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F=110Mhz
PRF,Framerate,DutyFactor
Increasefrequency,increaseattenuation
Attenuation3components:
1.Absorption
2.Reflection
3.Scattering
Absorptionenergyislostandconvertedintoanotherformofenergy,heatorvibrationofintracellularparticles.
ReflectionPropagatingenergyisredirectedandreturnstowardthetransducerwhenstrikingaboundarybetweentwomedia.
SpecularreflectionReflectionoffasmoothsurface(mirror)arecalledspecularreflection.Wavelengthissmallerthantheboundary
roughness
Scatteringboundarybetweentwomediahasirregularities(withsizeofboundarybeingsmallerthanthewavelength)thewaveisthen
redirectedintomanydifferentdirections.
Rayleighscatteringifareflector(aredbloodcellorintracellularparticle)issmallerthanthewavelengthsoenergyisdivertedinall
directions.Increaseintransducerfrequencyundergoesmorerayleighscattering.
Backscatterscatterreturningtowardthetransducer
AttenuationisdB,sinceintensityisdecreasing
Attenuationinsofttissuedependsonthefrequencyofsound
Increaseinfrequency=increaseinattenuationcoefficient
Attenuationcoefficientdoesnotchangewhenthepathlengthchanges
Totalattenuation=pathlengthXattenuationcoefficient
Increasefrequency=greaterattenuationcoefficient.Thisiswhyifyoudecreasetransducerfrequencyyoucanimagedeepertoagreater
depth.
Attenuationcoeff(dB/cm)=MHz/2
Attenuationisincreasedinboneandairascomparedtosofttissue
Boneisagreatabsorberandreflector
Lungisagreatscatterer
Ifattenuationincreasesfrequencyandpathlengthincreases
Halvevaluelayerthickness:depthatwhichintensityisreducedto1/2itsoriginalvalue(3dB)Alsocalledpenetrationdepth,depthof
penetration,halfboundarylayer
Penetrationdepth=3/attenuationcoeff(dB/cm)
Penetrationdepthdecreases,attenuationcoeffincreases,frequencyincreases
Attenuationcoefficientdoesnotchangewhenpathlengthchanges
Halvevaluelayerthicknessdependsonthemediumandthefrequency
Insofttissueincreasefrequencyresultinlesserpenetrationdepths
ImpedancemediumonlyRAYLS(Z)
Impendanceincreases,densityincreases,PSincreases
Reflectionofanuswavedependsuponthechangeintheimpedanceattheboundarybetweentwomedia
Impedance=densityXPS
MediumA&BhavethesamePSmediumahad10%greaterdensitythanmediumB.ThenmediumA'simpedanceis10%greaterthan
mediumB
Aspathlengthincreaseshalvevaluelayerremainsthesame*onlydeterminedbyfrequencyandmedium.
Impedanceisacharacteristicofamedium
Impedanceisimportantinreflectionsatboundaries
Specularreflectionoccurswhenultrasoundstrikesasmoothsurface
Normalincidence90degrees,rightangle,perpendicular,ORTHOGONAL

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Obliqueincidencenotat90degrees,acuteorobtuse
Reflected+Transmitted=IncidentIntensity
Verylittleoftheusintensityisreflectedbacktothetransducerataboundarybetweensofttissue.Theremainderistransmittedand
continuestopropagateforward.
Intensityreflectioncoeff(IRC)the%ofintensitythatbouncesbackafterpassingfromonemediumtoanother
IntensityTransmissionCoeff(ITC)%ofintensitythatisallowedtopassthroughwhenbeamreachesainterfaceorboundaryoftwo
mediums
IncidentIntensity(W/cm2)100%=IRC+ITC
Typicallyonly1%isreflectedatasofttissueboundaryanddifferentmedia(suchasbloodormuscle)
Whereas99%isreflectedatanairtissueinterface
Reflectiononlyoccursifthereisadifferenceofacousticimpedancesattheboundaryoftwomedia
IRC%=reflectedint/incidentintX100
IfyouincreasethedifferenceinimpedancesoftwomediathentheIRCwillincrease(amountofreflection)
Iftwomediahavethedameimpedanceallsoundistransmittedandnoneisreflected
ITC%=transmittedint/incidentint
Transmissionandreflectionmayormaynotoccurwithobliqueincidence
Reflectionangle=incidentangle
Refractioncanoccuronlywhenthereisadifferentpropagationspeedandobliqueincidence
IfPS2isincreasethanPS1thenthetransmissionangleisgreaterthantheincidentangle.
