Value of Ultrasound

Diagnostic ultrasound has multiple uses in today’s clinical practice being used for primary diagnosis and monitoring of known conditions to guidance of minimally invasive surgical procedures.  Since ultrasound imaging is non-invasive, does not utilize ionizing radiation and provides real-time imaging information, the use of ultrasound at the point of care by appropriately trained clinicians’ results in improved quality of care and reduces overall healthcare costs.   Access to diagnostic ultrasound at the point of care is needed most for the elderly and those less fortunate, and often times poorer areas do not have adequate hospital-based facilities and resources to deliver the care that their community requires.

Diagnostic capability is essential to having a cost effective healthcare system, as early detection and prevention can lower the number of high-cost treatments. For example, trauma surgeons use ultrasound to evaluate victims of blunt abdominal trauma.  Without the aid of ultrasound, they must resort to diagnostic peritoneal lavage, a highly invasive procedure that puts the patient at risk for infection or exploratory surgery.  With ultrasound, trauma surgeons can immediately perform an evaluation of the abdomen for free fluid collections and determine without delay and non-invasively whether the patient requires surgical intervention.  In critical care units, ultrasound is used both diagnostically for heart and lung as well as being used to guide thoracentesis and paracentesis.

While ultrasound is typically first thought of as the primary screening tool to monitor pregnancy, the device has many uses beyond maternal health. Ultrasound is no longer an isolated laboratory imaging service that is conducted apart from the clinical management of the patient.  Information gained from an ultrasound examination that is conducted immediately prior to the surgical intervention or as guidance during a minimally invasive intervention is important to the successful management of many medical conditions by surgeons, urologists, endocrinologists, emergency medicine physicians and other specialists.  Indeed, without ultrasound many specialists are unable to offer their patients the most advanced, efficacious diagnosis and treatment options available.

Ultrasound enables healthcare professionals to make the quick treatment decisions for diseases ranging from heart and liver disease to breast, colorectal and pancreatic cancer.[1] Aside from empirical evidence demonstrating its profound diagnostic capabilities, ultrasound is also used in a variety of other medical settings such as anesthesia and surgery to greatly improve patient safety and procedure effectiveness.[2]

Over the years, ultrasound has proven its value time and time again in low-resource areas, notably during disaster relief missions.[3] As mentioned above, ultrasound has the ability to diagnose a variety of conditions and illnesses from internal bleeding in adults to jaundice in infants and leg and abdominal pain in seniors. For example, a case study recounted a 63 year old man that visited a local clinic in Haiti complaining of increased abdominal pain. The physician conducted a physical exam, however it was only through using ultrasound at his bedside that the doctor found a 9 cm. abdominal aortic aneurysm.[4]

Ultrasound is often used in research projects to improve the quality of care in low-resource areas to help local healthcare professionals better combat the effects of malaria, severe dehydration, diarrhea and other tropical and parasitic diseases. Ultrasound is particularly useful when symptoms are unclear or cannot be detected by physical examination. It is also effective in avoiding more invasive and potentially harmful diagnostic investigation.[5]

As ultrasound becomes increasingly available around the globe, the innovative capacity of ultrasound manufacturers to develop new and more highly-advanced technologies will lead to even better visualization. As high frequency probes and 3-D and 4-D functionality become common features on an ultrasound system, this equipment will meet even more needs for doctors and patients whether they have access to a medical facility or not. Manufactures not only continue to improve the quality of their devices, but they also remain committed to ensuring that their products are appropriately used by a trained healthcare professional.

There is no doubt that, ultrasound “is a critical component in global health delivery and should be part of the evolving pedagogy of global health.”[6]

[1] Shah, Sachita, Daniel Price, Gene Bukhman, Sachin Shah, and Emily Wroe. Manual of Ultrasound: For Resource-Limited Settings. First Edition ed. Edited by Shah Sachita and Daniel Price. Partners In Health, 2011: 148-152.

[2] Shah, 11.

[3] Shah, 16.

[4] Shah, 369-372.

[5] Richter, Joachim, Christopher Hatz, and Dieter Haussinger. “Ultrasound In Tropical and Parasitic Diseases.” The Lancet no. 362 (2003): 900-902.

[6] Shah, 16.