There's more to ultrasound than baby pictures

It can be use to detect all sorts of ailments in a non-invasive way

OUR ELDEST has just celebrated a significant birthday. Naturally this was accompanied by a selection of baby photographs, the first of which was taken when she was less than one hour old.

But I have a confession to make. This wasn’t the first time her image had been pored over. For six of the nine months she was in utero, I was training in obstetrics and gynaecology. And while not directly involved in my wife’s care, part of my job was to carry out basic ultrasound scans on pregnant women who came to the hospital with urgent problems.

Working nights is part of the reality of hospital life. Strangely, Friday night didn’t seem so bad as it offered the probability of being off for the rest of the weekend. But early Saturday morning was also an especially quiet time in the hospital. So on one or three occasions when I was being collected from work, my wife and I would slip into the clinic and take a quick ultrasonic peek at “herself”. On one occasion, we were rewarded with some thumb-sucking; in hindsight, it was rather exciting and reassuring to sneak an occasional look at our baby.

In those days of course, the quality of the ultrasound images were rather grainy. With modern high-definition technology, it is possible to see so much more detail. Commercial, non-medical, ultrasounds are now advertised throughout the country for couples who want to have a look at their unborn.

I was reminded of this, not just by recent birthday celebrations but also by reading an obituary of the man widely considered the “father” of the use of ultrasound in medicine.

John Wild, who died in September aged 95, was someone who “tinkered” as he grew up. A Cambridge graduate, his early years as a doctor coincided with the second World War. Working as a surgeon in Greenwich, he treated many victims of the German V-I flying bombs.

Patients injured by these doodlebugs developed distended bowels. Wild noticed the effect of bloated bowels from the shock of the bombs could be as deadly as direct injury from the blast. This led him to experiment with echo-testing equipment that used sound waves to detect cracks in the armour plating of tanks. His idea was to see if the sound of returning echoes would vary with the thickness of the tissue in the bowel wall.

After heading to the US on a research fellowship, Wild was given access to a disused naval base near the University of Minnesota. There he worked with John Reid, an electrical engineer, and together they built a device that translated the ultrasound signals into visual images.

Wild then used the new machine to distinguish between cancerous and normal tissue. He and Reid further refined the technology, so that it could be used to detect and evaluate breast lumps.

Publishing their work in the journal Science in 1952, they wrote: “The immediate application of echography to the detection of tumours in accessible sites in the living human organism is envisaged”.

Even allowing for the development of CAT and MRI scans, I consider ultrasound one of the most useful non-invasive devices available to modern doctors. Uniquely, it does not cause pain or trigger claustrophobia. Usually the test involves nothing more than having jelly rubbed on the part to be examined, followed by a probe run slowly and gently across the tummy or some other part of the body.

While monitoring pregnancy is one of its major uses – the technique can give extremely accurate information on the exact length of pregnancy as well as detecting foetal abnormalities – ultrasound is a reliable test if you suspect a patient has gallstones. It is also the basis for cardiac echo testing, where it provides accurate diagnosis for heart valve problems, as well as a method of calculating how well the walls of the heart are pumping.

Probably the best aspect of ultrasound is its gentleness when it comes to assessing the old and frail patient. You can gain a great deal of information about suspected tumours and other diseases without putting the person through the trauma of placing flexible tubes in various orifices. It is this attribute, more than any other, which for me, makes Wild’s invention so incredibly useful.

• mhouston@irishtimes.com