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Sonography
Scanning
PRINCIPLES AND PROTOCOLS
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Sonography Scanning
PRINCIPLES AND PROTOCOLS
FOURTH EDITION
BETTY BATES TEMPKIN, BA, RT(R), RDMS
Ultrasound Consultant
Formerly Clinical Director of the Diagnostic
Medical Sonography Program
Hillsborough Community College
Tampa, Florida
3251 Riverport Lane
St. Louis, Missouri 63043
SONOGRAPHY SCANNING: PRINCIPLES AND PROTOCOLS,
FOURTH EDITION ISBN: 978-1-4557-7321-3
Copyright 2015, 2009, 1999, 1993 by Saunders, an imprint of Elsevier Inc.
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage
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This book and the individual contributions contained in it are protected under copyright
by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research
and experience broaden our understanding, changes in research methods, professional
practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge
in evaluating and using any information, methods, compounds, or experiments
described herein. In using such information or methods they should be mindful of their
own safety and the safety of others, including parties for whom they have a professional
responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised
to check the most current information provided (i) on procedures featured or (ii) by
the manufacturer of each product to be administered, to verify the recommended dose
or formula, the method and duration of administration, and contraindications. It is
the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors,
or editors, assume any liability for any injury and/or damage to persons or property as
a matter of products liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the material herein.
Executive Content Strategist: Sonya Seigafuse
Content Development Specialist: Laurie Gower
Content Coordinator: John Tomedi
Marketing Manager: Jaime Augustine
Publishing Services Manager: Jeff Patterson
Project Manager: Mary Stueck
Text Designer: Renée Duenow
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To Max
“Remarkable, Soulful, Honorable”
and
To David
“Exceptional, Insightful, Generous”
Contributors
Peggy Ann Malzi Bizjak, MBA, RDMS, RT(R)(M), CRA
Radiology Manager–Ultrasound
Radiology and Medical Imaging Department
University of Virginia Health System;
Adjunct Faculty
Diagnostic Medical Sonography Program
Piedmont Virginia Community College
Charlottesville, Virginia
Amy T. Dela Cruz, MS, RDMS, RVT
Medical Sonography Program Director
South Piedmont Community College
Monroe, North Carolina
Musculoskeletal Scanning Protocol for Rotator Cuff, Carpal Tunnel,
and Achilles Tendon
Kristin Dykstra Downey, AS, RT(R), RDMS
Echovascular Sonographer
Allied Mobile Imaging
Ooltewah, Tennessee
Neonatal Brain Scanning Protocol
Wayne C. Leonhardt, BA, RT(R), RVT, RDMS
Faculty
Foothill College of Ultrasound
Los Altos, California;
Staff Sonographer, Technical Director, and Continuing
Education Director
Summit Medical Center
Oakland, California
Thyroid and Parathyroid Glands Scanning Protocol
Maureen E. McDonald, BS, RDMS, RDCS
Staff Echocardiographer
Adult Echocardiography Instructor and Lecturer
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
Adult Echocardiography Scanning Protocol
Pediatric Echocardiography Scanning Protocol
vi
Marsha M. Neumyer, BS, RVT, FSVU, FAIUM, ASDMS
International Director
Vascular Diagnostic Educational Services
Vascular Resource Associates
Harrisburg, Pennsylvania
Abdominal Doppler and Color Flow Imaging
Cerebrovascular Duplex Scanning Protocol
Peripheral Arterial and Venous Duplex Scanning Protocols
Betty Bates Tempkin, BA, RT(R), RDMS
Ultrasound Consultant
Formerly Clinical Director of the Diagnostic Medical Sonography
Program
Hillsborough Community College
Tampa, Florida
Guidelines; Scanning Planes and Scanning Methods; Scanning Protocol
for Abnormal Findings and Pathology; Abdominal Aorta Scanning
Protocol; Inferior Vena Cava Scanning Protocol; Liver Scanning Protocol;
Gallbladder and Biliary Tract Scanning Protocol; Pancreas Scanning
Protocol; Renal Scanning Protocol; Spleen Scanning Protocol; Female Pelvis
Scanning Protocol; Transvaginal Scanning Protocol for the Female Pelvis;
Obstetrical Scanning Protocol For First, Second, And Third Trimesters;
Male Pelvis Scanning Protocol for the Prostate Gland, Scrotum, and Penis;
Thyroid and Parathyroid Glands Scanning Protocol; Breast Scanning
Protocol; Neonatal Brain Scanning Protocol
CONTRIBUTORS vii
Editorial Review Board
Liesa Bromet, RDMS, RDCS, RVT, BSN, RN
Program Director
Diagnostic Medical Sonography
Pensacola State College
Pensacola, Florida
Marcia J. Cooper, MSRS, RT (R)(M)(CT)(QM), RDMS, RVT
Clinical Coordinator
Diagnostic Medical Sonography Program
Morehead State University
Morehead, Kentucky
Casey Davis, RDMS, RVT
Sonography Program Coordinator
Angelina College
Lufkin, Texas
Stacey Dishion, RDMS
Faculty
Diagnostic Medical Sonography Program
Northern Virginia Community College
Springfield, Virginia
viii
Anita Freeman, MHS, BSRDMS, RVT, APS, RTR
Assistant Dean
Diagnostic Medical Sonography
Northern Virginia Community College, Medical Education Campus
Springfield, Virginia
Tim S. Gibbs, BSDMS, RT (r,f), RDMS, RVT, CTNM
Clinical Instructor and Part-Time Faculty
Orange Coast College
Costa Mesa, California;
West Anaheim Medical Center
West Anaheim, California
Ecaterina Mariana Hdeib, MA, RDMS
Clinical Assistant Professor
Diagnostic Medical Ultrasound Program
University of Missouri
Columbia, Missouri