The goals of the Division of Ultrasound Imaging are to provide effective, high-quality imaging services to patients in the most compassionate and stress-free manner possible; to provide high quality educational opportunities to students across a spectrum of professional backgrounds—radiology fellows and residents, medical students, and sonography trainees; to advance knowledge in clinical care and the technologies of ultrasound imaging; and provide an effective and collegial referral service to clinicians from throughout the Dartmouth-Hitchcock community. We work closely with the Children's Hospital at Dartmouth-Hitchcock (CHaD), and with the Department of Obstetrics and Gynecology. Utilization of ultrasound imaging has been increasing steadily—our clinical volumes have increased at an annual rate of roughly 9% over the past five years.
Ultrasound is used for imaging all body areas except the heart and vascular system, and also plays a role in image-guided interventional procedures, including the Prostate Biopsy Clinic at NCCC. We work in close collaboration with the members of the Maternal-Fetal Medicine (MFM) staff and Reproductive Endocrinology/ Infertility (REI) specialists, who conduct a complementary imaging service. Anal sphincter sonography is used to diagnose defects in the sphincter, which may lead to urinary or fecal incontinence following childbirth or trauma. Screening programs include nuchal scans for the early detection of Down's syndrome, liver and portal vein screening for cirrhosis.
The division employs eight sonographers, and maintains an eight-room facility equipped with Philips Medical and Siemens ultrasound systems and, new this year, the GE Logic E8. 3D imaging is increasingly common, as well as the use of cine clips that can be captured and displayed on workstations. Dennis Seguin, ultrasound team leader, has been invaluable in maintaining the quality of our service and systems.
Teaching and research are key components of our mission. Education occurs at the patient bedside; in resident, fellow, and medical student training programs; in sonography apprenticeships; and in monthly conferences on ultrasound and maternal-fetal medicine. At our monthly perinatal working group, obstetricians, neonatologists, radiologists, and geneticists gather to discuss interesting and difficult cases. With respect to technologists' education, we are collaborating with Lebanon College on a training program in sonography. Ongoing research interests and activities include:
- A pilot trial testing the validity of compact US for use in developing countries
- A multi-center retrospective analysis of the chorionic bump, a first trimester ultrasound finding first described at DHMC
- Participation in a multi-center study of US characteristics of thyroid nodules the use of ultrasound-guided core needle biopsy for diagnosis of bilateral testicular sarcoidosis
Several staff members, including Dr. Harris, are graduates of the MS or MPH programs at The Dartmouth Institute (TDI). Last spring, the division participated as a clinical improvement test site in a TDI course on continuous quality improvement. Other recent QI initiatives include the implementation of an OB/GYN automated reporting system aimed at decreasing the likelihood of recording errors.
- Color flow Doppler imaging
- General abdominal, obstetrical, gynecological, small parts and musculoskeletal ultrasound
- Ultrasound-guided biopsy
- Ultrasound contrast studies (experimental)
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