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ABDOMEN & PELVIS STUDIES
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| Streamline clinical reporting workflows using structured USG templates. |
USG OF WHOLE ABDOMEN (MALE)
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FINDINGS:
- LIVER: Normal in size and echotexture. Intrahepatic biliary radicles are not dilated. No focal or solid mass lesion seen. Portahepatis is normal. Portal vein measures 10 mm in diameter.
- GB: Well distended with normal wall thickness. No intraluminal calculus seen. Liver / GB demarcation is clear.
- CBD: Normal in diameter (4 mm). No calculus is seen in CBD.
- PANCREAS: Shows normal echotexture. MPD is not dilated. No peripancreatic fluid collection is seen.
- SPLEEN: Normal in size and echotexture.
- KIDNEYS: Both kidneys are normal in size, shape, and position with normal cortical echotexture. Corticomedullary differentiation (CMD) is maintained bilaterally. No calculus, mass, or hydronephrosis is seen in either kidney. Right Kidney (RK) measures 83 mm; Left Kidney (LK) measures 93 mm.
- UB: Urinary bladder is well distended with normal wall thickness. No mass or calculus seen.
- PROSTATE: Normal in size and echotexture. Estimated weight is approximately 14 gms.
OTHER FINDINGS:
- No ascites seen.
- No adenopathy seen.
IMPRESSION:
- No significant abnormality detected.
USG OF WHOLE ABDOMEN (FEMALE)
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FINDINGS:
- LIVER: Normal in size and echotexture. Intrahepatic biliary radicles are not dilated. No focal or solid mass lesion seen. Portahepatis is normal.
- GB: Well distended with normal wall thickness. No intraluminal calculus seen. Liver / GB demarcation is clear.
- CBD: Normal in diameter (4 mm). No calculus is seen in CBD.
- PANCREAS: Shows normal echotexture. MPD is not dilated. No peripancreatic fluid collection is seen.
- SPLEEN: Normal in size and echotexture.
- KIDNEYS: Both kidneys are normal in size, shape, and position with normal cortical echotexture. Corticomedullary differentiation (CMD) is maintained bilaterally. No calculus, mass, or hydronephrosis is seen in either kidney. Right Kidney (RK) measures 97 mm; Left Kidney (LK) measures 100 mm.
- UB: Urinary bladder is well distended with normal wall thickness. No mass or calculus seen.
- UTERUS: Normal in size and echotexture. No focal myometrial lesion is seen. Endometrium is normal. Cervix is normal. Uterus measures [___] mm.
- OVARIES: Both ovaries are normal in size and echotexture. No focal solid or cystic lesion is seen in either ovary.
OTHER FINDINGS:
- No ascites seen.
- No adenopathy seen.
IMPRESSION:
- No significant abnormality detected.
USG OF LOWER ABDOMEN (FEMALE)
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FINDINGS:
- KIDNEYS: Both kidneys are normal in size, shape, and position with normal cortical echotexture. Corticomedullary differentiation (CMD) is maintained bilaterally. No calculus, mass, or hydronephrosis is seen in either kidney. Right Kidney (RK) measures 97 mm; Left Kidney (LK) measures 100 mm.
- UB: Urinary bladder is well distended with normal wall thickness. No mass or calculus seen.
- UTERUS: Normal in size and echotexture. No focal myometrial lesion is seen. Endometrium is normal. Cervix is normal. Uterus measures [___] mm.
- OVARIES: Both ovaries are normal in size and echotexture. No focal solid or cystic lesion is seen in either ovary.
OTHER FINDINGS:
- No ascites seen.
- No adenopathy seen.
IMPRESSION:
- No significant abnormality detected.
USG OF KUB (MALE)
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FINDINGS:
- KIDNEYS: Both kidneys are normal in size, shape, position, and echotexture. No calculus, cyst, or hydronephrosis is seen. Ureters are not dilated. Right Kidney (RK) measures 102 mm; Left Kidney (LK) measures 103 mm.
- UB: Urinary bladder is well distended. No mass or calculus seen.
