• All general ultrasounds, including carotid doppler, are available for patients two years and above.
• Adult ultrasounds for inguinal hernia can not be ordered by primary care, as of April 1, 2017. Abdominal wall ultrasound, including of the inguinal regions, remains available for other indications. More information is available on the AMA’s Billing Corner website.
• Ultrasounds for soft tissue lumps are readily available.
• Wait times for MSK ultrasounds can be longer.
• Mayfair no longer offers Echocardiogram.

Ultrasounds Booked as Urgent

When contacting Mayfair Diagnostics Regina for the following presumptive diagnoses, these ultrasounds are considered urgent, and our booking coordinators will book them within the time frames specified:

• Ectopic pregnancies (24 hours)
• Deep vein thrombosis (24-48 hours)
• Acute scrotum/scrotal mass or testicular torsion (24-48 hours)
• First trimester bleeds (48 hours)
• Achilles or bicep ruptures (5 business days)

Urgent results will be faxed as soon as the report is available. You will receive a clear and concise diagnostic imaging report, outlining the radiologist’s findings as well as recommendations for follow up

Obstetrical Ultrasounds

At Mayfair Diagnostics, every obstetrical ultrasound exam focuses on the needs of your patient. Our obstetrical team is committed to performing studies that generate high-quality images to ensure accurate reporting.

Our experienced team includes an FMF-trained radiologist – a recognized international and Canadian standard – who is certified in several aspects of fetal medicine, as well as the interpretation of first, second, and third trimester exams. In addition to nuchal translucency (NT) and nasal bone licensing, Mayfair sonographers are certified as NT specialists through the Fetal Medicine Foundation. Every obstetrical exam is performed by trained experts who have met highquality standards for obstetrical imaging.

Our ultrasound equipment, GE Voluson E10 units, is designed specifically for obstetrical imaging and uses special probes that produce the highest resolution during imaging. This includes 3D capabilities for both transabdominal and transvaginal approaches, allowing for visualization and assessment of structures in both obstetrical and gynecological exams. The 3D algorithm aids in gynecological imaging by assisting with IUCD positioning, assessment of uterine malformations, and fibroid/polyp imaging. In obstetrics, 3D imaging can show the specific volume of an area (such as the fetal brain), allowing the radiologist to go back and reconstruct additional images or areas to reassess.

Obstetrical ultrasounds offer in-room monitors for patients to view their ultrasound exam, space for the support person to attend with the patient during their exam, Complimentary USBs of 3D images and, if requested, gender reveal envelopes

MSK Ultrasounds

Mayfair Diagnostics Regina offers MSK ultrasound for your patients. However, please note that complex MSK ultrasounds are not offered currently.

Available MSK Ultrasounds

Shoulder, elbow, hips, knees, Baker’s cyst, Achilles, Plantar facia, Carpal Tunnel. Unavailable MSK Ultrasounds. Shoulder Wrist, Hands, Ankles, Feet.

Shear Wave Elastography

Fatty liver is the most common liver condition in Canada. The aggressive variant is called NASH and can lead to cirrhosis of the liver which is the common irreversible end point of a variety of liver diseases. Ther is a 10-year mortality rate between 30-60% causes a poor quality of life for patients and a high cost to the health system. Liver dieses leading to cirrhosis are common (NAFLD 25% of Canadian population) and not all patients progress to end-stage.

Elastography measures liver stiffness and has been shown to correlate to degree of fibrosis (stage) on biopsy. It is Non-invasive sample of liver tissue is much larger and more representative. Elastography has the potential for widespread community implementation to select which patients are at high risk and require subspecialty referral

Mayfair Diagnostic is an advanced primary care pathway to establish patients with NAFLD. The overall goal is to provide a high yield service to patients while working closely with the hepatology service.

Elastography is appropriate for the following indications:

• Suspected or known NAFLD (Hepatology NAFLD pathway, specialistlink.ca):
  • Risk factors for NAFLD (obesity, Type II diabetes, hyperlipidemia, metabolic syndrome, etc.).
  • Fatty liver found on imaging (CT, MRI, ultrasound, etc.).
  • ° Abnormal ALT or AST.
• Excessive alcohol consumption.
• Other causes of chronic liver disease (e.g. viral hepatitis, hemochromatosis, autoimmune disorders, etc.).

