Adnexal masses found in the female pelvis are perhaps one of the trickiest abnormalities to diagnose. These masses are typically found in the ovaries and have a wide range of causes and characteristics. Because of this, it is extremely important to pay close attention to their slight differences in order to begin proper treatment. In the end, only a skilled sonographer with years of experience will be able to tell the difference and properly describe different types of adnexal masses so that the doctor can properly manage the patient.
One of the most important factors when determining what type of adnexal mass a patient has developed, is studying and becoming familiar with recurring patterns. In women younger than 20 years of age, the most common adnexal masses are malignant ovarian neoplasms, malignant germ cell tumors and granulosa cell tumors. By age 40, the most common are malignant ovarian neoplasm of epithelial origin. It has been noted that the most predictive elements for assessing the risk of malignancy in an ovarian mass are age, presence of solid elements and the presence of central arterial flow in these solid elements.
Other important factors to consider when evaluating ovarian lesions are the appearance of wall structure (thickness, internal and/or external papillae), internal echo structure (sonolucent, echogenic, low level echoes or mixed echogenicity), shadowing, blood vessels and many more. All of these are crucial skill sets you want to make sure your sonographer possesses in order to offer your patients high-quality care.
Because there are so many different types of adnexal masses that can appear in the ovaries or female pelvis, they can easily be misinterpreted by an inexperienced sonographer. Therefore, at Soundwaves, we would like to offer you, not only our highly trained sonographers, but also, our rich foundation of knowledge acquired through years of working in the industry. At Soundwaves, we make sure our staff attends ultrasound conferences and discussion panels all year round, in order stay up to date with the latest in sonographic findings. We pride ourselves in setting a standard in our industry and you should too. Find out more about Soundwaves by visiting SoundwavesImage.com.
3D Ultrasound plays a very important role in the area of gynecology. 3D ultrasound can detect uterine morphology, abnormally shaped uterus, fibroids, polyps and misplaced IUDs in a way that is unattainable with 2 dimensional ultrasound. For example, IUD placement can appear normal in 2D and when evaluated in 3D, one may find that the IUD is in fact, not correctly placed. Technology has drastically improved the level at which we can diagnose and understand gynecologic pathology, however there are two important factors to consider. You must have an ultrasound machine with the latest developments in 3D technology and an experienced sonographer performing the ultrasound.
So why does 3D ultrasound make all the difference? When the transducer takes a scan of an area, this data is then displayed on a screen in three orthogonal planes. These planes can then be rotated and viewed as desired and even be cut into slices. They can also be placed together to make one single 3D image in order to analyze the bigger picture. Another great advantage of 3D ultrasound is that the data can be swept in seconds and stored for review at a later time. This makes it possible to study and manipulate the reports in the absence of the patient, which will increase the efficiency of your appointments. The vast amount of data that is collected from a 3D scan is remarkable, therefore its accuracy and clarity is unmatched.
Making sure you have the latest equipment at your facility is extremely important, but making sure you have staff members with the right skill sets and technique, will guarantee high quality outcomes. At Soundwaves, not only do we guarantee top of the line 3D Ultrasound capability, we also hire and train sonographers with outstanding prerequisites and a fine-tuned specialization. This, along with our vast inventory of 3D equipment, is what sets Soundwaves apart from other ultrasound providers. To make sure your patients are receiving top quality care, please visit our website or give us a call today. We look forward to working with you!
In order to achieve the most accurate results, there are a few ultrasound studies that are best scheduled within a certain time frame. Namely, these studies are: sonohysterograms, studies performed for evaluation of the endometrium, nuchal translucency, and anatomy studies.
The best time to evaluate the endometrium for possible polyp, fibroid invasion, irregularity of the endometrium, or to get an accurate measurement when determining endometrial thickness, is between days 7 and 10 of the menstrual cycle. This is also very important when performing a sonohysterogram to avoid a false positive result. If your patient is spotting between periods or having abnormal bleeding, accurate evaluation of the endometrium and the timing of the evaluation are very important.
The guidelines given by the NTQR state that nuchal translucency (NT) ultrasound is to be performed between 11 weeks and 13 weeks 6 days. The objective is to balance early detection of a problem with the ability to see the baby well enough. Performing an NT ultrasound between 12 ½ and 13 ½ weeks will help allow for accurate evaluation. Sometimes, when performed earlier, it is difficult to clearly evaluate the NT due to the size of the baby.
With anatomy scans, we face the same issue. We want to detect abnormalities as early as possible, however, we also want to be able to see small structures well enough to clearly evaluate them. When we are looking at small structures such as the chambers of the heart, it is important that that we have the clearest view possible. Performing anatomy scans close to the 19-20th week rather than week 16 may help one evaluate these smaller structures.
