Diagnostic Medical Sonography

Definition

Diagnostic medical sonography, or ultrasound, is a technique using high frequency sound to create images of specific areas of the body to diagnose various pathologies. The diagnostic medical sonographer performs examinations, records anatomic condition and provides diagnostic information.

Description

Under the supervision of a physician, the diagnostic medical sonographer provides patient services using medical ultrasound to gather data necessary to diagnose various conditions and diseases. The sonographer uses advanced computerized technology to produce images. The images are viewed on a video screen or converted by computer to produce photographs or printouts of ultrasonic patterns. The imaged patterns help the physician determine the diagnosis.

The sonographer's responsibilities include image production through patient positioning and operation of clinical instrumentation, patient care, quality control, technical assistance with interventional procedures, image manipulation and processing, and the preliminary interpretation of the ultrasound examination for the sonologist.

Supporting the physician, the sonographer obtains, reviews, and integrates pertinent patient history and supporting clinical data to facilitate optimum diagnostic results. This involves performing appropriate procedures and recording anatomical, pathological, and/or physiological data for interpretation by a physician, and recording and processing sonographic data and other pertinent observations made during the procedure for presentation to the interpreting physician.

Before the procedure, sonographers explain the ultrasonic procedure to patients and help patients assume the correct physical positions for required exposure to ultrasonic waves. At all times, the sonographer is required to exercise good judgment in the performance of sonographic services.

Work settings

Some sonographers can work in a variety of medical settings including hospitals, clinics, private offices, and other facilities performing examinations in their areas of specialization. More experienced sonographers may work on a contractual basis or for mobile services.

Education and training

A sonographer must have a thorough knowledge of cross-sectional anatomy and pathology, as well as the skills to manipulate a wide variety of sophisticated instruments. Individuals entering diagnostic medical sonography are required to have a strong academic background in the basic sciences and a strong comprehension of computer technology.

Diagnostic medical sonography programs vary in length from one to four years depending on the program design and the degree or certificate awarded. Program entry requirements range from a high school diploma to specific qualifications in a clinically related Allied Health profession such as nursing, radiotechnology, nuclear medicine, etc. Typical program curriculums can include ultrasound physics and instrumentation, patient care procedures, professionalism and ethics, physiology and pathophysiology, and sonographic anatomy and scanning techniques.

Many programs involve an internship as part of the course of study. Interns work in medical facilities to apply classroom theory and gain practical skills. Following graduation, candidates take a national qualifying exam administered by the American Registry of Diagnostic Medical Sonographers (ARDMS). Continuing education is required of all sonographers to maintain registration. Candidates become Registered Diagnostic Medical Sonographer (RDMS) when they pass the ARDMS exam.

Advanced education and training

Diagnostic medical sonographers may wish to specialize through formal and/or continuing education after graduation and certification. Recent advancements in the technology have led to increased specialization. Specialties include spectral and color doppler, vascular sonography, endocavity imaging, and intraoperative ultrasound.

Future outlook

Diagnostic medical sonography is a rapidly expanding field. The non-invasive, non-ionizing nature of the technology makes it an attractive modality. Continuing advancements in the technology provide a broader application of sonography. Therefore, an increasing need exists for well-trained and dedicated sonographers.

Important recent advances include the transvaginal scan that involves specially designed probes placed in the vagina that produce better images and more information in patients in the early stages of pregnancy. Transvaginal scans are becoming valuable in the early diagnosis of ectopic pregnancies and in detecting fetal abnormalities in the first trimester of pregnancy. Another recent advancement, doppler ultrasound, is useful in detecting fetal heart rates and fetal blood flow. Color doppler is useful in the diagnosis and assessment of congenital heart abnormalities. Also, three-dimensional ultrasound, which can create better scans by providing volumetric measurement, is moving from the research and development stages and into more widespread application.

Graduates of diagnostic medical sonography programs can find many employment opportunities in hospitals, medical centers, and mobile services. There are many opportunities for advancement, both within an institution and within the field. Advancement can depend on continuing education, specialization, and experience. Starting salaries for recent graduates range from $28,000 to $32,000.

Career opportunities also exist outside the healthcare field. Graduates can find employment in industry as education specialists, researchers and administrators and with equipment manufacturers as sales representatives.

KEY TERMS

Color Doppler— An ultrasound technique used to locate areas of motion, such as blood flow in vessels.

Doppler— Technique for calculating the relative velocity between two points by measuring the shift in frequency of a sound wave transmitted from one point to another.

Transducer— Often called probes, transducers come in different shapes and sizes for use in different ultrasonic scanning situations.

Ultrasonic— A sound beyond the range of human hearing.

Ultrasound— The diagnostic or therapeutic use of ultrasound and esp. a noninvasive technique involving the formation of a two-dimensional image used for the examination and measurement of internal body structures and the detection of bodily abnormalities.

Resources

BOOKS

Fleischer, Arthur C. and Kepple, Donna M. Diagnostic Sonography. Philadelphia, PA: W.B. Saunders, 1995.

Hagen-Ansert, Sandra L. Textbook of Diagnostic Ultrasonography Volume Two. St. Louis, MO: Mosby, 1995.

Rowland, Jeanne. Introduction to Radiologic Technology. St. Louis, MO: Mosby-Year Book, Inc. 1996.

Zwiebel, William J. and Sohaey, Roya. Introduction to Ultrasound. Philadelphia, PA: W.B. Saunders, 1998.

OTHER

"Diagnostic Medical Sonography (Ultrasound)." Rochester Institute of Technology Department of Allied Health Sciences Diagnostic Medical Sonography Program 1998. 〈http://www.rit.edu/∼hhgscl/〉.