DMS 201 - Advanced Sonographic Imaging II

Continues the study of Doppler imaging with practice and simulation exercises of abdominal and lower leg scanning. Also includes GI pathology, transplants, MSK, pediatric hip/spine, labs, contrast sonography and new technology.

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  

1. 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
2. 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
3. Demonstrate knowledge of non-vascular extremity pathology.
   1. Describe a Baker's cyst
4. 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
   10. CMUT transducers
   11. Capacitance
   12. Matrix arrays
   13. Transmission and reflection with CMUT technology
   14. Tissue colorization
   15. Anisotropy
   16.  
5. 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.
6. Demonstrate knowledge of abdominal organ transplants as related to sonographic imaging.  
   1. Discuss renal transplantation and corresponding anastomoses
   2. Describe a basic renal transplant protocol
   3. Describe sonographic findings for renal transplant rejection
   4. Discuss liver transplantation and corresponding anastomoses
   5. List complications for abdominal organ transcripts with sonographic findings
7. 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
8. 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
9. 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
10. Demonstrate knowledge in image interpretation and case analysis.
    1. Demonstrate the use of appropriate sonographic terms to describe pathology
    2. Analyze a sonographic case to determine pathology differentials
    3. Identify key pathology differentials based on patient clinicals data and sonographic findings
11. Demonstrate knowledge of anatomy and sonographic appearance for normal MSK structures as related to sonographic imaging.
          A. Discuss transducer and
               equipment requirements
          B. Discuss proper scan orientation
          C. List uses for MSK sonographic imaging
          D. Demonstrate knowledge of MSK terminology
          E. Describe normal anatomy and sonographic appearance to include muscle, tendon, ligament and joint spaces
          F. Describe the rotator cuff protocol
          G. Describe a basic protocol for muscle, tendon, ligament and joint imaging
12. Demonstrate knowledge of pathology and its correlation to sonographic appearance for MSK imaging
    1. Describe sonographic findings for rotator cuff tear
    2. Describe sonographic findings for inflammation of the MSK system
    3. Describe sonographic findings for tendon/muscle/ ligament tears
    4. Discuss neuroma and correlating sonographic findings
    5. Define Baker’s cyst and correlating sonographic findings
13. Demonstrate knowledge of normal anatomy and pathology and its correlation to sonographic findings for the pediatric hip.
    1. Identify normal and relational anatomy along with sonographic appearance
    2. Discuss transducer design and equipment requirements
    3. Discuss proper scan orientation
    4. Describe a pediatric hip protocol
    5. List indications for pediatric hip imaging
    6. Describe congenital dysplasia of the hip and correlate with sonographic findings
    7. Describe the alpha angle used to determine acetabulum depth
14. Demonstrate of normal anatomy and anatomy and its corresponding sonographic findings for the pediatric spine.
    1. Identify normal and relational anatomy along with sonographic appearance
    2. Discuss transducer design and equipment requirements. 
    3. Discuss proper scan orientation
    4. List indications for pediatric spine imaging
    5. Describe a tethered spinal cord and correlate to sonographic findings
    6. Define lipomyelomeningocele, distematomeylia, and Arnold Chiari malformation
15. Demonstrate knowledge of normal and abnormal lab values as they relate to abdominal sonographic imaging.
    1. List labs corresponding to the liver/ biliary system
    2. List labs corresponding to the pancreas
    3. List labs corresponding to the urinary system
    4. Describe the difference between total, direct and indirect bilirubin
    5. Describe the two functions of the liver and the relationships to lab values
    6. Define “plasma clearance” and “synthesis”
    7. Describe lab values in relationship to liver/biliary pathology
    8. Describe lab values in relationship to pancreas pathology
    9. Describe lab values in relationship to the urinary system
16. Demonstrate knowledge of pathology and sonographic findings with an AIDS diagnosis
    1. List patient symptoms for an AIDS diagnosis
    2. Describe nonspecific sonographic AIDS findings
    3. Describe pathology frequently seen sonographically with and AIDS diagnosis
    4. Discuss the most common AIDS diagnosis tumor
    5. Describe AIDS nephropathy
    6. Describe AIDS cholangitis
    7. Discuss opportunistic infections that accompany and AIDS diagnosis
    8. Describe Pneumocystis Carinii
17. Demonstrate knowledge of GI system scanning and imaging
    1. Obtain a long and trans view of the pyloris
    2. Demonstrate the graded compression technique
    3. Obtain a view o the RLC iliac area and/ or normal appendix
18. Demonstrate knowledge of renal artery scanning and imaging
    1. Obtain a Doppler sampler of the aortic artery
    2. Obtain a Doppler sample of the proximal and distal main renal arteries
    3. Obtain a Doppler sample of a renal arcuate artery
    4. Obtain a Doppler sample of a segmental renal artery
    5. Calculate the distal and proximal RAR for right and left renal arteries