SWE exam protocol and interpretation are performed according to the Society of Radiologists of Ultrasound Consensus Statement on Elastography. [1]

• Five to 10 measurements are obtained.
• Interquartile range-to-median (IQR/M) shows variability in measurements.
• IQR/M

Results will indicate if there is a high probability of the liver being normal, if there’s suggestion of compensated advanced chronic liver disease or clinically significant portal hypertension, or if further confirmatory testing is needed such as liver biopsy.

MSK Ultrasound

Mayfair offers a variety of MSK and MSK complex Ultrasounds and have a team of MSK subspecialized radiologist and MSK technologists. Your patients can be seen for up to two exams per visit, except for rotator cuff/shoulder exams. Each area is evaluated separately, and a comparison is not made when reading the images and reporting. The intra-articular structures are not assessed and are limited in assessment of deep structures and attachment points. Ultrasound cannot be seen beyond bone. For the assessment of back/neck muscles, images will be taken to look for obvious/gross pathology such as mass, hematoma or atrophy.

Some tips for booking:

• Any exam that is booked by an MSK physician is automatically considered complex.
• Additional anatomy can be requested in the patient history and does not need a separate request/check box (i.e., no need to add it to Other or Muscle/Tendon). This expedites for one appointment, versus booking a complex exam for two appointments.

Ankle

• An Achilles tendon exam should be ordered if the concern is for the tendon/posterior and not the full ankle which expedites the exam and offers more flexibility.
• If both a full ankle and an Achilles exam are required, please ensure you order both exams.
• Retinaculums – can be added to basic routine if mentioned in patient history.

Wrist

• Order carpal tunnel if full wrist assessment is not needed. This ensures the exam is booked as general MSK, which expedites the exam and offers more flexibility.
• We will assess for DeQuervain’s tenosynovitis as part of the wrist exam.
• Wrist exam can be ordered if there are wrist concerns outside of carpal tunnel syndrome.

Foot

• Foot exams are limited in assessment for generalized pain without a clinical question or specific area of concern.
• Order a plantar fascia exam, if the clinical question is plantar fasciitis/heel pain/fat pad syndrome and there are no other concerns in the foot. This ensures the exam is booked as general MSK, which expedites the exam and offers more flexibility.

Hand/Finger

• Hand/Finger exam is limited in assessment for generalized pain without a clinical question or specific area of concern

Shoulder

• If ordering a shoulder assessment and there’s concern for a proximal biceps rupture, no need to order a separate biceps exam.
• If only ordering biceps assessment, full assessment of proximal and distal tendons and muscle is a complex MSK exam. The biceps muscle belly is not assessed during routine shoulder.
• A deltoid assessment is NOT included with the shoulder exam and needs to be ordered separately as a complex exam

Elbow

• No need to order a separate biceps exam for a rupture
• If only ordering biceps assessment, full assessment of proximal and distal tendons and muscle is a complex MSK exam.
• Triceps tendon and muscle assessment are a complex MSK exam.
• The biceps and triceps muscle bellies are not assessed during routine elbow.
• No need to order a separate exam for the nerves concern for ulnar neuropathy at the cubital tunnel or posterior interosseous.

Hip

• Piriformis, ischial bursa, hamstring origins, adductors, IT band – can be added to basic routine if mentioned in patient history.
• Please request an additional exam if the following areas are sciatic nerve, inguinal ligament, lateral femoral cutaneous nerve, full hamstring assessment (e.g., query hamstring strain/tear/rupture). The exam will then become a complex MSK exam.

Knee

• Ultrasound of the knee is a non-diagnostic in assessment of the intra articular structures, including the ACL and PCL with limited visibility of the menisci.

[1] 1 Barr RG, Wilson SR, Rubens D, et al. “Update to the Society of Radiologists of Ultrasound Liver Elastography Consensus Statement.” Radiology 2020; 296:263-274.