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B – SCAN  ULTRASONOGRAPHY       Dr. Parameshwar Rao   Dr. Haridev   Dr. Ashok   Dr. Siva Kumar.W (PG)
INTRODUCTION ,[object Object],[object Object]
[object Object],[object Object]
B - SCAN ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
sound waves from transmitter Echoes are received by receiver Amplification Oscilloscope screen Target tissue
 
[object Object],[object Object],[object Object],[object Object],[object Object],Types of frequency
[object Object],[object Object]
[object Object],[object Object],[object Object]
INCREASE IN GAIN -  INCREASE IN TISSUE PENETRATION AND SENSITIVITY – DECREASE IN RESOLUTION.
[object Object],[object Object]
AMPLIFICATION ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Instrumentation:
[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Indications:
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The patient is either reclining on a chair or lying on a couch. The probe can be placed directly over the conjunctiva or the lids. Examination technique:
Probe positions  ,[object Object],[object Object],[object Object],[object Object]
Transverse scan ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NASAL  AREA  TEMPORAL AREA
SUPERIOR AREA INFERIOR AREA
 
Longitudinal scan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Axial scan  ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Anterior segment evaluaton  ,[object Object],[object Object]
ULTRASONOGRAPHIC     CHARACTERISTICS
VITREOUS HAEMORRHAGE To detect extent, density, location and cause Fresh haemorrhage  shows dots or lines Old haemorrhage  the dots gets brighter
POSTERIOR VITREOUS DETACHMENT Posterior vitreous detachment: The detached posterior vitreous is seen as membranous lesion with no/some attachments to the optic disc
POSTERIOR VITREOUS DETACHMENT  Mobility of PVD is more than RD. The spike of RD is more than PVD. PVD becomes more prominent in higher gain settings
RETINAL  DETACHMENT The detachment produces a bright continuous, folded appearance with insertion into the disc and ora serrata. It is to determine the configuration of the detachment as shallow, flat or bullous
EXUDATIVE RETINAL DETACHMENT
RHEGMATOGENOUS RD
[object Object]
CLOSED FUNNEL RD WITH RETINAL CYST
CLOSED FUNNEL RD WITH RETINAL CYST
APPEARS  AS RD BUT IT IS A PVD. CLUES : NON UNIFORM THICNESS OF MEMBRANE VERY THIN ATTACHMENT TO THE DISC.
RETINAL TEAR
RETINAL TEAR WITH  FREE SUPERIOR END . THE MEMBRANE IS CONVOLUTED ON  ITSELF. POSTERIOR VITREOUS IS ATTACHED AT THE SUPERIOR END OF THE TEAR.
ASTEROID  HYALOSIS Asteroid hyalosis: Calcium soaps produce bright point like echos
[object Object],[object Object],[object Object],TUMOURS
RETINOBLASTOMA Size of the tumour Shows irregular configuration Calcification shows high internal reflectivity
 
 
Collar button or mushroom shape.Large tumours shows acoustic hallowing MELANOMA
TUMOURS - OSTEOMA
CHOROIDAL DETACHMENT   KISSING CHOROIDS Smooth, thick, dome shaped membrane in the periphery with very little after movement 360 degree detachment shows a pathognomonic “scalloped appearance
CHOROIDAL DETACHMENT   KISSING CHOROIDS
CHOROIDAL DETACHMENT
[object Object],[object Object],[object Object],[object Object],[object Object]
INTRA OCULAR FOREIGN BODY
CUPPED  DISC
MACULAR  EDEMA
PERSISTENT HYALOIDAL VESSEL
POSTERIOR STAPHYLOMA
LACRIMAL GLAND TUMOUR
NANOPHTHALMOS
RETINOSCHSIS
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ENDOPHTHLMITIS
CYSTICERCOSIS WITH RETINAL TEAR
COLOBOMA OF THE CHOROID AND DISC
PERSISTENT FETAL VASCULATURE
RETINOPATHY OF PREMATUIRITY
POSTERIORLY DISLOCATED LENS
INTRA OCULAR AIR / GAS
SILICON OIL FILLED VITREOUS
[object Object],[object Object],[object Object]
SCLERITIS
[object Object],[object Object],[object Object],Evaluation of extraocular muscles:
Nodular posterior scleritis with fluid in the Tenon capsule.   Positive T-sign at the insertion of the optic nerve.
Evaluation of optic nerve ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Advantages:
Disadvantages ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ULTRASONOGRAPHY IN PAEDIATRIC PATIENTS:
[object Object],[object Object],PITFALLS
REVERBERATION ARTEFACTS
ANGLE OF INCIDENCE ARTEFACT
PITFALLS ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],PITFALLS
PITFALLS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
B- SCAN REPORTING ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
THANK YOU

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B-Scan Ultrasonography Guide