Always a crowd pleaser at our hospital! In the spirit of the recent July 4th holiday, enjoy.
Always a crowd pleaser at our hospital! In the spirit of the recent July 4th holiday, enjoy.
Always a crowd pleaser at our hospital! In the spirit of the recent July 4th holiday, enjoy.
Always a crowd pleaser at our hospital! In the spirit of the recent July 4th holiday, enjoy.
Comments
Thx Martin! 😉
Thx Martin! 😉
That is neat, I’ll have to
That is neat, I’ll have to try that sometime. I just started scanning earlier this year. I am getting to the point where I am noticing things that could be abnormal. I am starting to play around with both color and power doppler over these suspect pathology regions. How do you all decide which one to place over something like a tumor? Or…do you usually do both power and color doppler over suspect pathology regions? I am hoping to get to the point of attempting fna’s later this year. I am thinking it would be good to place color doppler over the mass first…to attempt to stay away from larger vessels during aspiration. Thanks
Hi Robb:)
Generally I use
Hi Robb:)
Generally I use power Doppler for splenic hilus, kidneys (always do these, they are part of SDEP), and any pathology lesions as it is more sensitive than color; and you don’t need to know direction of flow as much as you need to see vascular areas.
When imaging an adrenal with pathology, I use color flow because here we are looking for possible CVC invasion. Also use color flow for shunt hunts as direction of flow is important when evaluiating for a possible shunt.
To get the proper flow, set your PRF scale about 30. Make your sector box match closely the area you are imaging. When you have color flow or power Doppler activated, turn up the gain then when it starts to speckle, turn it back down.
Yes it is important to apply power Doppler on any area prior to aspirating. Make a phantom jello mold and practice with that first. Here is the recipe along with a demonstration video: https://sonopath.com/resources/ultrasound-resources/phantom-mold-recipe-fna-practice. I would start with a spleen for your first one, big target. 25g x 1.5 inch needle.
Remember SonoPath has a telecytology service, more info here if you are interested.https://sonopath.com/services/telecytology-services
thank you, I have found the
thank you, I have found the feline splenic hilus seems to be difficult to find for doppler…basically I cannot seem to find it. Just a few more quick questions…do you ever fan and use doppler while fanning…or do you generally keep the probe still when using doppler? I was under the impression to keep the probe fairly still.
Is there a PRF scale button? I note that in the video for the fna, you do not aspirate. When you are in a fluid pocket or fluid filled mass, I presume you would want to aspirate some? If so, would you have an assistant aspirate for you, since you are holding the probe, or would someone else hold the probe for you? I’ve done for a urinary bladder, but feel I would need to be more steady if a smaller more vascular region.
The trick to the feline
The trick to the feline spleen is after scanning with the microconvex, go back and image with the linear probe. Easier to visualize the splenic hilus, you can easily use Doppler here. Don’t fan, keep the probe still enough to see the flow exiting the spleen – you may need to make mircroadjustments to do this.
Here is a pic of the PRF switch. I know it says scale- but when you are in color mode it will adjust the PRF up or down.
Yes in the aspiration procedure you initiallhy draw back air to about 2ml, and then gentle “jabs”, slightly changing your orientation with each jab to go through fresh tissue.
If you are in a fluid pocket/mass, yes you would draw back to remove fluid and/or get a sample. Generally I hold the probe and aspirate myself because I find it more effective to have my own hand on both the probe and the needle so I can keep the proper alignment and keep the needle where it is supposed to be. If you are using a butterfly you could always have someone draw back on the syringe for you, but I would still keep my hand on the needle.
If possible also aspirate any parenchymal portions for the standard FNA.