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Ultrasound uses high-frequency sound waves to create live images of the inside of the body. A small handheld probe, called a transducer, sends sound waves into the tissues and listens for the echoes that bounce back, and a computer turns those echoes into a picture. Most people think of ultrasound in pregnancy, but it is one of the most useful tools in everyday medicine, from finding a kidney stone to checking blood flow in the neck.
Ultrasound is safe and non-invasive. Unlike x-rays or CT scans, it does not use ionizing radiation, and the FDA describes its safety record as excellent. That makes it a good first test, and one that can be repeated as often as needed to follow a problem over time.
At NYMD Center, ultrasound is done in our own offices, usually at or near the time of your visit, by our long-time sonographer. Having it on site means you do not need a separate trip to an imaging center, and your physician can review the images with you and act on the findings without waiting days for a report.
What we use ultrasound for
Because our group includes urology, gynecology, internal medicine and vascular care, we use ultrasound across a wide range of questions.
Kidney and bladder
Kidney ultrasound shows kidney stones, blockage and swelling of the kidneys, cysts and masses. Bladder ultrasound measures how much urine is left after you urinate, called the post-void residual, which helps us understand urinary retention, weak stream and overactive bladder symptoms, and it can reveal bladder stones or thickening of the bladder wall.
Prostate
Prostate ultrasound measures the size and shape of the gland, which guides treatment for an enlarged prostate and helps interpret a PSA result. Combined with a bladder scan, it shows how much the prostate is affecting bladder emptying.
Scrotal and testicular
Scrotal ultrasound evaluates lumps, swelling or pain in the testicles, and distinguishes solid masses from fluid collections such as a hydrocele or cyst. With Doppler, it also shows blood flow, which helps identify a varicocele or inflammation.
Pelvic and transvaginal
Our gynecologists use pelvic ultrasound to examine the uterus and ovaries for fibroids, ovarian cysts, the causes of heavy or irregular bleeding and pelvic pain, and IUD position. A transvaginal ultrasound, in which a covered probe is placed in the vagina, gives a closer and clearer view of these organs.
Thyroid
Thyroid ultrasound shows the size of the gland and any nodules, including their size and features, which helps decide whether a nodule can simply be watched or needs a biopsy. It is part of our care for thyroid disease.
Abdominal
Abdominal ultrasound examines the liver, gallbladder, pancreas, kidneys and the abdominal aorta. It is the standard first test for gallstones and gallbladder disease, shows fatty liver and other liver changes, and can detect an abdominal aortic aneurysm.
Vascular and Doppler
Doppler ultrasound measures blood flow and its speed and direction. The National Institute of Biomedical Imaging and Bioengineering notes it is commonly used to detect blockages in the arteries that supply the brain. We use carotid ultrasound to look for plaque and narrowing in carotid artery disease, and leg vein ultrasound to check for blood clots (deep vein thrombosis) and vein problems. Our vascular specialists at 1Vascular use the same studies to plan treatment.
Ultrasound can also be used to evaluate a breast lump or an inflamed joint when your physician orders it. An echocardiogram, an ultrasound of the heart, is not done in our offices; when you need one, we arrange it by referral and your physician reviews the results with you.
How to prepare
Preparation depends on the type of scan, and our staff will tell you exactly what to do when you schedule. For bladder and abdominal pelvic ultrasounds, you will usually be asked to arrive with a full bladder, which means drinking water beforehand and not urinating until the scan is done. A transvaginal ultrasound is done with the bladder empty or partly full. For a gallbladder or abdominal ultrasound, you will be asked not to eat or drink for several hours beforehand, because eating makes the gallbladder contract and harder to see. Most other scans, including thyroid, scrotal and vascular studies, need no special preparation. Wear comfortable clothing that makes the area easy to reach.
What to expect during the scan
You will lie on an exam table, and the sonographer applies a warm, water-based gel to the skin over the area being examined. The gel removes air pockets that would block the sound waves. The transducer is then moved over the area, sometimes with gentle pressure, while images appear on the screen. You may be asked to change position or hold your breath briefly. Ultrasound is painless for most people, though pressing on a tender area or on a full bladder can be uncomfortable. Most scans take less than 30 minutes, and you can return to your normal activities right away.
Getting your results
After the scan, your physician reviews the images and explains the findings with you. If the ultrasound shows something that needs another look, such as a nodule, a mass or a clot, we tell you what it means and arrange the next step, whether that is follow-up imaging, a biopsy, a CT or MRI, or treatment. A suspected blood clot is treated as urgent.
Questions patients ask
Is ultrasound safe?
Yes. Ultrasound uses sound waves rather than ionizing radiation, so it does not carry the radiation exposure of an x-ray or CT scan. It has a long record of safe use, is non-invasive and can be repeated as often as needed to follow a condition over time. Most scans are painless, although pressure on a tender area can be uncomfortable.
Do I need a full bladder for my ultrasound?
It depends on the scan. Bladder and abdominal pelvic ultrasounds usually require a full bladder, so you will be asked to drink water beforehand and hold it until the scan is done. Transvaginal ultrasounds are done with an empty or partly full bladder. Our staff will tell you what to do when you schedule.
Do I need to fast before an ultrasound?
Only for some scans. A gallbladder or abdominal ultrasound usually requires not eating or drinking for several hours beforehand, because food makes the gallbladder contract and harder to see. Thyroid, scrotal, vascular and prostate ultrasounds usually need no fasting. We give you specific instructions when your scan is booked.
How long does an ultrasound take?
Most scans take less than 30 minutes, though the time varies with the area being examined and whether more than one area is scanned. Doppler studies of the blood vessels can take a bit longer. You can go back to your usual activities right after the exam.
When will I get my ultrasound results?
Because the ultrasound is done in our office, your physician reviews the images and goes over the findings with you, without sending you to an outside imaging center. If a result needs further testing, such as follow-up imaging or a biopsy, we explain why and arrange the next step for you.