN


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Wh&$ h& gain is high* weaker signalsare displayed s(ch as =i"&!(s !%acii&sa$' %!s&"i!" =i"&!(s '&ach)&$s.

Wh&$ h& gain is low* the weaker signalsdisappear* and only the strongerechoes s(ch as h& "&i$a "&)ai$ !$ h&sc"&&$.


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Ty%ically all e4aminations begin onhighest gain so that no weak signals aremissed h&$ h& /ai$ is "&'(c&' as$&c&ssa"y 0!" /!!' "&s!l(i!$ !0 h& s"!$/&"

si/$als

4


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INSTRUMENTATION....


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I&TR3ETATIO

O%hhal)ic (l"as!($' i$s"()&$s (s& +hais ,$!+$ as a pulse-echo system* +hichc!$siss !0 a s&"i&s !0 &)i&' %(ls&s !0s!($' &ach 0!ll!+&' -y a -"i&0 %a(s&

;)ic"!s&c!$'s< 0!" h& "&c&i=i$/ !0 &ch!&sa$' %"!c&ssi$/ ! h& 'is%lay sc"&&$.

Th& a)%licai!$ !0 h& 'is%lay ca$ -&

al&"&' -y a'(si$/ h& gain* +hich is)&as("&' i$ '&ci-&ls ;'B


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P"!-&

hic, +ih a )a",

&)i 0!c(ss&' s!($' -&a) a 0"&*(&$cy6)h4

0ar on the % s+an pro,e in(i+ates,ea0 orientation/area to-ar(s -hi+h0ar is (ire+te( appears at the top o)the e+hogra0 on (isp*ay s+reen


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TECHNIQUE....


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Th& %ai&$ is &ih&""&cli$i$/ !$ a chai" !" lyi$/!$ a c!(ch. Th& %"!-& ca$-& %lac&' 'i"&cly !=&" h&

c!$($ci=a !" h& li's.


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PROBE POSITIONS

Trans.erse : )!s c!))!$

La&"al &F&$ cl!c, h!("s

Longitu(ina* : "a'ial 6 cl!c, h"s AP'ia)&&" i$ R&i$al ()!"s a$' &a"s

Aia* : l&si!$ i$ "&lai!$ ! l&$s a$'!%ic $&"=& .


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TRANS#ERSE SCAN

EYE a$a&sh&is&'.

EYE l!!,i$/ i$ h& 'i"&ci!$ !0!-s&"=&"2s i$&"&s

'RO%E %a"all&l ! li)-(s a$' %lac&'!$ h& !%%!si& c!$($ci=al s("0ac&

'RO%E ARER s(%&"i!" ;i0&Fa)i$i$/ $asal !" &)%!"al< !"

$asal;i0 &Fa)i$i$/ s(%&"i!" a$'i$0&"i!"


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Th& cl!c, h!(" +hich h& )a",&"0ac&s is al+ays a h& !% !0 h& sca$.

Th& a"&a !0 i$&"&s i$ a %"!%&"ly'!$& "a$s=&"s& sca$ is al+ays a h&c&$"& !0 h& "i/h si'& !0 sca$.

I0 &Fa)i$i$/ $asal a"&a 6 cl!c,h"s

&)%!"al 6 cl!c,h"s s(%&"i!" 8 9 cl!c,

h"s


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&3'ERIOR AREA IFERIOR AREA


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LONGITUDINAL SCAN

EYE A$a&sh&is&'. EYE l!!,i$/ i$ h& 'i"&ci!$ !0 !-s&"=&"2s

i$&"&s.

PROBE %&"%&$'ic(la" ! h& li)-(s a$'

%lac&' !$ h& !%%!si& c!$($ci=als("0ac&.

PROBE MARKER 'i"&c&' !+a"'s h&li)-(s !" !+a"'s h& a"&a !0 i$&"&s"&/a"'l&ss !0 h& cl!c, h!(" ! -&

&Fa)i$&'.

O%ic $&"=& sha'!+ al+ays a h& -!!)!$ h& "i/h si'&.

6 cl!c, h!(".


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AIAL SCAN

EYE a$a&sh&is&'.

