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Ultrasound technique has been used in the past 60 years in medical services. It has since developed significantly and its role is more advanced and recognised by patients and health professions. Diagnostic imaging is an important part of the health service, US is one of this family, which contributes greatly to the patient's managements.
Title of this study is: Effectiveness of Ultrasound (US) imaging in Genito-urinary system (GUS) for diagnostic purposes: A comprehensive comparison with other modalities in view of safety and availability. Every modality has some kind of limitations and advantages. Safety is a major issue in using imaging techniques. Ultrasound is considered as one of the safest and most readily available imaging modality (Bates, 1999). However, these advantages do not justify the undermining of the other modalities, because limitations in ultrasound can be overcome by other modalities for patient managements.
GUT is prone to many diseases in which some of them are life threatening(Ref), patient managements require an efficient method for diagnosis. Sonography plays a great role in this regard. Some of the common GUT diseases:
- Infection, Glomerular disease,
- Diseases related to blood circulation: Atherosclerosis can cause hypofunction. Hypertension can lead to necrosis of the glomeruli.
- Metabolic disease: chronic renal failure, diabetes.
- Cysts: solitary, multiple, congenital
- Neoplasms: affects kidney, ureter, bladder and urethra
- Renal cell carcinoma: Wilm's tumour
- Bladder tumours
- Renal stones and urinary tract obstruction
- Advantages and disadvantages of US imaging in GUT.
- Can US be the first modality of choice in GUT imaging?
- Study the use of US imaging in GUT.
- Study the limitation of US imaging in GUT.
- Accuracy of US imaging for diagnostic purposes.
- Cover the latest technology in US imaging.
Ultrasound is a sound wave that cannot be heard by human ears, it uses a frequency above 20,000 hertz(Ref). The waves are converted by technology to enable us to view structures within our bodies, which is very useful for medical purposes (Szabo, 2004). Ultrasound attenuates differently in human body depending on tissues' attenuation coefficients, and tissues reflect wave differently, in which a variety of intensity and contrast images are produced.
Main advantages of ultrasound compared to other modalities that justify this study are:
- No major known risk
- Immediate diagnose or referral for further examination
- Readily available
- Short waiting time
- Patient convenience
- Cost effective
- Real time image
- Good contrast of soft tissue
- Can distinguish between stable and moving tissue (Doppler effect)
Ultrasound examination in GUT has a wide range of use. Imaging starts from kidneys down to bladder, urethra, and genital organs. Ultrasound can detect many pathologies and abnormalities in this system without the need for further examinations. In fact, some pathology such as obstructions and tumours can be detected without interventions, while other modalities intervene such as using contrast agents (Ref).
Other modalities used in GUT
- X-ray uses ionising radiation as the principle of producing radiographs, widely used in initial GUT examinations for being convenience and fast with high rate of diagnostic value images (ref).
- Computed Tomography (CT) Scan, uses ionising radiation as the principle of producing radiographs, widely used for further examination in GUT system. Produces high-resolution 2-dimensional images (can be reconstructed to 3-dimension). Very sensitive in detecting different lesions, calculi, obstruction and haemorrhage. Main concern about using CT is the high radiation dose to the patient (Ref).
- Magnetic Resonance Imaging (MRI), uses a strong magnetic field to align hydrogen atoms in the body, pulses of radio waves sent to realign and align hydrogen atoms, during this, hydrogen atoms release energy, which is detected to produce great contrast images particularly of soft tissue. MRI scan can provide definite answer to uncertain cases because of its superior soft-tissue contrast when other modality cannot. The role of MRI in GUT is mostly in differentiating benign lesions from malignant if CT has contraindication to the patient (Ref).
- Nuclear Medicine Imaging (NMI), Radiopharmaceuticals administered to the patients so that the patient become radioactive, Gamma camera scan the patient and detects gamma ray emitted from the radiation and then construct images from these data. NMI primarily used to examine the function in GUT system and investigate the obstructions (Ref).
This dissertation reviews literature in relation to ultrasound examination in GUT system. Comparing the use of other modality while investigating pathology of a patient. Why in some cases ultrasound is the first choice of use, why it is not in other cases? This paper can enhance the advantages of the examination and review the advances in this technology, these can support patient managements and also be used in education.
The question needs to be answered in this study: is US effective enough to be the first choice examination in GUT system issues? What makes it to be the first choice? What makes it not to be? The study attempts to analyse the conditions in which US examination can provide doubtless answers to indications.
All sources that have relevant information will be used, and the main database search will be Medline, CINAHL, Psycinfo, Embase, AMED, PubMed and e-books.