Ultrasound scans are being performed everywhere. Not only in the standard radiology department in your local hospital, but also in the emergency room, urgent care clinics, your doctor’s office, and even at the local mall. But are you getting the same value for your money at each of these different sites? I have personally witnessed a very wide variety of skill levels within each of these departments. What can help you identify a reputable ultrasound unit? Look for an accredited ultrasound practice.

Applying for and obtaining your ultrasound accreditation is a vigorous process. It requires that all physician and sonographer staff have earned the appropriate credentials for the scans being performed and that they are up to date on their CME (continued medical education). Studies must be submitted for review to the accrediting team to ensure that the appropriate anatomy is being captured, image quality is optimal, and images are labeled. The ultrasound report is reviewed to confirm that the patient information and required imaging components for the study have been assessed and documented correctly.

Accreditation can help reassure the patient and the referring physician that their selected ultrasound department is aware of and following the current accepted standard guidelines for their exam. This can lead to reduced patient anxiety regarding the quality of the ultrasound scan. The goal is to help ultrasound departments achieve the best imaging possible to improve overall patient care and safety.

Each specialty area has an accreditation system that provides confirmation that an ultrasound department has achieved and is maintaining the current national standards. Each system provides guidelines and learning resources to help departments meet these standards.

Accreditation Systems:

• AIUM – American Institute of Ultrasound in Medicine
• ACR – American College of Radiology
• IAC – Intersocietal Accreditation Commission

Why is accreditation important? So that images like these are not reported as normal.

The initial scan was done in a physician’s office. The gestational age by the known last menstrual period was 11 weeks, 2 days; however, the crown-rump length (CRL) by ultrasound measured 10 weeks. This pregnancy was re-dated using the ultrasound-estimated delivery date.

At 19 weeks, 6 days, the patient was referred for an anatomy scan and was diagnosed with acrania-exencephaly-anencephaly sequence. This malformation has no calvarium and the fetal brain is exposed to the amniotic fluid. The amniotic fluid is toxic to the exposed brain and eventually causes the disintegration of this tissue. Exencephaly is a precursor to anencephaly. The absence of the fetal skull (acrania) exposes the brain (exencephaly), which eventually leads to anencephaly. The degenerative process of the brain gives the amniotic fluid an echogenic appearance.

This patient’s maternal serum alpha-fetoprotein (MSAFP) was 7.69 MoM (multiple of the median); the cutoff for a normal scan is <2.50 MoM.

Ultrasound technology and image quality have improved tremendously. The accreditation process helps a department discover where its deficiencies are and can provide guidance on how to meet the minimum standards. Further training and education of the Sonographers and Sonologists will lead to improved patient safety and outcomes.

Why pursue an ultrasound-accredited practice? Maybe the better question would be, why not make accreditation mandatory?