FNAC of thyroid cyst:

 
This was a large cystic lesion of the right lobe of thyroid. Ultrasound guided fine needle aspiration of the cyst helped to drain the contents of the cyst as well as to ascertain the nature of the cyst contents. Ultrasound guided aspiration done here shows the needle tip descending into the cyst (seen as the bright mobile echogenic focus in the cyst lumen). The ultrasound probe (here) is placed perpendicular to the long axis of the needle- resulting in the needle tip being visualized. If the needle's long axis is parallel to the ultrasound beam (and the ultrasound probe), a linear echo of the needle can be visualized.
See: http://radiographics.rsna.org/content/28/7/1869.full 

Sonography quiz- What is your diagnosis?

This was a male patient with history of hematuria. What is your diagnosis? This ultrasound video shows a transabdominal scan in the first 2 parts of the video; the last part of the video shows a Transrectal ultrasound (TRUS) imaging of the bladder of the urinary bladder.

Answer: this is a freely mobile calculus in the urinary bladder. Seen rolling across the inner bladder surface on change in position. The TRUS imaging of the this case needed a lot of patience to capture this rather elusive urinary bladder stone.

Ultrasound guided thyroid FNA biopsy:

FNA or fine needle aspiration of the thyroid is mainly used to distinguish benign from malignant thyroid nodules. However, it is also useful in the biopsy of diffuse enlargement of the thyroid as is seen in Hashimoto thyroiditis and diffuse infiltration of the thyroid in lymphomas and certain forms of metastases (colonic adenocarcinoma spreading to the thyroid). In the case of Hashimoto thyroiditis, FNA biopsy helps to distinguish Hashimoto thyroiditis from lymphomas and papillary carcinoma of the thyroid which may coexist with the primary disease.

Method: the aim of ultrasound guidance whilst performing the FNA biopsy is provide visualization of the needle tip and guide it to the exact location within the thyroid where the nodule is located or where there is maximum possibility of collecting diseased tissue. This short ultrasound video clip shows the needle tip (seen as an echogenic linear focus) moving to and fro within the left lobe of the thyroid. The aim of the FNA study in this case was to rule out lymphoma involving the thyroid:

 

References: http://radiographics.rsna.org/content/28/7/1869.full
(free article on Ultrasound guided FNA biopsy of the thyroid).

Carcinoma of urinary bladder on TRUS

Often carcinoma of the urinary bladder can mimic an enlarged prostate (usually the median lobe). The projecting median lobe of prostate can often appear bilobed or even polypoid on Transrectal ultrasound scan (TRUS). Carefully imaging the entire prostate and checking for continuity of the prostate and the mass can help verify the exact origin of the mass in question.
  This case study just highlights this dilemma. The patient, an elderly male had a mass or rather a pair of masses located very close to the bladder neck. On TRUS the prostate appeared small and showed no direct continuity with the masses. The ultrasound and color Doppler video clips demonstrates this very well.

PCO in adolescents

This 15 year old female child has irregular menses. The question is - can Polycystic ovary disease be seen at such a young age?
I believe the answer is yes!
Both ovaries show a volume of 10 cc. (definitely enlarged) and multiple small follicles (each of less than 7 mm.).
Ultrasound image of the uterus:

Image of the ovaries showing multiple small follicles:

Left ovary- note the large size and "string of pearls"
sign of follicles:

Right ovary also showing changes of PCO in this child:

Power Doppler image- both ovaries- PCO:

Visit: http://www.ultrasound-images.com/ovaries.htm#Polycystic_ovaries_%28polycystic_ovary_disease-_PCOD

Name the part of the fetus in this ultrasound video:

This is a part of the fetal head. Can you name the part of the fetus we are focusing on?
Hint: the baby is actively doing something...

Sonography of Wharton duct calculus- video:

Ultrasound video clip shows the dilated duct of submandibular salivary gland (also called the Wharton duct).

  
This patient was a young adult male with typical history of pain in the left sublingual region whilst eating. There was also accompanying swelling of the left submandibular region with pain there when eating.
The ultrasound video clip shows the dilated submandibular salivary gland duct, measuring 4 mm.! Despite my best efforts with the small parts high frequency probe I could not detect the stone in the Wharton duct.
This was how the left submandibular salivary gland looked like:

There is a mild swelling of the left submandibular salivary gland compared to the right side.

The Wharton duct is clearly seen to be considerably dilated (ultrasound image above).

How can I be sure that the tubular structure shown in previous image is the Wharton duct? I switched on the color Doppler flow imaging and found (see image above), that this was indeed the Wharton duct and not a blood vessel.

I tried my best to find the terminal part of the duct with the stone in it, but failed. Finally I used the TV (endocavity) probe and managed to find the stone in the distal end of the Wharton duct.
For more on this topic visit: http://www.ultrasound-images.com/salivary-glands.htm#Calculus_in_left_Whartons_duct