- PROSTATE: Gland is normal in size and echotexture. No focal mass or calcification seen. Dimensions: 39 x 24 x 28 mm; estimated weight: 14 gms.
- S. VESICLES: Seminal vesicles are normal in outline and echogenicity.
OTHER FINDINGS:
- No ascites seen.
- No adenopathy seen.
IMPRESSION:
- USG features are within normal limits.
USG OF KUB (FEMALE)
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FINDINGS:
- KIDNEYS: Both kidneys are normal in size, shape, position, and echotexture. No calculus, cyst, or hydronephrosis is seen. Ureters are not dilated. Right Kidney (RK) measures 102 mm; Left Kidney (LK) measures 107 mm.
- UB: Urinary bladder is normally distended. No mass or calculus seen.
- UTERUS: Normal in size and echotexture. No focal myometrial lesion is seen. Endometrium is normal. Cervix is normal. Uterus measures [___] mm.
- OVARIES: Both ovaries are normal in size and echotexture. No focal solid or cystic lesion is seen in either ovary.
OTHER FINDINGS:
- No ascites seen.
- No adenopathy seen.
IMPRESSION:
- USG features are within normal limits.
USG WHOLE ABDOMEN (SCREENING) - EPLOIC APPENDAGITIS / OMENTAL INFARCT TEMPLATE
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FINDINGS:
- LIVER: Normal in size and echotexture. Intrahepatic biliary radicles are not dilated. No focal or solid mass lesion seen. Portahepatis is normal. Portal vein measures 9 mm in diameter.
- GB: Well distended with normal wall thickness. No intraluminal calculus seen. Liver / GB demarcation is clear.
- CBD: Visualized CBD is normal in diameter (4 mm). No calculus is seen in the visualized portion.
- PANCREAS: Normal in size, shape, position, and echotexture. MPD is not dilated. No peripancreatic fluid is seen.
- SPLEEN: Normal in size and echotexture.
- KIDNEYS: Both kidneys are normal in size, shape, position, and echotexture. No calculus, mass, or hydronephrosis is seen in either kidney.
- UB: Urinary bladder is well distended with normal wall thickness. No mass or calculus seen.
- PROSTATE: Normal in size and echotexture.
OTHER FINDINGS:
- Bright intra-abdominal fat is noted in the left lower quadrant of the abdomen with overlying probe tenderness.
- No ascites seen.
- No adenopathy seen.
IMPRESSION:
- Bright intra-abdominal fat in the left lower quadrant of the abdomen with overlying probe tenderness—highly suggestive of Epiploic appendagitis / Acute omental infarct.
- RECOMMENDATION: Clinical follow-up as indicated.
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OBSTETRIC STUDIES
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USG OF OBSTETRICS / PREGNANCY (TWIN GESTATION)
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FINDINGS:
- FETUS: Two live intrauterine fetuses are visualized.
* FETUS A (Breech Presentation):
- Biometry: BPD = 82 mm, FL = 89 mm, HC = 294 mm, AC = 249 mm
- Heart Rate: FHR = 132 bpm, regular
- Gestational Age: 31 weeks 3 days
- Estimated Fetal Weight (EFW): 1567 gms ± 229 gms
- Nuchal Cord: Not visualized around the neck
* FETUS B (Cephalic Presentation):
- Biometry: BPD = 85 mm, FL = 65 mm, HC = 305 mm, AC = 270 mm
- Heart Rate: FHR = 136 bpm, regular
- Gestational Age: 33 weeks 2 days
- Estimated Fetal Weight (EFW): 1990 gms ± 291 gms
- Nuchal Cord: Not visualized around the neck
- PLACENTA: Located posteriorly and towards the left side of the uterine body. It is not low-lying. Maturity: Grade II.
- LIQUOR VOLUME: Volume is normal. Largest vertical pocket measures 36 mm.
- DOPPLER: No reversal or absence of end-diastolic flow noted in the umbilical arteries of either fetus.
IMPRESSION:
- Twin live intrauterine pregnancy.
- Twin A in breech presentation at approximately 31 weeks 3 days maturity (EFW ~ 1567 gms).
