DMS 201 - Advanced Sonographic Imaging

Credits: 3
Instructional Contact Hours: 3

Continues the study of abdominal sonography to include sonographic findings, clinical signs and symptoms, and correlation of other imaging studies. Also continues the study of Doppler imaging with practice and simulation exercises of abdominal and lower leg scanning. Provides an overview of neonatal and infant brain sonography including normal and abnormal sonographic anatomy and pathology.

Prerequisite(s): DMS 111 , DMS 114 , DMS 115 , DMS 116W , and DMS 117W each with a "B" (3.0) minimum grade and LWA 206B with a minimum grade of "C" (2.0).
Corequisite(s): DMS 202 , DMS 206W , DMS 207 , and LWA 206C
Lecture Hours: 45 Lab Hours: 0
Meets MTA Requirement: None
Pass/NoCredit: No

Outcomes and Objectives

Demonstrate knowledge of anatomy and sonographic appearances of normal abdominal vessels.
1. Discuss transducer design and equipment requirements
2. Discuss proper scan orientation
3. Describe how to take measurements and indicate normal ranges
4. Identify normal and relational anatomy for the following abdominal vessels:
  1. Aorta
  2. IVC
  3. Hepatic veins
  4. Portal venous system
  5. SMA, IMA
  6. Celiac
  7. Hepatic artery
  8. Renal arteries and veins
5. Identify normal waveform appearances for abdominal vessels
Demonstrate knowledge of pathology and its correlation to waveform appearances for abdominal vessels.
1. Define aneurysm
2. Discuss Doppler waveforms for vessels with aneurysm
3. Define stenosis
4. Discuss Doppler waveforms for vessels with stenosis
5. Describe mesenteric ischemia and the vascular sonographic findings
Demonstrate knowledge of non-vascular extremity pathology.
1. Describe a Baker's cyst
Demonstrate scanning techniques for carotid, venous leg and abdominal vascular anatomy.
1. Obtain images of the following:
  1. Aorta
  2. Portal vein
  3. Hepatic veins
  4. SMA / Celiac
  5. Common, bulb, internal and external carotid
  6. Proximal, mid and distal femoral vein
  7. Popliteal vein
Demonstrate knowledge of technology advances in the sonography field.
1. Define and discuss application for the following:
2. 3-D
3. Broadband technology
4. Extended field of view
5. Spatial compounding
6. Tissue harmonics
7. Contrast harmonics
8. Elastography
9. Automated breast volume scanning
Demonstrate knowledge of emergency ultrasound scanning techniques and protocols.
1. Define FAST and RUSH exams and their application to emergency ultrasound
2. List healthcare workers who perform FAST exams
3. Describe how an emergency ultrasound exam differs from a conventional exam performed in an ultrasound department
4. Describe a protocol for the FAST exam
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the spleen.
1. Describe the sonographic findings for pathology and disease processes to include:
  1. Primary and secondary malignancies
  2. Splenomegaly
  3. Congenital anomalies
  4. Gaucher’s disease
  5. Trauma
  6. Infarction
  7. Granulomatous infections
2. Describe Doppler techniques and applications where applicable
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the adrenal gland.
1. Describe the sonographic findings for pathology and disease processes to include:
  1. Addison’s disease
  2. Cushing’s disease
  3. Conn’s syndrome
  4. Adenoma
  5. Pheochromocytoma
  6. Neuroblastoma
  7. Metastases
  8. Adrenal hemorrhage
2. Describe adrenal function as it relates to the cortex and medulla
3. Describe Doppler techniques and applications where applicable
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the GI system.
1. Describe the sonographic findings, clinical history and correlation for pathology and disease processes to include:
  1. Appendicitis
  2. Intussusception
  3. Diverticulitis / colitis
  4. Chrohn’s disease
  5. Pyloric stenosis
  6. Mesenteric adenitis
  7. Bowel obstruction
2. Discuss protocols, transducer selection and scan plane orientation for “A” above.
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the abdominal wall, peritoneum, and retroperitoneum.
1. Describe the sonographic findings, clinical history and correlation for pathology and disease processes to include:
  1. Abdominal wall hernia
  2. Abdominal wall hematoma, abscess and fluid collection
  3. Abdominal wall tumors
  4. Ascites
  5. Peritoneal and retroperitoneal fluid collections
  6. Peritoneal and retroperitoneal masses
  7. Spontaneous hemorrhage
  8. Retroperitoneal fibrosis
2. Discuss protocols, transducer selection and scan plan orientation for “A” above.
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the pediatric abdomen.
1. Discuss protocols and transducer selection for the pediatric abdomen
2. Describe sonographic findings, clinical history and correlation for pathology and disease process to include:
  1. Biliary atresia
  2. Choledochal cysts
  3. Other biliary disease processes and congenital anomalies
  4. Hepatoblastoma
  5. Cirrhosis
  6. Hepatitis
  7. Cholelithiasis
  8. Urinary obstruction
  9. Wilm’s tumor
  10. Neuroblastoma
  11. Imperforate anus
Demonstrate knowledge of renal transplant sonographic imaging.
1. Describe protocols and transducer selection for transplant imaging
2. Discuss complications of organ transplant
3. List sonographic findings for renal transplant rejection
4. Discuss organ placement and anastomoses for abdominal organ transplant
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the thorax.
1. Describe protocols and transducer selection for thoracic imaging
2. List indications for thoracic imaging
3. Describe thorax anatomy as related to sonographic imaging
4. Describe thorax pathology as related to sonographic imaging to include:
  1. Pleural and lung masses
  2. Consolidated lung
  3. Atelectasis
  4. Pneumothorax
  5. COVID 19
  6. Mediastinum and diaphragm
Demonstrate knowledge of basic invasive procedures using ultrasound guidance.
1. Describe transducer selection, equipment and protocols for invasive procedures
2. List types of invasive procedures
3. List medical supplies needed for an invasive procedure
4. Describe the types of biopsies done in the imaging department
5. Describe proper OR technique
6. List OR sonography procedures and applications
Demonstrate knowledge of anatomy and sonographic appearances of the normal neonatal brain.
1. Discuss transducer and equipment requirements
2. Identify normal anatomy
3. Discuss proper scan orientation
4. Describe the protocol for neonatal brain imaging
Demonstrate knowledge of pathology and its correlation to sonographic appearance for the neonatal brain.
1. Describe sonographic findings for pathology and disease processes to include:
  1. Grading and identification of hemorrhages
  2. Periventricular leukomalacia
  3. Ventriculomegaly / hydrocephalus
  4. Agenesis of the corpus callosum
  5. Dandy-Walker syndrome
  6. Holoprosencephaly
  7. Arnold Chiari malformation
  8. Hydrancephaly
  9. Porencephalic cyst
  10. Vein of Galen aneurysm
2. Describe Doppler techniques and applications where applicable
Demonstrates understanding of the role of the sonographer in evaluating scanning protocol modifications based on the sonographic findings and differential diagnosis.
1. Demonstrate ability to recognize indications and contraindications for the exam and exam modification
2. Demonstrate ability to correlate patient history with sonographic findings and make exam modifications as necessary
3. Demonstrate ability to correlate exam findings with patient history to produce a differential list
Demonstrates understanding of the role of the sonographer in patient management.
1. Demonstrates the ability to take a complete patient history according to the exam ordered
2. Demonstrates the ability to correlate patient history with related imaging, other testing and lab procedures and outcomes