I have been in the field of ultrasound for 25 years and I am able to advise your office on many ultrasound related subjects. Feel free to contact me for advice on how to make sure your ultrasound practice is of the highest accuracy and quality.
Denise Barbato RDMS
Fibroids and Adenomyosis are two extremely common conditions in women, however, adenomyosis is often mistaken for fibroids by ultrasound. Adenomyosis is a severely underdiagnosed condition that is commonly mistaken for Fibroids because of its similarities in sonographic appearance and symptoms. In order to avoid mixing them up, it is important to fully understand the sonographic difference between the two.
The treatment is different for these two conditions, therefore an experienced sonographer who can tell the difference between the two is crucial. So what are some of the most common characteristics that lead to this confusion? The main sonographic finding for Adenomyosis is an asymmetrical thickening of the myometrium and an increased echogenicity due to the invasion of endometrial cells. This is often accompanied by small cysts, which create a very inhomogeneous texture. This inhomogeneous texture may resemble ill defined fibroids, and an inexperienced sonographer may confuse the two. Fibroids, on the other hand, usually appear as well-defined masses that may protrude into the endometrium or outside the uterus. They seldom have cysts and are usually more hypoechoic. Other notable differences between Fibroids and Adenomyosis are that fibroids display peripheral vessels, distal shadowing, and calcification, whereas Adenomyosis, has central vessels, streaky shadows, and no calcification. Failure to properly diagnose either of these conditions can lead to the persistence of symptoms and possibly unnecessary surgery.
Soundwaves is a turn-key ultrasound service that specializes in Ob/Gyn sonography, made up of an experienced staff that studies cases like this on a daily basis. Allow us to help you perfect your practice and assure that you are providing your patients nothing but accurate and quality care. Call us today to book a Soundwaves sonographer at your office.
We have all been there before, the patient in the waiting room is glaring at everyone who walks by because she has a full bladder and the ultrasound tech is running 20 minutes behind. I have good news for you and your patients, in most cases, a full bladder is not needed, and as a matter of fact, when the patient drinks too much water and the bladder is too full, it can have negative effects on the transvaginal portion of the exam. The transabdominal portion of the exam is an overview, and an important way to rule out a large mass such as a pedunculated fibroid, or a mass that is located superiorly. These masses may be difficult to see transvaginally, making the transabdominal ultrasound very important. If we are looking at a fibroid uterus, or at a large mass, in most cases, a full bladder is not necessary to properly evaluate these structures because these structures are large and easy to see. When performing a transabdominal ultrasound, a partially filled bladder is usually all that is needed.
In the old days, the transvaginal ultrasound did not exist, therefore, the only way to see the uterus and ovaries was to fill the bladder completely. This is no longer the case. In most cases, the transvaginal ultrasound gives us a beautiful detailed look at the uterus, endometrium, and the ovaries. The detail that is achieved with transvaginal ultrasound is phenomenal. Polyps within the endometrium, septations or small polypoid structures within an ovarian cyst are virtually impossible to visualize transabdominally. The two studies complement one another very well. Not only is a completely full bladder unnecessary for the transabdominal study, if the patient drinks too much water, oftentimes after she empties the bladder, by the time she changes her clothes for the TV portion, her bladder has begun to fill again.
A partially filled bladder can interfere with the quality of the transvaginal images because the full bladder pushes the structures away from the probe. If the bladder is too full during the transvaginal portion of the exam, the patient must be sent back to the bathroom to empty a second or third time. You can imagine how frustrating this entire ordeal can be for the patient. This will also more than likely cause your ultrasound schedule to run behind. Avoid all of this frustration by not requiring your patients to completely fill the bladder, you will have happier patients and better quality pelvic ultrasounds!
At Soundwaves we believe that working with experienced sonographers who have a passion for what they do and having top of the line equipment will lead to ultrasound reports that are specific and accurate. Watch my video to find out more about why I founded my company, Soundwaves, and how we can help you with all of your ultrasound needs.
Soundwaves is an elite and highly specialized in-office ultrasound service that delivers reports which are tailored to the specific needs of the physician. Our turn key service brings state of the art equipment and highly skilled sonographers to your office to assist you in providing the most accurate results. As a sonographer with 25 years of experience, founder Denise Barbato, knows the importance of the details required to deliver accurate, detailed reports. Next time you find yourself understaffed or overbooked, let Soundwaves fulfill all your ultrasound needs.
As an ultrasound technologist for 25 years, I have seen many cases of misdiagnosis. Not
only can this be inconvenient for the patient, it can also be life threatening in some cases. Some
common findings that may be easily misdiagnosed or missed are: adenomyosis for fibroids, a
thick endometrium vs polyps vs. fibroids, polycystic ovaries, enlarged pelvic vessels for
hydrosalpinx, an involuting corpus luteum for a complex ovarian mass, a 2 mm polypoid
structure along the wall of a simple that may be cancerous, a 1.5 cm hypoechoic mass next to
the ovary that may be an ectopic, loculated fluid collections caused by adhesions that are
mistaken for a large complex mass.
