I. General ultrasound preparation

1. Liver   

Generally, no preparation is needed. In order to observe small changes in the intrahepatic portal vein and hepatic venous system, fasting or postprandial examination control can be done respectively. For those with abdominal distension, please assist in the evacuation of gas. Constipated people can take laxatives to clear the bowel the night before the examination.

2. Spleen No special.

3. Gallbladder, common bile duct     

(1) Before the examination, fast for more than 8 hours to ensure that the gallbladder and bile ducts are filled with bile and to minimize interference with gastrointestinal contents and gas. Fasting usually begins after dinner the day before and the examination is performed on an empty stomach the following morning.

(2) Barium for X-ray gastroenterography is a strong reflector and absorber of ultrasound. If barium remains in the gastrointestinal tract near the gallbladder and bile ducts, it interferes with the ultrasound examination. Although biliary X-ray contrast agents do not constitute a direct obstacle to ultrasonography, they affect the normal physiologic state of the biliary tract. Therefore, ultrasonography should be scheduled first; or ultrasonography should be performed 3 days after X-ray gastroenterography and 2 days after cholangiography.

(3) The transverse colon has more contents and gas, which can interfere with the imaging of the gallbladder and bile ducts. It should be examined after enema or defecation.

(4) Pediatric patients or uncooperative patients can be examined in sleep state after giving sleeping pills.

Emergency patients to relax the above conditions, seriously ill patients need to be accompanied by emergency physicians in the close observation of vital signs and emergency rescue preparations for the state of timely examination.

4. Pancreas   

Patients should generally fast for more than 8 hours. That is, eat a light diet the night before, fasting in the morning, to reduce the stomach food caused by excessive gas, hindering the ultrasound incidence. For those with abdominal distension or constipation, take laxative before bedtime, and then perform ultrasound examination after morning defecation or enema. If there is still a lot of gas in the stomach through the above methods, which makes the display of the pancreas unsatisfactory, the patient can drink 500-800ml of water to make the stomach cavity full of liquid as a transducer window, which is convenient for displaying the pancreas as a whole.

5. Transesophageal examination   

Before the examination, X-ray fluoroscopy of the esophagus with barium swallow should be performed to find out whether there is any lesion in the esophagus (such as cancer, diverticulum, varicose veins, etc., and those with lesions are generally not examined). Fasting for more than 4 hours before the examination, Valium 10mg, atropine 0.25mg can be injected intramuscularly in the first 15 minutes, and local anesthesia with lidocaine or other agent spray is applied to the oral pharynx before insertion of the probe. Connect the ECG lead wire and monitor the ECG; measure the blood pressure at any time if necessary. After the examination, observe whether there is any blood or foamy sputum spit out, and whether there is any change in heart rate, heart rhythm, and blood pressure. Listen for the presence of rales in the lungs if necessary.

*Note: This examination is generally not performed in pediatric cases. A pediatric esophageal ultrasound probe should be used if necessary.

6. Heart   

Transthoracic cardiac examination generally requires no special preparation. For chest tightness, angina pectoris, arrhythmia, the patient's general condition is very poor or extremely weak cases, must be connected to the electrocardiogram display at the same time; transesophageal cardiac examination, the examination of the preparations for the same section 5.

7. Kidney, ureter   

Generally, no special preparation is required. Only when it is necessary to detect the renal blood vessels or to know whether the renal tumor has metastasis (detecting the renal vein, inferior vena cava and renal hilar lymph nodes), it is necessary to examine on an empty stomach. If the abdomen is distended, an overnight antiflatulent or laxative should be taken to reduce intestinal gas and facilitate ultrasound penetration. When detecting stones or tumors in the renal pelvis, renal calyces and ureter, drink water half an hour before the examination to fill the bladder.

8. Bladder 

(1) Suprapubic transabdominal route: Drink 500 m1 of water 60 minutes before the test to fill the bladder.

(2) Transurethral route: no water is required before detection.

(3) Transrectal route: It is not advisable to overfill the bladder before the test, but a small amount of urine should be retained in the bladder.

9. Prostate 

(1) Probing the prostate through the abdominal wall does not require overfilling the bladder. Bladder retained half or less some urine is sufficient, too much filling to make the detection of inconvenience. In patients with prostatic hyperplasia, overfilling the bladder may induce urinary retention.

