CHAPTER

88

Abdominal
Ultrasonography
Rachel
E.
Pollard

Abdominal
ultrasound
has
become
a
common
and
valuable
tool
in
the
diagnostic
arsenal
for
small
animal
practitioners
(also
see
ch.
143).
A
fundamental
understanding
of
ultrasound
physics
and
imaging
principles
can
allow
the
user
to
make
basic
diagnoses.
Moreover,
a
consistent
and
repeatable
methodology
for
performing
an
abdominal
ultrasound
examination
will
minimize
errors,
omissions,
and
missed
lesions.

Ultrasound Physics
Medical
ultrasound
functions
in
a
way
similar
to
sonar.
A
sound
beam
of
a
specific
frequency
(megahertz
[MHz])
is
sent
into
the
area
of
interest
by
the
transducer.
The
transducer
waits
for
the
returned
echoes
and
“listens”
for
their
amplitude
(intensity)
and
location
(directly
related
to
how
long
it
takes
for
the
echo
to
return).
Once
the
ultrasound
beam
enters
the
area
of
interest,
it
can
be
absorbed,
refracted,
or
reflected.
If
the
beam
is
absorbed,
no
ultrasound
waves
will
return
to
the
transducer
and,
consequently,
no
information
becomes
available
for
generating
an
image.
Similarly,
if
the
ultrasound
waves
are
refracted,
their
pathway
is
altered
such
that
they
do
not
return
to
the
transducer.
Thus,
only
ultrasound
waves
that
enter
the
body,
encounter
an
object
(tissue),
and
are
reflected
directly
back
to
the
transducer
are
used
to
generate
an
image.
Highly
reflective
structures
will
appear
bright
(gas,
mineral),
whereas
parenchymal
organs
will
be
variable
in
their
reflectivity
and
appear
as
shades
of
gray.

Tissue Characteristics
Most
organs
are
described
according
to
their
size,
shape,
echogenicity
(brightness)
and
echotexture
(parenchymal
pattern).
Size
and
shape
are
self-explanatory
terms
and
will
not
be
further
discussed.
Echogenicity
is
assessed
on
a
relative
scale
in
comparison
to
other
organs
and
to
what
is
anticipated
as
normal.
An
object
or
tissue
that
is
anechoic
has
no
echogenicity
and
is
black.
An
object
that
is
bright
in
comparison
to
other
objects
or
the
anticipated
norm
is
hyperechoic.
An
object
that
is
dark
in
comparison
to
other
objects
or
the
anticipated
norm
is
hypoechoic.
A
relative
scale
of
normal
tissue
echogenicity
can
be
established
(Table
88-1).
It
is
essential
to
compare
tissues
to
one
another
in
order
to
establish
true
echogenicity
since
tissue
brightness
can
also
be
affected
by
machine
settings.
However,
using
this
scale
of
relative
echogenicities,
one
can
define
pathologic
changes.
For
example,
a
fibrotic
or
fat-infiltrated
liver
will
become
more
hyperechoic
than
it
should
be
in
comparison
to
other
organs
because
it
has
been
infiltrated
by
more
hyperechoic
tissue.
Similarly,
an
edematous
or
congested
spleen
will
become
more
hypoechoic
than
it
should
be
in
comparison
to
other
organs
since
it
contains
more
fluid
than
it
should.

TABLE 88-1
A List of Tissues in Order of Relative Echogenicity from Darkest (Fluid) to Brightest (Mineral, Gas)

TISSUE ECHOGENICITY

Water/fluid Anechoic

Renal
medulla Hypoechoic
Renal
cortex Medium
echogenicity

Liver Medium
echogenicity

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