IfPS2islessthanPS1thenthetransmissionangleislessthentheincidentangle
TheAttenuationcoeffinsofttissueis3.5dB/cm.Whatisthefrequency?Attcoeff=F/2orMHZ/2so3.5=X/2=2X3.5=X=7Mhz
Whenonereflectoristwiceasdeepasanotherthepulsestimeofflight(goreturntime)doublesforthedeeperreflector
13usec=1cmdeep26usec=2cm39usec=3cm52usec=4cm
Longitudinaltheabilitytodistinguishtwostructuresthatareclosetogetherfronttoback
LlongitudinalAaxialRradialRrangeDdepth
LARRDthesmallerthe#thebettertheimagequality
theshorterthepulsethebetterthelarrdresolution
LARRDresolutionimproves:1.Increasefrequency(shorterpulse,shorterwavelength)2.Fewercyclesinapulse(shorterpulse)*to
changeanyofthesefactorsrequiresanewtransducer
LARRD=SPL/2insofttissue:LARRD=.77X#cyclesinpulse/F(MHz)
increasefrequency,decrease#valueoflarrdresolution
increasefrequency=betterlarrdresolutionandhigherqualityimages
LARRDisdeterminedbythesoundsourceandmediumbecausedependentonSPL
Theabilitytodistinguishtwostructuresclosetogetherisresolution
Increase#cyclesinapulse,Increase#valueforrangeresolution
Piezoelectriceffect(reception)propertyofcertainmaterialsthatcreateavoltagewhentheyaremechanicallydeformed.
Reversepiezoelectriceffect(transmission)materialdeformorchangeshapewhentheyhaveavoltageappliedtothem.
PiezoelectricmaterialsAlsocalledFerroelectric
ManmadeisLeadzirconatetitanate(PZT)
ThemostcommonPZTmaterialusedinimagingtransducerisPZT5
PZTinustransducersisalsocalledceramic,activeelementorPZTcrystal
CurietemperaturePointatwhichdepolarizationoccurs.Ifweheatcrystalabove350600degreesFitloosesitpiezoelectricity
Caseprotectscomponentsfromdamageandpatientfromelectricalsignals.
Donotuseatransducerwithacrackedhousing
Wireprovidesanelectricalcontacttothecrystalsothatthevoltagefromtheusmachinecancausethecrystaltovibrateandproducea
waveandreturnedvoltagebacktoussystemforanimage

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Matchinglayer:Differencesinimpedancescausereflection.Theincreasehasanimpedancebetweenthatoftheskinandactiveelementto
increasethepercentoftransmittedultrasoundbetweentheskinandactiveelement.Thebestchoiceforthethicknessofthislayerisone
fourththewavelength.Thethinlayerofgelweuseontheskinsurfaceisabout1/4thewavelength.
DampingElement(backingmaterial):Materialbondedtoactiveelementtolimittheringingofthepulse.CommonlymadeofEpoxyResin
impregnatedwithTungsten.
Dampingmaterialadvantages:1.increasepicturequalitybyimprovingLARRDresolution
2.Shortenpulseduration(PD)andspatialpulselength(SPL)3.DecreasenumericalvalueoftheLARRDresolution.
Dampingmaterialdisadvantages:1.Decreasetransducerssensitivity2.Increasethebandwidth(therangeoffrequenciesinvolvedina
pulse)3.DecreasetheQfactorcreatesalowQtransducer.
Bandwidth:Thedifferencebetweenthehighestestimatedandthelowestestimatedfrequencyemitted.
Thesmallerthebandwidth(narrowbandwidth),themoreexactthefrequency(withsmallrangeofarounddesiredfrequency).
Shorterthepulse,thehighertherangeoffrequencies.
Themainfrequencyemittedbythetransducerisitscenter,resident,primary,ornaturalfrequency.
Qualityfactor:UnitlessRepresentsthedegreeofdamping.
ImagingtransducersarelowQtransducersbecausetheyhavemoredampingmaterialsthantherapeutictransducers.
Qfactor=ResonantFrequency(MHz)/Bandwidth
IfyoudecreaseQfactorthere,youwillincreasethedegreeofdamping
Qfactordecreaseswhen:1.dampingisgreat2.pulselengthisshort3.bandwidthiswide4.imageisgood
ContinuouswaveultrasoundThesoundwave'sfrequencyisdeterminedbythefrequencyofvoltageappliedtotheactiveelement.
PulseultrasoundPRFisdeterminedbythenumberofelectricalpulsestheultrasoundmachinedeliverstotheactiveelement.
