Ultrasound Imaging
The Ultrasound Imaging Division continues to be an integral and vital component of the Department of Radiology. The section does the major portion of women's imaging, OB-GYN, and to this end, we have purchased four new machines from Siemens.
We now have the capability to utilize cine clips, real-time clips of 5-10 seconds that we can capture and display on workstations and office computers, as well as projectors for teaching purposes.
Click the PLAY button > to watch the cine clip
(Broadband recommended. Free Flash player required)
The Radiology Department's PACS system links ultrasound with other modalities using digital, "filmless" technology.
Sonographic examinations of all areas of the patient's body, except vascular and cardiology regions, are performed in the Radiology Department. Musculoskeletal ultrasound is a well-established modality, spearheaded by Douglas Goodwin, MD and Robert Harris, MD. Anal sphincter sonography is a well-established procedure, done to diagnose defects in the anal sphincter occurring after childbirth or trauma and causing urinary or fecal incontinence. The procedure seems to aid in patients' outcomes.
Ultrasound radiologists work closely with trained obstetricians and gynecologists, and we see a large number of high-risk pregnancy patients for prenatal diagnosis and treatment. 3D and 4D imaging continue to comprise an ever-growing portion of the daily imaging studies. Ultrasound team leader Dennis Seguin has been invaluable in maintaining the high quality of work in ultrasound, and keeping the multiple disciplines involved both satisfied and interested in developing technology.
Teaching and Research
Clinical acumen is the primary goal of the technologists and radiologists, but teaching and research are also vitally important. Education occurs at the patient bedside; in resident, fellow, and medical student training programs; in sonographer student apprenticeships; and in monthly conferences on general ultrasound topics and maternal-fetal medicine. At our monthly perinatal working group, obstetricians, neonatologists, radiologists, and geneticists gather to discuss interesting and difficult cases.
Research is ongoing on several fronts. We are participating in a large multi-center trial on characterization of thyroid nodules. Other ongoing research includes the study of anal sphincter ultrasound (comparing transvaginal vs. transperineal) and a cervical lymph node injection study with tumor vaccine with Dr. Camilo Fadul for brain tumors. In addition, Dr. Harris and his colleagues are exploring a satellite tele-ultrasound system linking DMS to developing countries and mass disaster areas. Dr. Harris and his team have traveled to Nicaragua and Vietnam to donate compact ultrasound units and train local physicians in performing ultrasound. They have also tested the tele-ultrasound system, which appears promising.
Accreditation
Some states have established that accreditation by a national ultrasound board is necessary for reimbursement from third-party payers. New Hampshire may adopt this regulation in the near future. In 2006, the Division obtained re-accreditation by the American Institute of Ultrasound in Medicine (AIUM) for our programs in abdominal, general, obstetrical and gynecological screening. This important quality assurance program certifies that the work in the Division has been examined by independent outside observers and has been judged to meet or exceed standards established by the AIUM, the dominant organization in American ultrasound.
Robert Harris, MD, Director