- Twin B in cephalic presentation at approximately 33 weeks 2 days maturity (EFW ~ 1990 gms).
- Normal umbilical artery Doppler waveforms without reversal or absence of diastolic flow bilaterally.
USG OF OBSTETRICS / PREGNANCY (SINGLE GESTATION WITH OLIGOHYDRAMNIOS)
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FINDINGS:
- FETUS: Single live fetus is visualized in Cephalic presentation.
- FETAL PARAMETERS & BIOMETRY:
* BPD: 71 mm
* FL: 53 mm
* HC: 252 mm
* AC: 228 mm
* Fetal Heart Rate (FHR): 167 bpm, regular
* Gestational Age (GA by USG): 27 weeks 2 days
* Estimated Fetal Weight (EFW): 1117 gms ± 163 gms
* EDD by LMP: 20.02.2018
* EDD by USG: 23.02.2018
* Nuchal Cord: Not visualized around the neck
- PLACENTA: Located posteriorly along the uterine body. It is not low-lying. Maturity: Grade I.
- LIQUOR VOLUME: Mildly reduced. Largest vertical pocket measures 23 mm. Amniotic Fluid Index (AFI) is 7.6 cm.
IMPRESSION:
- Single live intrauterine pregnancy in cephalic presentation at approximately 27 weeks 2 days maturity.
- Mildly reduced liquor volume (AFI = 7.6 cm).
- RECOMMENDATION: Follow-up scan advised.
USG FOR EARLY PREGNANCY
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FINDINGS:
- UTERUS: Bulky with normal myometrial echotexture. No myoma visualized.
- GESTATIONAL SAC: A well-defined, rounded, fundal intrauterine gestational sac is seen implanting normally.
- EMBRYO: A single viable embryo is noted within the sac. Fetal heart rate measures [___] bpm at the time of the scan and is regular.
- YOLK SAC: An approximately [___] mm sized rounded yolk sac is identified within the gestational sac.
- EVALUATION PARAMETERS:
* Mean Sac Diameter (MSD): [___] cm, corresponding to [___] weeks [___] days
* Crown-Rump Length (CRL): [___] cm, corresponding to [___] weeks [___] days
* Estimated Gestational Age by USG: [___] weeks [___] days
* Estimated Date of Delivery (EDD) by USG: [___]
- PATHOLOGY: No evidence of subchorionic hemorrhage is seen.
- CERVIX: Normal in length. Internal os is closed.
- OVARIES: Bilateral ovaries are normal in size and echotexture. No free fluid visualized in the cul-de-sac.
IMPRESSION:
- [___] Weeks [___] Days gestational age single live intrauterine pregnancy.
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SMALL PARTS & VASCULAR DOPPLER
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HIGH-RESOLUTION USG OF THE NECK (THYROID)
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FINDINGS:
- THYROID GLAND: Both lobes are normal in size and echotexture. No focal solid mass, cyst, or calcification seen. No focal areas of hypoechogenicity are identified.
* Right lobe measures: 37 x 11 mm
* Left lobe measures: 30 x 11 mm
- ISTHMUS: Normal in thickness.
- VASCULARITY: Normal color flow pattern noted throughout the thyroid gland.
- SALIVARY GLANDS: Bilateral parotid and submandibular glands appear normal in size and echostructure.
HIGH-RESOLUTION USG OF SCROTUM
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FINDINGS:
- TESTIS: Both testicles are normal in size, shape, and echotexture. No focal hypoechogenicity, mass, or calcification seen. Testicular vascularity is normal.
* Right testis measures: 46 x 23 mm
* Left testis measures: 40 x 20 mm
- EPIDIDYMIS: Bilateral epididymides display a normal outline and echogenicity. No cystic or solid mass identified.
* Right epididymis measures: 16 x 8.6 mm
* Left epididymis measures: 10 x 6.4 mm
- FLUID POCKET: Fluid collections within the tunica vaginalis are within normal bilateral limits.
- SPERMATIC CORD: Bilateral cord veins show normal caliber. No varicosities or abnormal pampiniform plexus dilations seen.
OTHER FINDINGS:
- No adenopathy seen.