Frequencyisdeterminedbythethicknessofcrystalandpropagationspeed.
FrequencyisequaltoPS/2Xthickness
Thincrystal=increaseinfrequency
Increasepropagationspeedofthecrystal=Increasethefrequency
Focus:Thelocationofminimaldiameterofthebeam.
FocallengthorFocaldepththedistancefromtransducerfacetosmallestdiameter(focus)
NearzoneorFresnelRegionbetweenthetransducerandthefocus
FarzoneorFraunhoferRegionbeyondnearfield.
Attheendofthenearzone,thebeamdiameterisonehalfofthetransducerdiameter.Attwonearzonelengths,thebeendiameteris
equaltothetransducerdiameter.
FocaldepthorlengthDistancefromtransducertofocus
Focaldepthdeterminedby:1Transducerdiameter
2frequency
Increasecrystaldiameter=longer(deeper)focaldepth
Increasethefrequency=longer(deeper)focaldepth
Smallcrystal=moredivergence
Largecrystal=lessdivergence
Ascrystaldiameterincreases=beamdiameterinthefarfielddecreasethebeambecomeslessdivergent
Pulseultrasoundincreasingfrequency=narrowbeam(lessdivergence)
IncreasingfrequencyimprovesbothLARRDandLATAresolution
LARRDresolutionisusuallybetterbecauseelectricpulsesarewiderthantheyareorshort.
DiffractionSmallsourceproduceswavesnearwavelengthofthesound.Wavesdivergeina"V"shape.
Huygen'sPrincipalhourglassshaperesultofconstructiveanddestructiveinterference.
Lateralresolution(LATA)
LateralAngularTransverseAzimuthal
Whenthedistanceislessthanthebeamdiameterthedotswillappearasone.Twosidebysidestructuresareclosertogetherthanthe
beamwidthsoonlyonereflectionappearsontheimage.

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LATAMinimumdistancetwostructuresareseparatedsidetosidethatwillstillproducetwodistinctstructures.
LATAresolution=beamdiameter.
BeamdiametervarieswithdepthsoLATAwillalsovarywithdepth.
AfocusingimprovesLATAinthefocalzone.
LATAresolutionisbestatthebeamdiameter.
Increasedfrequency,narrowbeam,lessdivergence=greatLATAresolution.
Focusingcreatesthefocus(improvesLATAresolution)
1.Lens2.CurvedPZTcrystal(internalfocusing)3.Focusingmirror(theleastcommoninmodernday)4.Electronicfocusing
(phasedarray)
Focusingisachievedwiththelens,curvedcrystalormirror.
Focusingproducedbysinglecrystalareconsideredaconventional,fixedormechanicalfocusing.
Phasedarraysprovidesdynamicorvariablefocusingthatadjustablebythesonographer.
Amode:Dots(Amplitudemode)
Bmode:Brightness
Mmode:Motion(intime)
Bscanadvantages:Largeimagesandgoodresolution.
Dupleximagesanddoppler@thesametime.
Increaseframerate=increasedtemporalresolution(pertainingtotime)
Increasedtemporalresolution:
1.Singlefocussavestime
2.Shallowdepthshorterlistingtimesavestime
3.SmallersectorAfewerultrasoundpulsessavestime.
4.lowlinedensity(fewerultrasoundpulsessavestime)
PULSEECHOINSTRUMENTATION
Pulsedwave,singlecrystal1.Shortdurationelectricalspike2.Oneelectricalspikeperalterstheirownpolls
Pulsedwavearrays1.Shortdurationelectricalspike2.Manyelectricalspikesperultrasoundpulse
Dynamicrangearatioofthelargesttothesmallestpowerthattheamplifiercanhandle(db).The#ofshadesofgray.
CRT(cathoderaytube)televisionscreenAnelectronbeamstrikesaphosphorcoatingonthescreenanditglows.Turnselectronsinto
light.
TelevisiondisplayTheresultof525closelyspacedhorizontallines.1,3,5,7...x525oddfield
2,4,6,8....524evenfield.Togetheriscalledaninterlaceddisplay.
Alternativeformatiscalledprogressivescanornoninterlaceddisplay1,2,3,4,....523,524,525
Bistableonlytwochoiceseitheronoroff,whiteorblack.
GrayscaledisplayNumberofdifferentlevelsofbrightnesswhite,gray,darkgray,lightgrayorblack.Theshadedependsonthe
echoesamplitude(strengthofthesignal).
