Unit 15: Preliminary interpretation

Question 1

T/F:

Sonographers can LEGALLY interpret exams

Answer 1

False.

• Avoid practicing medicine without a license
• You can write a report of the findings for the INTERPRETING PHYSICIAN

Question 2

If you must give a verbal report to a physican, what must you do?

Answer 2

Must identify yourself as a sonographer and preface with “This is a preliminary report of findings.”

Question 3

How must a written report be identified as?

Answer 3

Preliminary report.

Question 4

How do you preform a preliminary interpretation-step by step analysis?

Answer 4

1. Check patient history/symptoms
2. Check CCA for inflow/local/outflow obstructions, compare RT to LT
3. Grade ICA
   
   1. psv and edv
   2. Ratio
   3. Image % and characteristics of plaque
   4. Do they agree? Why not? Find a reason.
4. Check ECA for stenosis
5. Check VERT for direction, obstruction
6. Check SCA for obstruction
7. Check for other pathology
8. Do steps 2-7 for contralateral side
9. Compare results to previous exam
10. Do symptoms and results match? Anything missing? Artifacts?

Question 5

What must an exam report include?

Answer 5

• Test performed
• Indication
• Patient name, ID, DOB
• Referring physician
• Sonographer
• Interpreting physician
• Data
• Analysis
• Conclusion

Question 6

Why do you want to make sure the most important points appear in the conclusion for each vessel?

Answer 6

Most referring physicians will only read the conclusion.

Question 7

What should you report in a carotid interpretation?

Answer 7

• Report image quality
  
  • A fair or low quality exam may influence the referring physician to obtain further imaging
• Report unusual level of bifurcation
• Report limitations/artifacts, ie calcification
• Report tortuosity, arrhythmias, unusual waveforms
  
  • ie parvus tardus CCA, long duration reversed flow may be from aortic regurgitation

Question 8

What are some unsual findings that one can encounter in an carotid exam?

Answer 8

• Carotid tortuosity
• Carotid dissection
• Fibromuscular dysplasia
• Moving thrombus in carotid
• Carotid body tumor
• Carotid aneurysm or pseudoaneurysm
• Arteriovenous fistula
• IJV thrombus
• Carotid surgery, i.e. patch, bypass, stent
• Radiation in neck area