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Ultrasound Offers Insight As Diagnostic Techniques
03.30.04
 
A hockey player needs to know if he'll be sidelined by an ankle injury. Emergency personnel need to assess a car accident victim's injuries at the scene of the wreck. An astronaut onboard the International Space Station, 240 miles above the nearest hospital, needs to evaluate a persistent pain in the abdomen.

Expedition 5 Flight Engineer Peggy Whitson Image right: The Human Research Facility (HRF) ultrasound, being used here by Expedition 5 Flight Engineer Peggy Whitson on September 23, 2002, is deployable to allow flexibility in how the subject is positioned, while still giving the operator adequate access to both the hardware and the subject. She holds the probehead in her right hand. A strap keeps the keyboard, monitor, and cables in place and an extending arm connects the monitor to the Human Research Facility (HRF).

Thanks to a new technique developed by NASA, all of these people may soon be using ultrasound to get the answers they need.

The new procedure allows non-physicians to bypass the lengthy ultrasound training process because an expert evaluates the images remotely via an Internet, telephone or wireless transmission. For example, a Space Station crewmember could diagnose another astronaut's ailment by using the ultrasound device on orbit while receiving real-time instructions from a radiologist on the ground.

The probability of a crewmember developing a serious medical condition increases on long-duration missions. Although X-ray and computerized tomography (CT) scans are routinely used by doctors to diagnose medical conditions on Earth, they are not available on the Station due to weight and power requirements.

Ultrasound is fast and safe. It uses sound waves to gain information about medical conditions ranging from gallbladder disease to kidney stones. Currently, a 76-kilogram (168-pound) ultrasound machine is being evaluated on the Space Station as part of the Station's Human Research Facility. The equipment is capable of high-resolution imaging in many applications, research and diagnostic.

Expedition 5 Flight Engineer Peggy Whitson assisted by trainer Jim Searcy Image right: Astronaut Peggy Whitson, Expedition 5 Flight Engineer, assisted by trainer Jim Searcy, is photographed in Human Research Facility (HRF) Rack training in the International Space Station (ISS) Destiny laboratory mockup/trainer at the Johnson Space Center's Space Vehicle Mockup Facility.

NASA ISS Science Officer Peggy Whitson served as an ultrasound "guinea pig" during her 2002 stay aboard the Space Station.

"I was impressed that even with the slight delay in transferring the video images to the ground, I was able to perform -- with guidance from the ground team -- imaging of my heart, carotid artery, kidney and bladder," Whitson said. "The remote application of these methods has very positive implications for long-duration spaceflight, as well as potential uses here on Earth."

These uses could include athletic medicine -- in fact, the procedure already has been tested on members of the Detroit Red Wings of the National Hockey League. The Red Wings conducted a test of these techniques to diagnose player injuries in the team's locker room rather than transporting athletes to a local hospital for an X-ray, CT or magnetic resonance imaging (MRI).

A portable ultrasound device was placed in the team's locker room and connected to an ultrasound workstation at Detroit's Henry Ford Hospital. A radiologist, serving as the remote expert, worked with the NASA team to guide the Red Wings' trainers performing ultrasound tests on players. The remote expert helped the trainers perform an ultrasound test on a shoulder, ankle, knee, hand and foot. The resulting high-quality images were transmitted to the hospital and could have been used to confirm or exclude injuries to these areas.

"This trial demonstrated that ultrasound can be used to enhance athletic medical care with minimal training and cost," said Dr. Scott Dulchavsky. "We are investigating satellite phone technology to allow the technique to be expanded for use on ambulances or at accident sites." Portable ultrasound machines can also be used to extend medical care into challenging areas such as remote rural or military locations.

Expedition 6 NASA ISS Science Officer Don Pettit Image right: Astronaut Don Pettit, Expedition 6 NASA ISS Science Officer, performs the Human Research Facility (HRF) Ultrasound functional checkout in the Destiny laboratory on the International Space Station (ISS).

Dulchavsky, chair of the Department of Surgery at Henry Ford Hospital in Detroit and principal investigator for the ultrasound experiment, leads a team of NASA scientists.

"These ultrasound techniques will improve the chances of treating medical emergencies in space and on Earth," Dulchavsky said. "Although we use ultrasound every day in trauma centers to diagnose injuries of the abdomen, we are encouraged that ultrasound can be used in many more medical conditions."


+ Click here for more information about the Human Research Facility.