EYE i$ %"i)a"y /a4&

'RO%E c&$&"&' !$ h& c!"$&a .


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HOW THE SCAN LOOKS LIKE..


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Th& %"!-& 0ac& is (s(ally !=al i$ sha%& a$'+h&$ %lac&' !$ h& /l!-& is "&%"&s&$&' -yh& i$iial +hi& li$& !$ h& l&0 si'& !0 h&

'is%lay sc"&&$.

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NORMAL BSCAN

C!"$&a AC a$' h&a$&"i!" ca%s(l&$!&asily =is(alis&'+ih!( i))&"si!$

&ch$i*(& L&$s !=al hi/h

"&>&ci=& s"(c("& #i"&!(s

ac!(sically cl&a" R&i$a ch!"!i' a$'

scl&"as&&$ !/&h&"as a hi/h "&>&ci=&s"(c("&


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Scl&"a 6 "&>&ci=&

O%ic $&"=&+&'/& sha%&' ac!(sic =!i' i$"&"!-(l-a" s%ac& !$ aFial sca$

EF"a!c(la" )(scl&s&ch!l(c&$ ! l!+"&>&ci=& 0(si0!") !"-ial s"(c("&s


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SOME ABNORMAL B SCANS....


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#ITREOUS HAEMORRHAGE

To detect extent, density,

location and cause

Fresh haemorrhage showsdots or lines

Old haemorrhage the dots

gets brighter


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ASTEROID HYALOSIS

As&"!i' hyal!sis:

Calci() s!a%s%"!'(c& -"i/h%!i$ li,& &ch!s


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"i8erentiation ,et-een V9 : asteroi(9ya*osis;

AH is hi/hly &ch!/&$ich&y a"& sill =isi-l&+h&$ h& /ai$ s&i$/ is "&'(c&' (%! 'B+h&"&as #H +hich (s(ally 'isa%%&a"s -y 'B

7


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As&"i!' Hyal!sis #i"&!(s Ha&)!""ha/&

#ITREOUS IN@LAMMATION


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#ITREOUS IN@LAMMATION

USG is =&"y h&l%0(l i$ ass&ssi$/ h& s&=&"iy a$'&F&$ !0 i$"a!c(la" i$>a))ai!$ i$ a %ai&$s(s%&c&' !0 ha=i$/ &$'!%hhal)iis.

#ITRITIS a%%&a"s i$ Bsca$ as scattered particleor large aggregates.

s!)&i)&s i$ a-s&$c& !0 &F&"$al i$>a))a!"ysi/$s i is important to di7erentiate betweenendophthalmitis and vitreous hemorrhage.8' is generally associated with 98! andlayering of blood in inferior portion of theeye to produce sheet-like echoes

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POSTERIOR #ITREOUS DETACHMENT

P!s&"i!" =i"&!(s'&ach)&$:

Th& '&ach&'%!s&"i!" =i"&!(s iss&&$ as

)&)-"a$!(s l&si!$+ih $!s!)&aach)&$s ! h&!%ic 'isc


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POSTERIOR #ITREOUSDETACHMENT

M!-iliy !0 P#D is)!"& ha$ RD.

Th& s%i,& !0 RD is)!"& ha$ P#D.

P#D -&c!)&s )!"&

%"!)i$&$ i$ hi/h&"/ai$ s&i$/s


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TOPOGRAPHIC

EXAMn.

SHAPE

LOCATION

ETENSION

KINETIC

EXAMn.

MOBILITY

A@TERMOBILITY

#ASCULARI TY

QUANTITATIVE

EXAMn.

RE@LECTI#I TY

;SPIKE H. 5PEAKS<

TETURE

SOUNDATTENUATI

ON

'V"RETIA

"ETAC9EC9OROI"

"ETAC9E


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'V" "ETAC9ET

"ETAC9ET

SHAPE Linear

LOCATION

ATTCH. TO ON Variable Yes No

OTHER Thicker inferiorly Folds/Breaks Vortex Vein

SPIKE HT. 40-90% 0-!00% 90-!00%

SPIKE PEAKS"in#le "in#le

$oble / & sha'e

'eak

MOBILITY&arked ()a**ock

like+&oderate &ini*al

A@TER MO#MT. &arked&oderate to

se,erebsent


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RETINAL DETACHMENT

Th& '&ach)&$%"!'(c&s a -"i/hc!$i$(!(s 0!l'&'a%%&a"a$c& +ihi$s&"i!$ i$! h& 'isca$' !"a s&""aa.