BrightnessDeterminethebrillianceofsignal
ContrastTodeterminetherangeofbrilliancefromweaknesstothestrongestthataredisplayed.
AnalogAnyrange(continuousvalues)
Digitalonlycertainchanges(onlydiscreetvalues).
ScanconverterMadegrayscalepossiblebystoringtheimageandthendisplayingonCRT.Imagecanbealteredororchangedin
betweenstoringanddisplayingofdata.Blackonwhiteimagecanturnintowhiteonblackimage.
AnalogscanconverterMadegrayscaledisplayspossibleoriginally.
Dividespicturesinto1000X1000matrixwithelectricalstorageelementsateachlocation.
ElectronsfromCRTstrikeselementsandthechargeisstored.Sporedchargesarereadtoretrieveinformation.
DisadvantagesImagefade,imageflickers,driftanddeterioration.
DigitalScanConverterUsesacomputerandcomputermemorytodigitizeimages.Thisconvertsimagesintonumbersandstoresthe

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numbersinmemory.
ComputermemoryiscalledRAM(randomaccessmemory).
PixelSmallestelementofthedigitalpicture
Themorepixelsperinch(calledpixeldensity)thebetterthepicture.
Ifyouhavegridoneboxofthegridrepresentsonepixel.
Thebestspatialresolutionisobtainedwhentherearemoreelementsorpixelsintheimagematrix,regardlesswhetheritsanalogordigital
converter.
Betterspatialresolutionisobtainedwith1000X1000analogdisplaythanwitha512512digitaldisplay.Thebiggerthematrixsizethe
bettertheimage.
Bitsmallestamountofdigitalstorage.Abinarydigit.
Abitisbistableeither0or1/onoroff.
Agroupofbitsisassignedtoeachpixelforthegrayscaletobeassignedtothatpixel.
Agroupof8bits=onebyte
Themorebitsperpixel,themoreshadesofgraycanberepresented.
Agroupofbitsrepresentsabinarynumber,aseriesofzerosandonesIE0010011
Example:Whatisthenumberofshadeswith8bits?
2x2x2x2x2x2x2x2=256shadesrepresentedbyeightbitsoreight2's.
PreprocessingManipulatingdataBEFOREimagesisstoredinscanconverter,butafteritisacquired.
PostprocessingManipulatingdataAFTERithasbeenstoredinthisscanconverter.Memorybutpriortodisplay.Processingofafrozen
imageisalwayspostprocessing.
Howasignalisprocessed:1.AnalogsignalfromTransducerisrealworld2.Analogtodigitalconverter3.Processingbydigitalscan
converter(computer)4.Digitaltoanalogconverter5.AnalogsignaldisplayedonCRTrealworld.
AnalogtoDigital(incomputer)
DigitaltoAnalog(outofthecomputer)
Readmagnification(Postprocessing)Afterimageisacquiredinscanconverterthisispostprocessingbecauseitusesdataalreadyin
scanconverter.
Writemagnification(Preprocessing)Scansonlyregionofinterest.Ultrasoundrescansonlyregionofinteresttoacquirenewdata.
Improvestemporalresolution!
Increasingthedynamicrangeisgood(aratioofmoreshadesofgray).
Generally,themorethedynamicrangeisprocessed,themorethedynamicrangeofthesignaldecreases.
40decibels=10,000Think40meansfour10'ssojustaddfourzerosto1
MOTION
DopplerfrequencyorDopplershiftAmountofchangeinthefrequencyofofsoundasaresultofmotionbetweenthesoundssourceand
thereceiver.IfyouIncreasethevelocityyouincreaseinthedopplerfrequency.
Positivechanges=soundsourceandreceiverapproacheachother.
Negativechanges=soundsourceandreceivermoveapart.
Ifsoundismovingtowardyougetahigher(+)frequencyifsoundismovingawayfromyouyougetalower()frequency
DopplerShiftsrangefrom20Hzto20KHz
Typicalvalue2000HzandisAUDIBLE
Resultsfromsoundbouncingoffofredbloodcells
Flowtowardtransducer=increasedfrequency,shorterwavelength
FlowawayfromTransducer=decreasedfrequency,longerwavelength
Frequencyshiftisalwaysrelatedtovelocity.
