Transducer manipulation

Under-appreciated, yet critically important; how you hold and control the transducer is a fundamental skill in capturing high-quality images.

The following page will describe maneuvers to manipulate the transducer. This page primarily references Bahner et al. (2016) for the convention from the American Institute of Ultrasound in Medicine. On this page we will also compare these terms to naming conventions from the American Society of Echo (Mitchell et al. 2019). We favor use of the AIUM convention as the terms are more clearly defined with less nuance.

Sliding the probe

To “slide” the probe refers to the translation of the probe with respect to its long axis. The probe is held in the same upright position, but instead moves across the body in same axis as marker.

ASE does use the term “slide”, but can be applied whenever the probe moves across the skin (independent of direction).

Rocking the probe

To “rock” the probe refers to moving the probe in line with the long axis of the beam (or the index marker). The imaging plane is kept constant, but the area of focus is changed.

ASE uses a similar terminology to describe this movement and highlight this term when attempting to “Centre” an image (A4C, PLAX). They also use an additional term “angling”, which essentially refers to the same movement, but rather than centering an image–it refers to deliberately focusing specific on new of the heart. Angling is often used to optimize cardiac imaging including examining the tricuspid valve, aortic or pulmonic valve in the parasternal sort axis view, base level.

Sweeping the probe

To “sweep” the probe refers to lateral translation of the beam in the short axis of the probe. The probe is held in the same upright position but is moved across the skin perpendicular to the index marker.

ASE defines “sweep” essentially as recording any long clip of data that attempts to capture a large anatomical area (e.g. from anterior to posterior in subcostal space). The closest term ASE uses to describe this maneuver is “slide”, but can be applied whenever the probe moves across the skin.

Fanning the probe

“Fanning” of the probe refers to movements perpendicular to the long axis of the probe, but maintaining contact on a single point of the body. The comparison is often made to fanning oneself, where your wrist is the single, stable hinge point. The effect is similar to the “sweep” but the probe does not move from one point of contact.

‚ÄčASE refers to this maneuver as “tilt”.

Pressure on the probe

One of the most commonly applied maneuvers, “pressure” refers to increased force being applied towards the patients body. This is maneuver is perhaps over-used by novice sonographers. More learned users will realize that image generation is more finesse than force.

Rotation of the probe

Another intuitive probe movement, but can be hard to do with eloquence. We suggest that learners may consider holding the probe with one hand, while rotating the probe with the other.

ASE also uses the convention “rotate”.

Video tutorial

This video provides an in-depth review of transducer manipulation.