(2) When detecting through the rectum, a small amount of urine in the bladder is enough, too much filling can still check the prostate and seminal vesicles, but only a small part of the bladder can be scanned. A bowel movement or enema should be performed before transrectal exploration.

10. Adrenal glands   

Should be detected on an empty stomach, abdominal distension patients, need to use laxatives or anti-flatulence tablets to get better results.

11. Gastrointestinal tract   

Gastrointestinal examination, need to be in the examination of 2 ~ 3 days before fasting flatulence food, such as milk, soy products. The night before the examination should be into the less crumbly food, no more food or drink after dinner, but need to take diarrhea medication (such as senna 3 ~ 9 grams of brewing). The next morning fasting examination.

12. Large abdominal vessels   

Generally do not need to make special preparations. When more gas in the intestinal lumen, hindering the detection, the patient can be asked to repeat the detection in the case of fasting. If necessary, enema can be given first, fasting easy to ferment gas-producing food; or take dimethylsiloxane tablets 1 ~ 2 days before ultrasound detection.

13. Uterus and ovaries 

(1) Transabdominal surface detection   

In order to avoid the influence of gas and fecal matter in the intestines, it is required to check after defecation. If you are constipated, take laxatives the night before. Generally 1 hour before the examination, drink 300-500m1 of water, so that the bladder is moderately full; if necessary, oral or injectable diuretics (tachycardia), so that the bladder fills quickly, the standard of moderately full bladder to show the bottom of the uterus is appropriate. Excessive filling may change the position of the uterus, which is unfavorable for image observation.

(2) Transvaginal ultrasound   

The patient should be free of acute or subacute inflammation of the reproductive tract; there is no need to fill the bladder, or make the bladder a little full to facilitate the localization of the uterus.

(3) Transuterine ultrasound   

The patient should be free of acute or subacute inflammation of the reproductive tract; it should be performed within a few days after the end of menstruation, and the aseptic technique should be strictly adhered to.

(4) Ultrasonography of the uterus and fallopian tubes 

The examinee should have no contraindications such as acute or subacute inflammation of the reproductive tract; it should be performed 3-5 days after the end of menstruation. The night before the examination, take a laxative (sorbitol) to clean the bowel. The bladder should be moderately full during the examination, and scopolamine or atropine 0.5 mg should be injected intramuscularly 10 minutes before the procedure to prevent muscle spasm of the uterine horn.

14. Pregnant uterus

(1) Transabdominal body surface detection   

   Moderate filling of the bladder

1) In order to push open the air-containing intestinal cavity in front of the uterus in early pregnancy, the patient should drink 500-800 m1 of water 2-3 hours before the examination. 20-30 minutes after drinking water, urine spraying can be seen at the ureteral opening in the bladder. Ultrasonography can be performed when the patient's urge to urinate is more urgent. If the examination is performed in the morning, it is sufficient if the urine is not voided in the morning. Avoid rushing to drink before the examination, then not only the bladder filling is not ideal, delay the examination time; and easy to cause the bowel cavity containing fluid, resulting in false impression. The so-called moderation is generally based on the bottom of the filled bladder just beyond the bottom of the uterus. If the filling is not good, the pelvic structure will be poorly displayed; if the filling is excessive, the uterus may be squeezed, resulting in deformation of the gestational sac, or even flattened and not clearly displayed, and the adnexa may also be pushed out of the pelvis. A small number of patients who can not tolerate the discomfort of holding urine, can be sterilized after inserting a catheter, injected into the bladder 20-25 ℃ warm saline, passive filling of the bladder. This method is more complicated, but it can fill the bladder quickly without having to wait. It can not only shorten the examination time, but also control the appropriate amount of filling, improve the examination effect, especially for patients with acute illness.

2) Middle and late pregnancy, because the bottom of the uterus rises out of the pelvis, in addition to the need to observe the relationship between the lower edge of the placenta and the position of the inner cervix, the bladder does not need to be filled before the examination.

(2) Transvaginal ultrasound detection A small amount of urine should be retained in the bladder to assist in localization.

(3) Transrectal ultrasound detection The bladder should not be overfilled before the examination and a small amount of urine should be retained.

15. Bones, muscles, joints 

No special preparation is needed for general patients. For open trauma, care should be taken to protect the wound from contamination. For those suspected of having special surgical infections, special treatment is needed to avoid cross-infection. Ultrasonography should be performed before arthrography and arthroscopy. When sacral and pelvic tumors need transabdominal scanning, the bladder should be filled.