Velocityisdefinedasmagnitudeanddirection
Speedisonlymagnitude
Themagnitudeofshiftdependsonthecosineoftheangle
Dopplerfrequencydependantondirection

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Measuredvelocity=truevelocityXcosineangle

90degrees=velocity/0becausecosineof90degrees=0
Dopplershift=2xRSxIFxCos/PSThe2representsthatthereisadoubledopplershiftwhenthesoundstrikesabloodcell
1firststrikingredbloodcell
2secondofmovingredbloodcellaway,reradiatingwave.
Imagedatabestangle=90degrees
Dopplerdatabestangle=0degrees
Bestexamduplexangle=60degrees
Unidirectional(Noncoherent)Onlymeasurespresenceofmovement.Cannotdistinguishbetweenbloodmovingtowardorawayfrom
transducer.Alsocallednoncoherent.
BidirectionalDistinguishesbetweenbloodtowardsandawayfromtransducerbytheappearanceofpositiveandnegativedopplershifts.
Flowtowardtransducer=abovebaseline
FlowawayfromTransducer=belowbaseline
Bothrequireaheadphones,speakersandadisplay.
Bloodinadjacentarteriesandveinsflowindifferentdirections.Whenadjacentarteriesandveinsaredopplered,onevesselwillbeheardin
rightaearandtheothervesselwillbeheardintheleftear.
ContinuouswavedopplerAbletomeasureveryhighvelocities.Twocrystalsintransducer.1.receiver(constantlylistening)2.
transmitter(constantlysendingoutsignal)
Range(depth)ambiguityechoescancomefromanywherealongthelengthofthebeam.
PulsedwavedopplerOnecrystal,alternatesbetweenlisteningandsending.
Range(depth)resolution,Range(depth)specificity:Echoescanonlycomefromoneareabeinginvestigated,thesamplevolume.
Aliasing:Mostcommonobservedartifactsinpulsedopplerimagingisaliasing.Becausepulsedopplerisunabletomeasurehighvelocities
accurately,soelevatedvelocitiesappearasnegative(alias).
NyquistlimitorfrequencyThedopplerfrequencyatwhichaliasingoccurs.
Nyquistfrequency=1/2PRF
Highfrequencytransducersormorelikelytoalias
Lowfrequencytransducersaremoreeffectivebecausedopplershiftsarelesslikelytoreachthenyquistlimit.
Toeliminatealiasing:1.Selectatransducerwithalowerfrequency2.Selectanewtransducerwithashallowersamplevolume3.Use
continuouswavedoppler.4.Changebaselineshift(onlyappearstoeliminate).
PulseddopplerContinuousdopplerOnecrystalTwocrystalsRangeresolutionRangeambiguityLimitedvelocityUnlimitedmaximum
velocityNyquistlimit
ImagingDopplerNormalincidents90degrees0or180degreesincidence(oblique)increasedfrequencydecreasefrequencyPulsewave
pulseorcontinuouswave
ColordopplerPulsedultrasoundtechnique,providesrangeresolutiontherefore,subjecttoaliasing.
ColordopplerProvidesinformationregardingdirectionofflow.
Dopplershiftregardsvelocity.
VelocitymodeshowsdirectionVariancemodeshowsdirectionandturbulenceordisturbflow
Turbulentflowordisturbflowflowisrandomchaoticandirregular
LaminarflowFlowissmoothanduniform.
Multiplepulsesareneededtoaccuratelyidentifyredbloodcellvelocities
MultiplepulsesarecalledPackets320pulsesperpack
Themorepulsesperpacketincreasestheaccuracyofvelocitymeasured.RequiresmoretimeDecreasetheframerateDecreasethe
temporalresolution
Wallfilterseliminatelowmagnitudedopplershiftsthataremorelikelytobecreatedbypulsatinganatomy(vesselwalls)thanmovingred
bloodcells.
Continuouswavedopplerincreasevelocitiesanywherethereisnoaliasing
Pulsewavedopplerprovidesaccuratevelocities(rangeresolution),goodtemporalresolution.

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ColorflowProvidesinformationdirectlyonanatomicimageintwodimensions.
SpectralanalysisPerformedtoextractoridentifyindividualfrequenciesmakingupthecomplexsignal.Interpretindividualvelocities
fromthesignal.
Forpulseorcontinuous:FastFourierTransform(FFT)
Forcolorflowdoppler:Autocorrelationorcorrelationfunctionusedbecauseerroneousamountsofinformationthatrequiresprocessing.
SlightlylessaccuratebutfasterthanFFT.
Withinphysiologicalrange,variationsinredbloodcellconcentrationwouldnotaffectabilitytoperformadopplerexam.
Whenanobviousartifactisnotchangingthefunctionoftheinstrumentisinquestion.Callingaserviceengineerabeappropriate.