IMPRESSION:
- Normal scrotal and testicular ultrasound study.
RENAL DOPPLER STUDY
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FINDINGS:
- B-MODE SCANS: Both kidneys are normal in size, shape, and echotexture. No calculus, cyst, or calcification seen. No hydronephrosis is noted. Corticomedullary differentiation (CMD) is maintained bilaterally.
* Right Kidney (RK) measures: 105 x 52 mm
* Left Kidney (LK) measures: 106 x 51 mm
- MAIN RENAL ARTERIES: The renal ostia and proximal segments of the bilateral renal arteries are partially obscured by overlying bowel gas. Main renal arteries visualized at the hilar regions show no abnormal narrowing, with peak systolic velocities (PSV) under 100 cm/s.
- INTRARENAL VESSELS: Bilateral intrarenal vessels show a normal flow configuration; however, evaluation parameters reveal distinct spectral changes:
* Right Kidney Parameters:
- Upper Pole: RI = 0.53 | Acceleration Time = 0.053 sec
- Mid Pole: RI = 0.55 | Acceleration Time = 0.044 sec
- Lower Pole: RI = 0.60 | Acceleration Time = 0.062 sec
* Left Kidney Parameters:
- Upper Pole: RI = 0.54 | Acceleration Time = 0.053 sec
- Mid Pole: RI = 0.55 | Acceleration Time = 0.053 sec
- Lower Pole: RI = 0.64 | Acceleration Time = 0.040 sec
*(Reference: Normal RI < 0.7; Normal Acceleration Time < 0.07 sec)*
IMPRESSION:
- Parvus tardus flow pattern in the intrarenal vessels of both kidneys with prolonged acceleration time. This provides indirect hemodynamic evidence of significant bilateral renal artery stenosis.
- Main renal arteries are incompletely evaluated due to limiting bowel gas artifacts.
- RECOMMENDATION: Advise CT Angiography (CTA) of the renal arteries to definitively evaluate for ostial or proximal renal artery stenosis.
COLOUR DUPLEX DOPPLER STUDY OF THE RIGHT LOWER LIMB
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FINDINGS:
- ARTERIAL SYSTEM: Evaluated using a high-frequency 7.5 MHz probe. The arterial system of the right lower limb is normal in course and caliber. Focal areas of intimomedial calcification are noted within the lower limb vessels without evidence of dynamic hemodynamically significant stenosis or aneurysm formation. Spectral analysis reveals a preserved triphasic flow pattern down to distal segments, with a gradual reduction of peak velocity and no zones of turbulent flow.
- VENOUS SYSTEM: Bilateral saphenofemoral and saphenopopliteal junctions, great saphenous veins (GSV), common femoral, superficial femoral, and popliteal veins are normal in caliber. They demonstrate full wall compressibility, normal respiratory variations, and intact post-compression augmentation. No intraluminal thrombus, varicosities, or perforator incompetence is noted.
IMPRESSION:
- Intimomedial calcification in right lower limb vessels, likely secondary to age-appropriate atherosclerotic changes.
- Maintained normal triphasic arterial flow within the right lower limb.
- Negative for deep vein thrombosis (DVT) or superficial venous insufficiency.
CAROTID DOPPLER STUDY
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FINDINGS:
- COMMON CAROTID ARTERIES (CCA): Intimomedial thickening is noted in bilateral common carotid arteries. No discrete plaque or filling defects visualized. Normal color signal mapping and normal peak systolic velocities are present.
* Right CCA IMT = 1.1 mm
* Left CCA IMT = 1.1 mm
- INTERNAL & EXTERNAL CAROTID ARTERIES:
* Extracranial ICA: Visualized bilateral internal carotid arteries show normal course and a standard low-resistance flow pattern. No atheromatous plaque, dilatation, or lumen narrowing is seen.
* ECA: Visualized bilateral external carotid arteries demonstrate normal high-resistance triphasic flow patterns without plaque or narrowing.
- VERTEBRAL ARTERIES: Bilateral vertebral arteries display a normal low-resistance flow profile with clear antegrade flow directed towards the brain. No subclavian steal phenomenon is identified.
