Asked By: Dr. Megan Harlow – Bristol, UK
Answer: Unless someone suitably qualified/knowledgeable in your particular ultrasound make and model (usually a clinical application specialist from the system distributor) has been in to help your practice to set up the presets on your practice system to your liking, then it may well be that you are relying on factory-set presets, which often demonstrate little variation.
Remember though, a preset is a simply a series of baseline settings to help novice users form a reasonable image at the start of a scan and will not replace the need for a good understanding of system controls.
Well-set presets will show useful differences in a wide range of common functions such as overall gain, depth, frequency, sector width, focal zones and positioning, dynamic range and so on for a selection of ultrasound applications (such as abdominal, cardiac, musculoskeletal, nerve block etc), as well as different patient species and sizes. For example, a large dog abdominal preset will typically have a lower transmission frequency set for greater beam penetration, a greater depth of perhaps 15 – 20 cm and a wide sector width to allow inclusion of big abdominal organs, with a mid-depth focal point and so on.
Compare this to a superficial nerve block preset, where the frequency is high in comparison to abdominal scanning for greater image resolution, with the depth deliberately set quite shallow for the superficial nerve, typically using a linear probe instead of a micro convex one, with multiple focal zones providing a sharper image over greater depth. The dynamic range may also be set to enhance the contrast of detecting arteries, veins and nerve bundles in amongst muscle and fascia.
If when you change from one probe preset to another the common functions hardly vary, then why not get back in touch with the system distributor. They will want you to get the most from your ultrasound system for the benefit of you, your practice, your patients and their owners.
Asked By: Dr. Olivia Sanden – Auckland, New Zealand
Answer: The transmission frequency of an ultrasound beam will determine the ability to perceive closely spaced reflectors along the axial beam as well as the distance the beam can penetrate the patient. Typically, a lower frequency probe such as a micro convex probe operating at 5MHz will have a longer wavelength than a higher frequency probe, such as a linear array operating at say 14MHz. The shorter the wavelength is (the higher the frequency), the greater the number of wavefronts there will be per second and for a given depth, when compared to a lower frequency. This means with a high frequency probe, there is greater opportunity for the multiple short wavefronts to interact and become reflected by closely spaced interfaces within the patient’s body (providing better resolution). However, everything is a trade-off with ultrasound! The downside is that the greater the number of short wavefronts there are, the more likely it is that the higher frequency beam will be attenuated (stopped, lose energy) and is less likely to return to the probe to contribute towards a useful image.
In general, the ‘golden rule’ is the higher the frequency, the better the image resolution but poorer beam penetration, and the lower the frequency, the better the beam penetration, but the poorer the resolution will be.
Always select the highest frequency possible to reach the required depth for the area under investigation within the patient.
Asked By: Dr. Tomás Blake – Galway, Ireland
Answer: In short, the probe footprint is the area of the probe which is in contact with the skin – the region from which the sound beam is emitted as well as the shape of that surface i.e., flat or curved.
Ideally you would select a probe footprint to suit the type of scan you are performing. For cardiac scanning, you need a flat, almost point source probe with a small footprint to fit between the ribs and enable good heart visualisation. For nerve blocks, you may require a wide flat straight footprint to provide excellent skin contact with a wide rectangular field of view. A micro convex probe was originally designed for paediatric medical patients because it delivers ultrasound through a small skin contact area over a steeply curved probe surface – the perfect footprint for little patients to tolerate, whilst providing a wide far field of view for fitting in full length kidneys and so on.
Asked By: Dr. Ethan Caldwell – Toronto, Canada
Answer: Sometimes it may be necessary to use surgical spirit as a coupling fluid, especially in critical or time-pressured, life or death situations. Whenever possible, cover your probe, as this not only avoids probe contact with the surgical spirit, but also contamination with any body fluids. Continual probe contact with alcohol / spirit can cause some probe surfaces to dry out, form micro-cracks or complications with the probe adhesive properties, leading to a potentially electrically unsafe probe.
Continual use of gel / spirit as a necessary coupling fluid on a damaged probe, can act as an electrical conductor and can be hazardous o both the user and the patient.
Top Tip: Place a small amount of ultrasound gel inside the palm of a nitrile glove, tear off the rim of the glove, place the probe footprint in contact with the gel inside the glove and pull the glove round to cover the probe. Now use the rim of the glover, like an elastic band, to secure the glove cover and prevent the glove fingers from flapping around whilst you scan!
