Ecografía del aparato urinario / Ultrasound of the urinary system

La ecografía es una técnica que permite una exploración bastante completa del aparato urinario, alcanzando una alta sensibilidad para la detección de enfermedades relevantes, sobre todo a nivel renal, vesical y prostático. La detección temprana de afecciones como los tumores o la obstrucción de la vía urinaria, en ocasiones incluso antes de presentar expresión clínica, ha mejorado su manejo y pronóstico en muchas ocasiones. Esto, junto con su bajo coste e inocuidad, convierte a la ecografía en la técnica idónea para el abordaje inicial y el seguimiento de un número amplio de enfermedades del aparato urinario. En el presente artículo se revisan las características ecográficas de las principales afecciones que se pueden diagnosticar con esta técnica en el aparato urinario (AU)

Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed (AU)

Ecografía de bazo y retroperitoneo / Ultrasound of spleen and retroperitoneum

La ecografía aporta datos de extraordinario valor a la hora de estudiar la enfermedad esplénica, resultando diagnóstica en la esplenomegalia y traumatismos esplénicos, y muy orientadora en enfermedad focal tanto benigna como maligna, con especial mención del linfoma. En la evaluación de la enfermedad suprarrenal y retroperitoneal, sin embargo, la ecografía se ve superada por otras técnicas como la TAC o la RMN, si bien sigue constituyendo un excelente método de screening y de seguimiento, y resulta también en ocasiones útil a la hora de un abordaje terapéutico no invasivo (AU)

Ultrasound provides data of extremely great value when studying spleen pathology, being diagnostic in splenomegaly and splenic trauma, as well as offering a good approach to the diagnosis of both benign and malignant focal pathology, particularly lymphoma. However, for the evaluation of adrenal and retroperitoneal diseases, other techniques such as CT or MRI are more suitable, even though ultrasound is still an excellent screening and monitoring method, as well as being useful in non-invasive therapeutic approaches (AU)

Ecografía hepática: lesiones focales y enfermedades difusas / Liver ultrasound: focal lesions and diffuse diseases

La ecografía hepática es actualmente la primera técnica diagnóstica para la detección y caracterización de la mayoría de las lesiones del hígado, especialmente en la detección de lesiones focales o en el seguimiento de las enfermedades hepáticas crónicas. No solo se utiliza el modoB, sino también el doppler color y más recientemente la ecografía con contraste. Se usa principalmente en el diagnóstico de enfermedades hepáticas difusas como la esteatosis, la hepatopatía crónica y la cirrosis. En este artículo se van a revisar las características principales de las lesiones focales fundamentales y los principales signos de enfermedades difusas (AU)

Liver ultrasound is frequently used as a first-line technique for the detection and characterization of the most common liver lesions, especially those incidentally found focal liver lesions, and for monitoring of chronic liver diseases. Ultrasound is not only used in the Bmode, but also with Doppler and, more recently, contrast-enhanced ultrasound. It is mainly used in the diagnosis of diffuse liver diseases, such as steatosis or cirrhosis. This article presents a practical approach for diagnosis workup, in which the different characteristics of the main focal liver lesions and diffuse liver diseases are reviewed (AU)

Ecografía de los grandes vasos abdominales / Ultrasound of the large abdominal vessels

La ecografía se ha convertido en los últimos tiempos en una herramienta indispensable para el médico de familia, tanto si ejerce en atención primaria como en urgencias; y del mismo modo se ha extendido a muchas otras especialidades: medicina interna, cuidados intensivos, neurología, neumología, digestivo, etc., ya que los ultrasonidos han demostrado ser una herramienta segura y tener gran capacidad diagnóstica. Nosotros creemos firmemente que la ecografía realizada a 'pie de cama' del paciente, realizada por el médico de familia, puede complementar en gran medida la exploración física y mejorar sobremanera la eficacia del clínico, permitiendo al explorador una visión inmediata a la anatomía y fisiología de determinadas estructuras. Es dentro de este contexto donde cobra especial relevancia el estudio ecográfico de la aorta y de los grandes vasos abdominales, realizado por el propio médico de familia o de urgencias, que vamos a desarrollar a lo largo de este artículo (AU)

Ultrasound has recently become an indispensable tool for the family physician, whether exercised in primary care and emergency department; and likewise it has spread to many other specialties: internal medicine, critical care, neurology, pneumology, digestive, etc. and that ultrasound has proven to be a safe diagnostic tool and have great capacity. We firmly believe that ultrasound done to 'bedside' the patient by the family doctor, can greatly complement the physical examination and greatly improve clinical effectiveness, allowing the browser an immediate view of the anatomy and physiology of certain structures. It is within this context is particularly relevant ultrasonography of the Aorta and large abdominal vessels, made by the family doctor or the emergency itself, which will develop along this chapter (AU)