I is ! '&&")i$& h&c!$/("ai!$ !0 h&

'&ach)&$ asshall!+ >a !" -(ll!(s


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EUDATI#E RETINAL DETACHMENT


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RHEGMATOGENOUS RD


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RHEGMATOGENOUS RETINALDETACHMENT


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CLOSED @UNNEL RD WITH

RETINAL CYST


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CLOSED @UNNEL RD WITH

RETINAL CYST


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Appears as rd but it is a pvd.

Clues: non uniform thicness of membrane Very thin attachment to the disc.


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RETINAL TEAR


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R&i$al &a" +ih 0"&& s(%&"i!" &$' . Th& )&)-"a$& is c!$=!l(&' !$ is&l0.

P!s&"i!" =i"&!(s is aach&' a h& s(%&"i!"&$' !0 h& &a".


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Di&"&$iai!$ &F"ascl&"al &F&$si!$ si4&ass&ssi$/ ()!(" /"!+h !" "&/"&ssi!$.

M&as("&)&$ !0 ()!(" 'i)&$si!$s s(ch as

&l&=ai!$ a$' -as&. H&l% i$ 'isi$/(ishi$/ s!li' 0"!) cysic

l&si!$s.

TUMOURS


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RETINOBLASTOMA


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RETINOBLASTOMA

Si4& !0 h& ()!("

Sh!+s i""&/(la"c!$/("ai!$

Calcicai!$ sh!+shi/h i$&"$al"&>&ci=iy


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IRIS MELANOMA


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COLLAR BUTTON OR MUSHROOM

SHAPE.LARGE TUMOURS SHOWSACOUSTIC HALLOWING


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TUMOURS OSTEOMA

CHOROIDAL DETACHMEN


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CHOROIDAL DETACHMEN T: KISSING CHOROIDS

Smooth, thick, dome shaped

membrane in the periphery with

very little after movement

!" de#ree detachment shows a

patho#nomonic $scallopedappearance


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CHOROIDAL DETACHMENT

KISSING CHOROIDS


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CHOROIDAL DETACHMENT


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INTRAOCULAR @OREIGN BODIES:

L!calisai!$ a$' &F&$ !0 i$"a!c(la"'a)a/&

M&allic 0!"&i/$ -!'i&s %"!'(c& =&"y hi/h

-"i/h si/$al

Sha'!+ %"&s&$ %!s&"i!" ! h& 0!"&i/$-!'y

W!!' /lass a$' !"/a$ic )a&"ial %"!'(c&s%&cic &ch!/"a%hic $'i$/


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INTRA OCULAR @OREIGN BODY


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CUPPED DISC


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MACULAR EDEMA


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PERSISTENT HYALOIDAL #ESSEL


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POSTERIOR STAPHYLOMA


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LACRIMAL GLAND TUMOUR


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NANOPHTHALMOS


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RETINOSCHISIS


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Retinos+hisis; S)!!h hi$ '!)& sha%&' )&)-"a$& ha

'!&s$2 i$s&" !$ !%ic 'isc

"ia,eti+ retinopathy; Na("& a$' &F&$ !0 h& 'is&as& T! )!$i!" %"!/"&ss !0 h& 'is&as& Ai's i$ %"& =i"&c!)y &=al(ai!$


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ENDOPHTHALMITIS

CYSTICERCOSIS WITH RETINAL


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CYSTICERCOSIS WITH RETINAL TEAR


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COLOBOMA O@ THE CHOROID

AND DISC


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PERSISTENT @ETAL #ASCULATURE


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RETINOPATHY O@ PREMATURITY


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POSTERIORLY DISLOCATED LENS


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INTRA OCULAR AIR GAS


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SILICON OIL @ILLED #ITREOUS


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SCLERITIS

NODULAR POSTERIOR SCLERITIS WITH @LUID IN THE


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NODULAR POSTERIOR SCLERITIS WITH @LUID IN THE TENON CAPSULE. POSITIVE T-SIGN AT THE INSERTION OF THE OPTICNERVE.


