Ultrasonography

What is ultrasonography?

Ultrasound uses high frequency sound waves and their echoes to make cross-sectional images of the inside of your child's body. Ultrasound produces no radiation and is painless.

• The sound waves go through your child's skin and reflect or "echo" in a different way off of each part of the body, such as bone, fluid and soft tissue
• These echoes form a picture
• The technique is similar to the echolocation used by bats, whales and dolphins, and SONAR used by ships and submarines.

When is ultrasonography needed?

Ultrasound can be performed on many parts of the body. Some include:

Abdomen

An abdominal ultrasound is an ultrasound of the internal organs, including the liver, gallbladder, spleen, pancreas, kidneys and bladder. We perform an abdominal ultrasound when a child has:

• abdominal pain
• stones in the gallbladder or kidneys
• enlargement of an abdominal organ
• pyloric stenosis
• appendicitis

Head

A head ultrasound is an ultrasound of the brain. It looks at the brain tissues and ventricles. It is usually performed on infants who still have a soft spot (called the fontanelle) in their skulls. We perform a head ultrasound when:

• A baby has an enlarged head circumference
• screening for bleeding in the brain, especially in premature babies
• looking for signs of infection
• screening for congenital abnormalities

Hip

Hip ultrasound is used to take pictures of the hips of babies to look for a dislocated or underdeveloped hip. It can be performed in babies from the newborn period to about six months of age. We perform a hip ultrasound when:

• an abnormality is found through physical examination of a baby's hip
• a family has history of hip dysplasia
• a baby is breech

Kidney

A kidney ultrasound takes pictures of both kidneys and the urinary bladder. It does not directly test the function of the kidneys.  Some reasons we perform a kidney ultrasound are:

• prenatally detected abnormalities (such as hydronephrosis)
• urinary tract infection
• blood in the urine
• high blood pressure
• back or abdominal pain
• known or suspected kidney stones
• family history of kidney disease
• syndromes and conditions associated with kidney abnormalities.

Pelvic

A pelvic ultrasound is used to take pictures of the pelvic organs, and is usually done to look at the uterus and ovaries in a girl. It will also be used to look at the bladder. Pelvic ultrasound can also be done in boys. A pelvic ultrasound is done to look for a cause of pelvic pain or search for a possible mass.

Spine

A spine ultrasound is used to take pictures of the spinal cord and surrounding structures in a baby who is usually less than 4 months old. A spine ultrasound is done to look for an abnormality of the spinal cord.

What kind of equipment do we use to perform ultrasounds?

• Ultrasound machines are about the size of a grocery cart.
• A TV screen for viewing the images is attached to the machine.
• Ultrasound machines are portable and require no special support or shielding other than a good source of electricity.
• The room used for scanning has dim lighting so that the pictures can be seen more clearly.

How should I prepare my child for an ultrasound?

Most ultrasound studies require no special preparation. However, some exams do require special preparation, such as an empty stomach or full bladder. The examinations that require preparation are listed below. If these guidelines are not followed, your child's examination may be delayed:

Abdominal ultrasound

Abdomen and pelvic ultrasound

Follow the same instructions as for an abdominal ultrasound. A very full urinary bladder is required to view the organs in the pelvis:

• Children who are 1 or older should drink water prior to the exam. If your child is toilet trained, he should not empty his bladder until the study is finished.
• Prior to the age of toilet training, or in situations where the child is not continent, we will do our best to image when your child's bladder is as full as possible.
• We may give your child water to drink and ask you to wait for a period of time in our department until your child's bladder is full. 

Pelvic ultrasound 

A very full urinary bladder is required to view the organs in the pelvis:

• Children who are 1 or older should drink water prior to the exam. If your child is toilet trained, he should not empty his bladder until the study is finished.
• Prior to the age of toilet training, or in situations where the child is not continent, we will do our best to image when your child's bladder is as full as possible.
• We may give your child water to drink and ask you to wait for a period of time in our department until your child's bladder is full. 

Renal ultrasound 

Generally, no preparation is required. However, if symptoms include hematuria (blood in the urine), we will want to scan your child with a full bladder. Fluids should be encouraged in this situation and your child should not empty his bladder prior to his exam. 

What should I expect when I bring my child to the hospital for an ultrasound?

When you arrive, please go to the Ultrasound check-in desk on the second floor of the main hospital or the Radiology check-in desk at our Waltham or Lexington facilities. An ambulatory service representative will check in your child and verify his registration information.

What happens during the ultrasound?

• You and your child will be escorted into one of our scanning rooms.
• You are encouraged to stay with your child the entire time.
• Most patients will not be asked to remove their clothing.
• The sonographer will position your child on the examination table, move his clothing aside and place some warm gel on the area of his body being imaged.
• The sonographer will place a transducer, which is shaped a bit like a microphone, on the area of your child's body that is being examined and move it around in order to take the pictures.
• Your child will be encouraged to lie as still as possible.
• Once the pictures are made, the sonographer will review them with one of our pediatric radiologists. In some cases, the radiologist will scan your child as well.

Depending on the examination, scanning takes between 10 and 30 minutes.

Will my child feel anything during the ultrasound?

Ultrasound is painless.

What happens after the ultrasound?

The radiologist reviews your child's images and creates a written report of the findings and diagnosis.

How do I learn the results of the ultrasound?

The radiologist will provide a report to the doctor who ordered your child's ultrasound.