Ecografía de la vesícula y la vía biliar / Ultrasound of gallbladder and bile duct

La naturaleza quística de la vesícula y de las vías biliares cuando están dilatadas, y las ventajas de la ecografía como técnica rápida, repetible, cómoda, de bajo coste, exenta de riesgo y con una sensibilidad y especificidad altas, hacen que esta se considere la técnica de elección en el estudio de la enfermedad biliar. Para el médico, la ecografía es una herramienta valiosa para el estudio de la enfermedad biliar y sus complicaciones, desde alteraciones analíticas en el perfil hepático, pasando por el dolor en el hipocondrio derecho o ictericia, hasta la sospecha de colelitiasis, colecistitis o tumores biliares (AU)

The cystic nature of the gallbladder and bile duct when dilated, and the advantages of ultrasound as a quick, reproducible, convenient, cheap and low risk technique, with a high sensitivity and specificity, make it the most eligible technique in biliary pathology studies. Ultrasound has become a valuable tool for doctors studying biliary pathology and its complications, from abnormal liver function results, right upper quadrant pain, or jaundice, to cholelithiasis, cholecystitis, or suspicion of biliary tumors (AU)

[Ultrasound of spleen and retroperitoneum]. / Ecografía de bazo y retroperitoneo.

Ultrasound provides data of extremely great value when studying spleen pathology, being diagnostic in splenomegaly and splenic trauma, as well as offering a good approach to the diagnosis of both benign and malignant focal pathology, particularly lymphoma. However, for the evaluation of adrenal and retroperitoneal diseases, other techniques such as CT or MRI are more suitable, even though ultrasound is still an excellent screening and monitoring method, as well as being useful in non-invasive therapeutic approaches.

[Ultrasound of the urinary system]. / Ecografía del aparato urinario.

Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed.

[Ultrasound of gallbladder and bile duct]. / Ecografía de la vesícula y la vía biliar.

The cystic nature of the gallbladder and bile duct when dilated, and the advantages of ultrasound as a quick, reproducible, convenient, cheap and low risk technique, with a high sensitivity and specificity, make it the most eligible technique in biliary pathology studies. Ultrasound has become a valuable tool for doctors studying biliary pathology and its complications, from abnormal liver function results, right upper quadrant pain, or jaundice, to cholelithiasis, cholecystitis, or suspicion of biliary tumors.

[Ultrasound of the large abdominal vessels]. / Ecografía de los grandes vasos abdominales.

Ultrasound has recently become an indispensable tool for the family physician, whether exercised in primary care and emergency department; and likewise it has spread to many other specialties: internal medicine, critical care, neurology, pneumology, digestive, etc. and that ultrasound has proven to be a safe diagnostic tool and have great capacity. We firmly believe that ultrasound done to «bedside¼ the patient by the family doctor, can greatly complement the physical examination and greatly improve clinical effectiveness, allowing the browser an immediate view of the anatomy and physiology of certain structures. It is within this context is particularly relevant ultrasonography of the Aorta and large abdominal vessels, made by the family doctor or the emergency itself, which will develop along this chapter.

[Liver ultrasound: focal lesions and diffuse diseases]. / Ecografía hepática: lesiones focales y enfermedades difusas.

Liver ultrasound is frequently used as a first-line technique for the detection and characterization of the most common liver lesions, especially those incidentally found focal liver lesions, and for monitoring of chronic liver diseases. Ultrasound is not only used in the Bmode, but also with Doppler and, more recently, contrast-enhanced ultrasound. It is mainly used in the diagnosis of diffuse liver diseases, such as steatosis or cirrhosis. This article presents a practical approach for diagnosis workup, in which the different characteristics of the main focal liver lesions and diffuse liver diseases are reviewed.

Ecografía pancreática / Pancreatic ultrasonography

La ecografía abdominal continúa siendo la primera exploración a realizar en los pacientes con sospecha de enfermedad pancreática. Pese a los recientes avances tecnológicos en las pruebas de imagen, la ecografía no ha sido desplazada como primer escalón diagnóstico debido a su inocuidad, accesibilidad y bajo coste. Se trata de una técnica fundamental en el estudio de los procesos inflamatorios, ya que no solo valora las alteraciones del parénquima pancreático, sino que orienta la etiología (biliar o alcohólica), es fundamental en la detección y el seguimiento de las posibles complicaciones y sirve como guía en las punciones tanto diagnósticas como terapéuticas. Es también la primera técnica a utilizar en el estudio de los tumores pancreáticos, con una sensibilidad en la detección de los mismos en torno al 70%, y una especificidad del 90% (AU)

Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90% (AU)

[Pancreatic ultrasonography]. / Ecografía pancreática.

Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90%.

Anatomía ecográfica abdominal normal. Sistemática de exploración / Normal abdominal ultrasound anatomy. Examination procedure

Para realizar una exploración ecográfica abdominal lo más completa y precisa posible es fundamental conocer bien la anatomía y las medidas normales de los distintos órganos. De esta manera conoceremos la normalidad y con mayor facilidad identificaremos la patología y su localización. Es muy importante tener una adecuada sistemática de exploración con el fin de llevar siempre la misma dirección de barrido y así no dejar ningún órgano sin explorar. Proponemos una sistemática realizando cortes longitudinales, transversales y oblicuos para visualizar todos los órganos abdominales, iniciando la exploración en el epigastrio, barriendo primero el hipocondrio derecho, posteriormente el hipocondrio izquierdo, ambos fosas ilíacas y la zona hipogástrica (AU)

To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region (AU)

[Normal abdominal ultrasound anatomy. Examination procedure]. / Anatomía ecográfica abdominal normal. Sistemática de exploración.

To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs, starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region.

Curso de ecografía abdominal. Introducción a la técnica ecográfica. Principios físicos. Lenguaje ecográfico / Abdominal ultrasound course an introduction to the ultrasound technique. Physical basis. Ultrasound language

La ecografía es una técnica diagnóstica no invasiva, asequible y versátil que emplea el ultrasonido para definir los órganos del cuerpo humano, sin radiaciones ionizantes, en tiempo real y con capacidad de visualizar varios planos. La gran rentabilidad diagnóstica de la técnica, unida a su facilidad de realización, y a las características antes mencionadas, la han colocado en la actualidad como un método de rutina en la práctica médica diaria. Es por esto por lo que, día tras día, se refuerza el carácter multidisciplinario de la técnica. Para una adecuada realización de la técnica se requiere tener conocimientos de los principios físicos del ultrasonido, del método e instrumental y de la anatomía humana, para así conseguir recopilar la máxima información posible y evitar errores de diagnóstico por mala interpretación u omisión de información (AU)

Ultrasound is a non-invasive, accessible, and versatile diagnostic technique that uses high frequency ultrasound waves to define outline the organs of the human body, with no ionising radiation, in real time and with the capacity to visual several planes. The high diagnostic yield of the technique, together with its ease of uses plus the previously mentioned characteristics, has currently made it a routine method in daily medical practice. It is for this reason that the multidisciplinary character of this technique is being strengthened every day. To be able to perform the technique correctly requires knowledge of the physical basis of ultrasound, the method and the equipment, as well as of the human anatomy, in order to have the maximum information possible to avoid diagnostic errors due to poor interpretation or lack of information (AU)

[Abdominal ultrasound course an introduction to the ultrasound technique. Physical basis. Ultrasound language]. / Curso de ecografía abdominal. Introducción a la técnica ecográfica. Principios físicos. Lenguaje ecográfico.

Ultrasound is a non-invasive, accessible, and versatile diagnostic technique that uses high frequency ultrasound waves to define outline the organs of the human body, with no ionising radiation, in real time and with the capacity to visual several planes. The high diagnostic yield of the technique, together with its ease of uses plus the previously mentioned characteristics, has currently made it a routine method in daily medical practice. It is for this reason that the multidisciplinary character of this technique is being strengthened every day. To be able to perform the technique correctly requires knowledge of the physical basis of ultrasound, the method and the equipment, as well as of the human anatomy, in order to have the maximum information possible to avoid diagnostic errors due to poor interpretation or lack of information.

[The usefulness of hydrogastric ultrasonography in the detection of neoplastic lesions of the gastric wall]. / Utilidad de la ecografía hidrogástrica en la detección de lesiones neoformativas de la pared gástrica.

Forty patients endoscopically diagnosed of different gastric neoplastic lesions were explored by hydrogastric ultrasonography to evaluate the usefulness of this method in the detection of such lesions and to analyze the characteristics of the ultrasonographic images and their correlation with the anatomopathologic findings. The sensitivity of the detection of the lesions was 87.5% being close to 100% in those located in the antrum, showing the body and fundus more difficulties due to gas and the costal ribcage. A clear correlation was observed between the ultrasonographic images and the anatomographic findings. It was concluded that this may be a complementary technique to gastroscopy in the diagnosis of sumucosal lesions and extrinsic compressions of the gastric wall. The infiltration of the wall may be delimited in neoplastic lesions and thus may contribute to correct T stratification of the tumor, although this should be confirmed in further studies.