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N!")al )(scl&s sh!+ l&ss &ch! '&$s& ha$

s(""!($'i$/ !"-ial s!0 iss(&

D!c()&$i$/ h& /"!ss si4& a$' c!$!(" !0 a)(scl&


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E#ALUATION O@ OPTIC NER#E

G&$&"al !%!/"a%hy "&lai!$shi% !s"(c("&s !%ic 'isc a$!)ali&s a$'al&"ai!$ i$ c!$!(" !0 h& /l!-&

Th& s(-a"ach$!i' s%ac& s(""!($'i$/!%ic $&"=& a%%&a"s as &ch!l(c&$

c"&s&$"ic !" ci"cl& a"!($' h& $&"=&call&' 1"oughnut sign


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N!$ i$=asi=&

P&"0!")&' i$ a$ !c& s&i$/

D!&s $! &F%!s& ! "a'iai!$

Hi/h "&s!l(i!$ &ch!/"a%hy %"!=i'&s"&lia-l& a$' acc("a& ass&ss)&$

I'&al 0!" 0!ll!+ (% !0 l&si!$

AD#ANTAGES:


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DISAD#ANTAGES

Hi/h 0"&*(&$cy s!($'s +a=&s ha=& li)i&'%&$&"ai!$


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PIT@ALLS


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PIT@ALLS.....


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Arte)a+ts;

I$s(ci&$ >(i' c!(%li$/ ; i.&. lac, !0

)&hyl c&ll(l!s&< ca(s& &$"a%)&$!0 ai" -&+&&$ h& %"!-& a$' &y&l&a'i$/ ! 'is%lay !0 -"i/h &ch!s+hich "&%"&s&$ )(li%l& si/$als

RE#ERBERATION ARTE@ACTS


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RE#ERBERATION ARTE@ACTS

ANGLE O@ INCIDENCE ARTE@ACT


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ANGLE O@ INCIDENCE ARTE@ACT


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T()!("s:

Mass )ay -& )iss&' is l&ss ha$ .7 ))

@als& =& "&s(ls i$ cas& !0 s)all l&si!$ a$'-"!ic iss(&

@als& V =& i$ s(-"&i$al ha&)!""ha/& a$')&asaic ()!(" +ih )assi=& i$l"ai!$


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#i"!"&i$al 'is&as&:

I$ RD ($a-l& ! '&&c ac(al &a"

I$ =i"&c!)is&' &y&s =i"&!(sha&)!""ha/& is 'i(s& l&a'i$/ !&ch!l(c&$cy

Silic!$ !il '&c"&as& i$ s!($' =&l!ciy


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I$"a!c(la" 0!"&i/$ -!'y:

S)all I$"a!c(la" 0!"&i/$ -!'y !0 6))

)ay -& )iss&'.

O"-i:

A$ !"-ial )ass ca$ -& '&&c&' !"

'i&"&$ia&' i0 9 )) i$ si4& i0 a$&"i!"a$'

)) i$ %!s&"i!" !"-is.

B SCAN REPORTING


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B SCAN REPORTING

D&sc"i-& h& 0&a("&s a$' c!""&la& +ihcli$ical $'i$/s.

D!$ ()% ! 'ia/$!sis.

Al+ays &Fa)i$& -!h i$ sii$/ a$' &"&c%!s("&s i$ cas& !0 RD.

EFa)i$& !h&" &y& als!.

T"y ! a,& h& -&s %ic("& %!ssi-l&.


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@!(" "a$s=&"s& sca$s

O$& h!"i4!$al aFial sca$ ! &=al(a& h&%!s&"i!" %!l& a"& s(ci&$.

CAUTION


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Correlation with clinical findings is essential to make a

diagnosis


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Date post:	06-Jul-2018
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