Asked By: Dr. Helena Duarte – Lisbon, Portugal
Answer: The purpose of clipping a furry patient is to remove the air trapped between the hairs which prevents the transmission of sound. Ultrasound cannot pass though air – hence why we see reverberation artefacts or A-lines when scanning normal lungs, we don’t see any detail of the lung tissue. And with bowel gas, we also see a posterior ‘dirty’ reverberation shadow which obscures dorsal structures. By clipping the hair we create good contact as well as a slippery surface for sliding the probe over the skin.
Asked By: Dr. Nora Becker – Berlin, Germany
Answer: No, absolutely not! There is no logical reason to do this, it wastes twice as much ultrasound gel and just imagine how weird this would be if you attended for an ultrasound scan and the sonographer rubbed the gel into your skin before scanning you!
Sometimes a patient’s skin may well be greasy after clipping, in which case apply a small amount of spirit to de-grease the skin.
Then apply gel to the probe surface and to the skin at the start of your scan and then as and when you need. Re-apply more ultrasound gel as you move around the patient’s skin surface and examine one structure after another, or if you begin to lose skin contact.
Asked By: Dr. Andrej Petrovic – Belgrade, Serbia
Answer: Skipping the foundations — after years of experience at teaching clinical ultrasound means we believe it is essential to understand how an ultrasound image is formed and how to drive the controls on an ultrasound system to optimise images. This skill constitutes around 50% of your diagnostic potential.
Far too many ultrasound training providers skip or gloss over these fundamental components of learning ultrasound, a highly operator-dependent practical skill.
Once our members have mastered the ultrasound system, then they are in a much better position to take on board other, essential and often more exciting aspects of ultrasound, such as refreshing anatomical relations, scan techniques, ergonomics, and image interpretation. We see too many vets focus on ‘finding the adrenal glands and the pancreas’ or ‘diagnosing disease’ before they can confidently identify drive an ultrasound system properly. Without these necessary system skills, it is possible to miss or misinterpret significant on-screen scan findings. Aspire UCS training builds skills from the ground up to fix that gap permanently.
Asked By: Dr. Chen Wei – Singapore
Answer: Ultrasound is a practical skill, and as with any other new practical skills, the only way to become confident, competent and consistent with a news skill is to practice, practice, practice! Scan often, review images to see how you are improving, and seek feedback on your findings and diagnostic impressions.
We advocate our ‘Sonographer on Your Shoulder’ members practising one of the 8 steps in our 8-Step Abdominal Survey each time a dog or cat is sedated for a routine operation. It only takes a little while to scan each step, but by practising each regularly, it’s not long before they become confident to start bolting all 8 steps together to form a full comprehensive abdominal survey.
Aspire UCS provides ongoing mentorship and case review support so learning continues well beyond the classroom — transforming temporary skills into a more permanent level of confidence, competence and consistency.
Asked By: Dr. Samir Patel – London, UK
Answer: Dramatically. By retaining cases (less reliance on outsourcing scans to other companies) and by providing higher-value diagnostics internally, practices create new income streams, improve patient continuity, provide better, faster diagnostics and increase client retention — often offsetting training and equipment costs within months. Having a clinical team who are confident at performing comprehensive abdominal ultrasound scans, rather than being reliant on target scanning, means they develop a more advanced and holistic approach to diagnostic ultrasound, and are able to ethically charge more for their enhanced skill levels.
Asked By: Dr. Peter Wainwright – Dundee, Scotland
Answer: We would advise you to start with the fundamentals of ultrasound (the underpinning physics, image formation, artefacts and image optimisation skills) before getting fixated with techniques and interpretation. Learn to scan and recognise normal structures and tissue characteristics in a stepped approach. Then over time, and with increased confidence levels, start to build a more comprehensive approach to scanning. It goes without saying though, that all learning journeys are easier, faster and far more enjoyable when you learn under great mentorship and in a supportive environment. The last aspect you become good at is the time-factor and how long your scans take, so don’t let this one worry you. Aspire UCS’s Sonographer on Your Shoulder™ model mirrors this developmental pathway — from beginner to confident independent scanner.
Asked By: Dr. Alex Davies – Cardiff, Wales
Answer: To empower veterinary teams to deliver safer, faster, evidence-based diagnostics — and to build sustainable, in-house ultrasound services that raise clinical standards, reduce outsourcing, and keep ultrasound-generated income within the practice. What’s not to love?
Asked By: Dr. Sophia Delaney – Sydney, Australia
Answer: We advise using the L.E.M.O.N.S. Criteria to describe any ultrasound findings (normal or abnormal) using clear, visual language: Accuracy, Brevity, Clarity, whether that is communicating to another veterinary professional or a client.
For example: “This is your pet’s liver — we can see its texture looks smooth and even with a fine capsular margin, which is normal.”