- JUGULAR VEINS: Bilateral internal jugular veins (IJV) are patent without evidence of intraluminal thrombus.
IMPRESSION:
- Intimomedial thickening in bilateral common carotid arteries, consistent with atherosclerotic changes.
- No hemodynamically significant plaque or thrombus within the bilateral extracranial ICA, ECA, or CCA.
- Patent vertebral arteries with normal antegrade cephalic flow. No steal phenomenon detected.
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Frequently Asked Questions
1. What are the key measurements included in a normal male KUB ultrasound template?
A standard male KUB (Kidneys, Urinary Bladder, Prostate) template records normal kidney dimensions (typically between 100 mm to 110 mm), checks for ureteral dilation, confirms normal bladder wall thickness without internal masses, and measures the prostate dimensions alongside its estimated clinical weight (usually around 14 gms for a healthy young adult).
2. How should an early pregnancy ultrasound report be structured?
An early pregnancy template focuses on establishing early structural viability. It documents uterine configuration, the location and shape of the gestational sac, the visibility of the yolk sac, the presence of a live embryo with regular fetal heart rate (FHR) values, accurate Mean Sac Diameter (MSD) or Crown-Rump Length (CRL) metrics, and verifies the absence of subchorionic hemorrhage collections.
3. What fetal parameters are tracked in multi-fetal obstetric reports?
For a twin or multi-fetal scan, the reporting sheets separate each fetus individually (Fetus A, Fetus B). They map distinct presentation positions (breech or cephalic), calculate comprehensive biometric markers including BPD, FL, HC, and AC, track independent fetal heart rates, evaluate individual estimated weights, and check for structural umbilical cord loops around the neck.
4. What does a "parvus tardus" waveform pattern suggest on a renal Doppler scan?
A parvus tardus waveform pattern indicates an altered intrarenal vessel profile showing a prolonged acceleration time combined with dampened systolic peaks. In clinical reporting, this serves as strong indirect hemodynamic evidence indicating significant upstream renal artery stenosis, which warrants further diagnostic evaluation via CT Angiography.
5. How is a normal carotid Doppler study described?
A normal carotid study notes smooth, uniform color signal filling throughout the common carotid arteries (CCA), internal carotid arteries (ICA), and external carotid arteries (ECA). It confirms normal low-resistance profiles in the ICA, high-resistance triphasic profiles in the ECA, antegrade cephalic flow in the vertebral arteries, and the absence of focal atheromatous plaques or internal jugular vein thrombosis.
6. What is the normal baseline value for the Carotid Intimomedial Thickness (IMT)?
In clinical reporting templates, baseline intimomedial thickness (IMT) measurements for the common carotid arteries typically hover around 1.1 mm or less. Values exceeding this threshold are documented as localized or systemic intimomedial thickening, which is usually an early indicator of underlying systemic atherosclerotic alterations.
7. How does an ultrasound screening report describe suspected epiploic appendagitis?
When scanning an acute abdomen showing localized left lower quadrant issues, the template highlights localized areas of bright, hyperechoic intra-abdominal fat layers. When this finding matches perfectly with reproducible probe tenderness directly over the site, it is highly indicative of localized epiploic appendagitis or an acute omental infarct.
8. Why is it important to standardize reporting formats for new sonologists?
Enforcing structured report formats creates a systematic scanning methodology that prevents clinicians from accidentally skipping small organs during routine screening. It also helps referring healthcare providers quickly locate key diagnostic markers by keeping metrics and structural summaries in consistent locations.
9. What are the reference limits for normal intrarenal vascular Doppler metrics?
When analyzing the intrarenal microvasculature, a normal Resistivity Index (RI) value should fall comfortably below 0.7. Concurrently, a normal systolic acceleration time should remain under 0.07 seconds. Variations outside these parameters typically point to underlying renovascular pathologies.
10. What is the ideal format for the final "Impression" section of a USG report?
The final Impression section must function as a concise, highly focused clinical summary of the entire study. Rather than rehashing every individual measurement, it needs to directly answer the specific clinical question or primary symptom raised by the referring physician on the original consultation request.