Principles and Practice of Ultrasonography Satish K Bhargava
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1Principles and Practice of ULTRASONOGRAPHY
2Principles and Practice of ULTRASONOGRAPHY
SECOND EDITION
Satish K Bhargava MD (Radiodiagnosis), MD (Radiotherapy) DMRD, FICRI, FIAMS, FCCP, FUSI, FIMSA, FAMS Professor and Head Department of Radiology and Imaging University College of Medical Sciences (Delhi University) and GTB Hospital Dilshad Garden, Delhi, India
3
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Principles and Practice of Ultrasonography
© 2010, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition: 2002
Second Edition: 2010
9788184489057
Typeset at JPBMP typesetting unit
Printed at
4Dedicated To
My late parents Sh Jagannath Bhargava and Smt Brahma Devi Bhargava
My loving late wife Kalpana
My son Sumeet and his wife Shivani
My brothers and sisters Surendra, Munish, Narendra and Santosh whose inspiration and sacrifice have made possible to bring out this book
5Contributors
A Verma
Resident Medical Officer, Arpana Hospital
Karnal (Haryana), India
AK Srivastava Physicist
Department of Radiology and Imaging
University College of Medical Sciences
(Delhi University) and GTB Hospital,
Dilshad Garden, Delhi, India
Atin Kumar md (Radiodiagnosis)
Assistant Professor, Department of Radiodiagnosis
All India Institute of Medical Sciences
Ansari Nagar, New Delhi, India
Atul Luthra mbbs, md, dnb
Diplomate, National Board of Medicine
Consultant, Physician and Cardiologist
New Delhi, India
Brig. Chander Mohan md (Radiodiagnosis)
Sr. Consultant, Interventional Radiology and HOD Radiology
BL Kapoor Memorial Hospital
Pusa Road, New Delhi, India
Gopesh Mehrotra md (Radiodiagnosis)
Professor, Department of Radiology and Imaging, University College of Medical Sciences
(Delhi University) and GTB Hospital, Dilshad Garden, Delhi, India
IK Inderjit
Air Force Hospital
Bengaluru, India
Karuna Taneja md (Radiodiagnosis)
Ex Associate Professor
Department of Cardiac Radiology
All India Institute of Medical Sciences
Ansari Nagar, New Delhi, India
M Patel
INHS, Port Blair, India
Poonam Narang md (Radiodiagnosis)
Professor, Department of Radiology
Maulana Azad Medical College and Associated
GB Pant Hospital, New Delhi, India
Rajul Rastogi md (Radiodiagnosis)
Head, Department of Radiology
Yash Diagnostic Center, Civil Lines
Moradabad, India
Rekha Jain md (Radiodiagnosis)
St Joseph Mery Hospital
Pontiac, Michigan, USA
Rohini Gupta md (Radiodiagnosis)
Assistant Professor
Department of Radiology and Imaging
Vardhman Mahavir Medical College and Associated Safdarjung Hospital, Delhi, India
Satish K Bhargava md (Radiodiagnosis)
md (Radiotherapy), dmrd, ficri, fiams, fccp, fusi, fimsa, fams
Head, Department of Radiology and Imaging
University College of Medical Sciences
(Delhi University) and GTB Hospital
Dilshad Garden, Delhi, India
Shuchi Bhatt md (Radiodiagnosis), MNAMS, FICR
Reader, Department of Radiology and Imaging
University College of Medical Sciences
(Delhi University) and GTB Hospital
Dilshad Garden, Delhi, India
Sudhanshu Bankata md (Radiodiagnosis)
Dy. General Manager (Medical)
Fortis Health Care, Escort Heart Institute and Research Centre
Okhla Road, New Delhi, India
Sumeet Bhargava mbbs, dnb (Radiodiagnosis)
Sr. Resident, Department of Radiodiagnosis
All India Institute of Medical Sciences
Ansari Nagar,
New Delhi, India
6Preface to the Second Edition
Ultrasound being non-ionizing, non-invasive, and relatively cheap modality is widely acceptable in developing countries as a first line of investigation in diagnostic armentarium. Due to recent advancement in transducer technology, availability of high frequency transducers and better resolution, its application has extended in almost every system of the human body. Due to wide application and the demand of this book from the readers not from this country but also from abroad, it was decided to come out with the latest Edition with more number of illustrations. Addition of new chapters on Color Doppler, Echo-cardiography and Intravascular Ultrasound–Current Concept will definitely be beneficial to postgraduates and practitioners.
Satish K Bhargava
7Preface to the First Edition
Introduction of ultrasound was a boon to the medical field, due to its noninvasive and non-ionizing nature leading to constantly growing interest in the application of ultrasound as a diagnostic modality. Its easy acceptability in the developing countries is also because of its wide availability and low cost.
Ultrasound is a stethoscope of a radiologist to look into the intriguing pathological conditions and provide useful information to the clinician for better patient care. However, this technology is very much operator-dependent and thus a thorough understanding of standard scanning technique and knowledge of the sonographic anatomy is essential for optimum results. Thus we embarked on the monumental task of providing a basic book on clinical diagnostic ultrasound. The main feature of this book is extensive coverage and easy comprehension. The book has gone deeply into normal sonographic anatomy and the basic technique of performing ultrasound. The book beautifully covers sonography of the abdomen and superficial parts. A special effort has been made to include a large number of illustrations and scans to provide a clear impression of the sonographic appearance of normal and pathologic lesions. Obstetric ultrasound has also been covered in the text. A chapter on Doppler has been included in order to provide the basic knowledge of the subject. Introduction to interventions and latest advancement in ultrasound emphasises its importance in therapeutics.
I am sure that this book will be of great help to the budding radiologists and the technologists and help them in optimum utilization of this extremely useful modality and this in turn will bring laurels to the professions.
Satish K Bhargava
8Acknowledgments
I am grateful to my colleagues and friends who gave timely support and stood solidly behind me in our joint endeavor of bringing out this Second Edition of book which was required keeping in view of wide acceptability of ultrasound in developing countries like ours. I would also like to thank Shri Jitendar P Vij, Chairman and Managing Director, Mr Tarun Duneja, Director-Publishing, Ms Samina Khan of M/s Jaypee Brothers Medical Publishers (P) Ltd. It is indeed the result of the hardwork of the staff of M/s Jaypee Brothers and the contributors who have always keen desire to work with a smiling faces and with polite voices as a result of which this book has seen the light of the day.