Showing and discussing good quality ultrasound images, report findings and diagnostic impressions when relevant and accurate can only serve to build trust and strengthen your reputation and that of your practice for thoroughness.
Asked By: Dr. Leo Carmichael – Melbourne, Australia
Answer: When you can describe what you see, explain what it means (clinical context), and decide what to do next without hesitation. Confidence isn’t arrogance — it’s repeatable, evidence-based decision-making. Our training is built around the evidence-based best practice guidelines we co-authored (BMUS – ‘Small Animal Veterinary Guidelines for Professional Ultrasound Practice’) and the principle that becoming good at ultrasound isn’t simply about being confident, it’s also about being consistent and competent with your practice.
Asked By: Dr. Isla Turner – Edinburgh, Scotland
Answer: We would advocate basing pricing on the time, level of expertise, and the diagnostic value of a scan. If you’re providing full abdominal surveys with confident reporting, your service deserves to be priced accordingly. Our business support modules help practices align clinical value with financial return.
Asked By: Rowan Ellis RVN – Nottingham, UK
Asked By: Dr. Katerina Nováková – Prague, Czech Republic
Answer: Short courses teach, mentorship transforms. Ultrasound is a dynamic, highly operator-dependent form of imaging and as such it is highly practical. Diagnostic impressions are formed during an ultrasound scan rather than being interpreted retrospectively, as with plain film, CT and MRI. This is why learning ultrasound can be such a lonely journey in primary practice. Ongoing guidance allows for feedback, reflection, correction, and confidence-building in real clinical scenarios — the essence of Aspire UCS’s success model.
Asked By: Dr. Mia Johansson – Stockholm, Sweden
Answer: Not necessarily. Many users feel their ‘old’ systems are “underperforming” when often, it’s a case of not understanding how to fully optimise their use.
-optimised. Before upgrading, why not get in touch, we can help you with tips on how to ensure your presets, probe selection, and maintenance are correct. Aspire UCS offers independent system performance reviews to help you get the most from what you already own. And if we can’t help you to optimise it, we can help to work out you’re your service needs are connect you with the right people.
Asked By: Dr. Jean-Luc Perrin – Lyon, France
Answer: Gas is the enemy for all ultrasound users as ultrasound cannot pass through a gas. Instead, the sound reverberates amongst the gas particles and consequently forms a characteristic artefact on our ultrasound image, for example ‘dirty’ shadows associated with bowel gas. Understanding how to recognise on-screen air-associated artefacts will mean confident and correct interpretation. Pathology, however, such as mineralisation or foreign body shadows usually forms a more prominent, hypoechoic and often static shadow. Rock the probe and watch for any shifting artefacts: gas can often be displaced with graded pressure, lesions don’t. We train vets to read artefacts as clues, not noise.
Asked By: Dr. Amira El-Sayed – Lebanon
Answer: Not necessarily — but you should know how to undertake these for a more holistic approach to diagnostic ultrasound. We have seen many initial ‘target scans’ fall short as the really significant scan findings affecting the patient were not scanned, leaving the clinician / sonographer and the patient open to clinical risk. Full surveys are key for thoroughness, clinical confidence, competence and consistency. Once mastered, you’ll begin to perform full surveys faster, you’ll be able to confidently interpret the significance of incidental findings, and justify charging for higher-value diagnostics — a major goal of the Sonographer on Your Shoulder™ programme.
Asked By: Dr. Alejandro Ruiz – Madrid, Spain
Answer: Practice and consistency beats intensity. Practise on normal patients daily, focusing on hand stability, broad and fine probe movements, probe rocking and angle control. Learn to isolate probe movements – rotating on the spot on a kidney or vessel for example, moving from long to short axes of the structure or following a linear structure by sliding and rocking the probe. It’s a skill that becomes an unconscious movement over time.
Our Aspire UCS mentorship uses live feedback to refine these techniques — the biggest hidden factor in improving scan quality.
Asked By: Dr. Liam O’Donnell – Boston, USA
Answer: There are three parts to the diagnostic quality of ultrasound – understanding system use and image optimisation, learning repeatable techniques and interpreting scan findings correctly. Leaning to appraise your images will help to make you feel confident about the first part. Reviewing previous images enables us to reflect and improve on how we could have optimised or demonstrated a given structure better. Developing good scan techniques which are repeatable is essential and key to analysing required anatomical structures when establishing normality. And finally, interpreting scan findings by taking them into full clinical context of the patient is the only way to forming the correct conclusion from your scans.
Begin by becoming confident, competent and consistent at recognising normal scan findings before taking on the abnormal! Aspire UCS teaches structured scanning so you can begin recognising diagnostic adequacy in real time, with positive reinforcement from our Aspire UCS mentors.