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5 Specialty Areas for Diagnostic Medical Sonographers

Nothing is more precious than a child’s first picture, which today will often consist of an image taken before birth. [1] While this diagnostic modality frequently offers the first glimpse of a long set of pictures saved for posterity, ultrasound examinations serve a critical purpose in evaluation of fetal anatomy and, in some cases, providing guidance in correcting prenatal conditions.

Sonographer checking woman's stomach.

A benefit of sonography is that is does not use ionizing radiation; and it can also be more cost effecting as compared to other imaging modalities including, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans. [2] Sonographers use advanced medical equipment, which transmits sound waves, to acquire images of anatomy and pathology so that care providers can accurately diagnose and treat patients. Some sonographers also assist surgeons during operations, including removal of brain tumors.

In the future, heart surgeons hope to use ultrasound technology to perform remote procedures, eliminating the need to transport patients to distant operating theaters. In the meantime, most diagnostic medical sonographers assist care providers in making important medical assessments. There are multiple specialty areas of sonography and many sonographers will become certified and practice in more than one of these areas, five of which are explained below.

Breast Sonographer

In this discipline, sonographers use ultrasound to acquire images of female mammary glands. [3] Ultrasound breast exams require little preparation, are painless, and are also used as an adjunct to mammography.

As the breast anatomy and any pathology is viewed, Doppler imaging may also be used to identify and evaluate blood flood. This can assist in determining the risk for malignancy of certain tumors, so that an appropriate treatment plan can be determined.

Abdominal Sonographer

During abdominal sonograms, sonographers acquire images of the abdominal organs including the abdominal aorta, gallbladder, kidneys, liver, pancreas, and spleen. [4] Care providers might order an ultrasound examination to find the cause of liver malfunctions, or abdominal pain, as well as to locate life-threatening aneurysms or stones in the gallbladder or kidney.

Sonographers may use Doppler imaging to identify blood clots, evaluate tumors, or assess other blood flow issues in the abdominal region. Sonographers rarely focus on abdominal imaging alone and frequently combine their skills in abdomen with other specialty areas, such as OB/Gyn, to perform more comprehensive evaluations in radiology ultrasound departments.

Obstetrics/Gynecology (OB/GYN)

Sonographers practicing in the arena of obstetrics and gynecology focus on the pregnant and non-pregnant female pelvis. [5] Obstetrical sonographers evaluate the uterus and ovaries of pregnant women while focusing on fetal anatomy and any conditions or abnormalities that could adversely affect the pregnancy including their unborn child.

Gynecological sonographers assist in of the identification of anatomy, pathology, and conditions relating to female pelvic anatomy which may include the cervix, fallopian tubes, uterus, and ovaries. Evaluation of female pelvic anatomy may focus on infertility, congenital abnormalities, tumors, and abnormal bleeding and may be used in across the lifespan, from pediatrics to geriatrics.

Vascular Sonographer

Vascular sonographers focus primarily on imaging of the arteries and veins throughout the body. This may include looking at blood flow within major organs, such as the liver and brain, or evaluating circulation in the arms and legs. Vascular sonographers may evaluate the carotid arteries in patients who are at risk for having a stroke, or in patients who have already had a stroke. They also assess for blood clots in the legs that can become life threatening if part of the clot breaks off and travels to other organs such as the lungs. Vascular sonographers may also evaluate vessels in patients with vascular disease to document the response to treatment. Vascular sonographers may work in dedicated vascular laboratories, in combined cardiac and vascular departments, or radiology ultrasound departments.

Cardiac Sonographer

Cardiac sonographers may also be called echocardiographers and focus on the many functions, defects, and diseases of the heart. Cardiac sonographers may focus on the pediatric patient and/or the adult patient, each bringing specific types of conditions and diseases that the sonographers must understand in order to adjust the imaging technique. Cardiac sonographers may also assist in evaluating the heart using contrast solutions, acquire images using 3-dimensional technique, and assist the physicians during procedures such a transesophageal echocardiography (TEE). Workplace distribution is relatively even, with half of these imaging specialists working in institutions and the other half working in private practices.

An Expert’s Thoughts on Maximizing Sonography Use

In recent Medscape interview, clinical assistant professor of anesthesiology at Hospital for Special Surgery (HSS) in New York City Stephen Caleb Haskins, MD, voiced his opinion on what he believes represents the next frontier for sonography applications. Haskins expressed that bedside ultrasound examinations help him and his peers diagnose potential illnesses and save lives. The anesthesiologist compares sonography equipment to a modern, high-tech version of the stethoscope. Through the American Society of Regional Anesthesia and Pain Medicine (ASRA) Haskins trains other doctors in using ultrasound technology to perform detail evaluations of patient airways, hearts and lungs.

Haskins goes on to state that the course teaches providers how to use ultrasound equipment to enhance planning and delivery before, during and after procedures. However, he articulates, sonography technology can also prove beneficial in emergency service environments, and using the technology in this fashion has gained favor among many cardiologists.

Sonography diagnostics promote considerable improvements in clinical decision-making. Doctors can use the equipment to determine important factors, such as whether to postpone a procedure or revise surgical procedures during an operation. Ultrasound technology also helps doctors make decisions while operating on patients’ with unstable blood flow. In fact, doctors can use the technology to make many lifesaving diagnoses.

Learn More

The Adventist University of Health Sciences online Bachelor of Science in Diagnostic Medical Sonography degree program was specifically crafted for working adult learners. We know that flexibility in completing your coursework can be a major factor in you starting – and completing – your sonography degree. Our online Bachelor of Science degree in Diagnostic Medical Sonography allows you maximum flexibility in meeting your work, family, personal, and education commitments.