I know that helping the doctor come to a proper diagnosis is an art that is found in the
fine details, and achieved by utilizing a deep foundation of experience and knowledge.
Soundwaves ultrasound technologists have spent several years working in either a hospital or a
diagnostic center surrounded by other technologists and doctors to help build their foundation of
knowledge. After that, most Soundwaves sonographers have then specialized in ob/gyn offices
and perinatology offices.
At Soundwaves, we know the importance of a proper diagnosis the first time. Our
dedicated, experienced sonographers are well prepared to do that. Soundwaves brings state of
the art equipment with 3D/4D capability and experienced sonographers into your office. Call us
today and experience the Soundwaves difference!
We know how it is, your ultrasound tech just let you know she needs time off and your ultrasound schedule is overflowing with patients. Not to worry, Soundwaves has you covered! Soundwaves can provide you with experienced, knowledgeable and professional sonographers when your ultrasound tech takes time off.
The Soundwaves sonography team is made up of ARDMS certified sonographers who are experts in their field. They are experienced and knowledgeable in the art of properly describing pathology and specifically answering the question at hand. These sonographers are hand picked by the Soundwaves founder Denise, who is an experienced sonographer with 25 years in the field.
Denise has experienced first hand, ultrasound reports that are inaccurate and of poor quality. Denise created Soundwaves with the intention of eliminating poor quality in ultrasound reports and therefore, each one of our team members goes through a rigorous training process. We hope that we have opened your eyes to the future of staffing solutions. Good help is hard to find, but it’s all about where you look for it. Give us a call today and get to know our experienced and professional team first-hand.
Soundwaves can also offer sonographers on a part-time and full-time basis if needed. We can even provide you with a sonographer and a machine if you don’t have one, or just want more help on busy days. At Soundwaves our slogan is ‘Image is Everything’ and that’s because we understand your practice is your reputation. We know how important it is for your team to provide a knowledgeable and professional sonographer to every single patient that walks into your facility, so let us help you be the very best, one sonographer at a time. Visit our website for more information.
My passion for Ultrasound began over 25 years ago while working hands-on in the sonography field. I started off working closely with OBGYN’s and Perinatologists, which gave me an inside look at what these doctors were looking for when it came to ultrasound reports. Eventually, this early training would become a crucial stepping stone to founding my own company.
Ultrasounds are such an important tool for diagnosing uterine and ovarian pathology and analyzing fetal development. Therefore, most people are shocked when I tell them that while working in these private offices at the beginning of my career, I found that many patients would arrive with third-party ultrasounds that were inaccurate and extremely poor in quality, therefore, making it extremely difficult to form a proper diagnosis. Situations like this are what really began my passion for high-quality sonography and thus my company Soundwaves was born.
Today, my company focuses not only on providing the most accurate ultrasound reports and patient diagnosis, but also, hiring highly-trained and experienced, ARDMS certified sonographers and equipping them with the best ultrasound machines and technology the market has to offer. This combination makes all the difference. When bringing on new members to the team, I make sure to follow a very strategic protocol. Are they able to identify, and demonstrate knowledge regarding pathology in my prepared powerpoint of images? Are they on top of the latest findings and trends in the ultrasound world? Are they passionate about the work that they do? All of this lets me know whether or not a sonographer is qualified to work independently in the field. Once we hire someone that meets all these criteria, we begin reading through the Soundwaves handbook which contains structured training that involves discussing scanning protocols, discussing the proper way to describe ultrasound findings, and analyzing case studies. We also incorporate continuous training by meeting with applications specialists that will assure that everyone is up to speed with the latest techniques and technology, sharing interesting cases amongst each other and sharing information learned at conferences. All of this helps us to convey what we find in our ultrasound scans into an accurate and descriptive report for our patients.
Shortly after Soundwaves was founded, my mother was diagnosed and eventually lost her battle to ovarian cancer. This is what continues to fuel my passion for providing excellent service. I believe that everyone should have access to the most detailed and comprehensive sonography reports and that no one’s health should be at risk due to a poor diagnosis. Today, we continue on that mission, by donating money to the ovarian cancer research fund in honor of every single doctor we work with. This allows us to help make a difference, not only in the lives of our patients but also in the lives of patients all around the country.
Every day more and more doctors are taking notice of the incredible effect a strong and dedicated sonography team can make in their practice. We are so proud to be the best at what we do and we look forward to helping your office operate to its fullest potential. Join us today and experience the Soundwaves difference for yourself! We look forward to working with you.