ARTIFACTS
ReverberationMultipleechoesmultipleequallyspacedateverincreasingdebtlikealatter
Also,Comettailringdownappearsasasolidlinedirecteddownward(mergedreverberation)
ShadowingSoundcannotpassthroughthefirststructurebecauseithasahigherthanusualattenuationrateorisamajorscatterof
ultrasound.
Refraction:Shadowingattheedgeofacircularstructure.
Enhancement:brighterthannormalloworattenuationratethansofttissue.
Mirrorimage:Soundcanbounceoffastrongreflectorinitspath,reflectoractsasamirroraredirectsthepulse.Asecondcopyofthe
reflectorisplacedthedeeperthantheactualreflector.Mirroredisalwayslocatedonastraightlinebetweenthetransducerandartifact.
PropagationspeederrorResultinacorrectnumberofreflectorsappearingatincorrectdepthsonthedisplay.
Propagationspeedinmediun2ishigherthan1540m/s,thereflectorwillbetooshallow
Ifthepropagationspeedinmedium2islessthan1540m/s,thereflectorwillbetoodeep
Refraction:Soundchangesdirectionwhenstrikesboundariesobliquelywhenmediahastwopropagationspeeds.
Secondcopyofreflectorisplacedsidebysideoftrueatomicstructure.
SideLobesMechanicalorsinglecrystaltransducers.Remembermechanicaltansduerssweepsidetosidesidelobes!
GratingLobesArrays
SlicethicknessStructuresaboveorbelowtheimagingplaneappeareintheimage.
MultipathPathgoingtoreflectorisdifferentlengththanreturningpath,thentheimagewillbeincorrectlypositioned.Generalimage
degradation,notspecificallyidentified.
Temporalresolutionisbestwithincreasingframerates.
Higherframerateoccurswithshallowimagingdepthandlower
linedensity.Machinehastoworkless!
Waterpathsalsocalledstandoffpads
Pulseristhebeginningofeverything.EstablishesthedutyfactorandthePRF
PRF(producedbythepulser)=PRFofthetransducer
Pulserisresponsibleforvoltageamplitude
Ifyoudecreaseoutputpoweryouwilldecreesvoltageandpulser
CompensatewithTGCisfortheloss.
RECEIVER
Receivesthesignalssentbythetransducer
SignalsareanalyzedandpreparedforCRTunit
AmplificationCompensationCompressionDemodulationRejection
Theonlypurposethereceiveristoprocesssignalssowecanseeanimageonthedisplay
PreamplificationThisisnotafunctionofthereceiverbutaprocessthatoccursbetweentransducerandreceiverthatamplifytheweak
signalssothatthesignalcanbeamplifiedbytheamplificationfunction.
Amplification=gain(receivergain)
Ifyoudecreaseyourgainyoulosetheweekechoes
Ifyouincreasethegainyouwillsaturatetheimageinabilitytodistinguishalltissuesfromoneanother(brightpicture).
Increasedfrequency=ashorterwavelengthorshorterspatialpulselength,andaincreaseinattenuation

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Strongerintensity/amplitude=lessattenuation
Youcanpenetratedeeperandstrongerbyincreasingtheamplitude
Theincomingsignalistheonewecompensatefor
Outputpowerincreasedexposuretopatient(dB)
OverallgaindoesnotexposethepatienttoincreasedintensityalsomeasuredindB
DynamicrangeWemustreducethehighvoltageechoessotheycanbeprocessed.Thehighvoltagesignalscannotbeprocessed,so
decreasethem
LogarithmiccompressionThelargeamplitudesarecompressedandatthesametimeamplifyingthelowsignals.
Demodulation1.Rectificationchanging()partsto(+)
2.Smoothingsmoothingoutbumpsorroughedgesinthesignal
Rejectionisalsocalledthresholdorsuppressiontakesawaythenoise.
Rejectionisdonebythereceiverafterdemodulationeliminatesweakechoessignalssothattheycannotbedetectedonthemonitor.
BeamFormeronlyusedwithphasedarray.
MasterSynchronizerMemory,keepstrackofallcomponentsofultrasoundmachinewhattheyaredoing,andeverythingoperatingata
propertime.
QualityAssuranceRoutineperiodicevaluationoftheUltrasoundsystemtoguaranteeoptimalimagequality.Requiresanumberoftests
toevaluatesystem,repair,preventativemaintenanceandrecordkeeping.
Goalsofqualityassurance:1.Properequipmentoperation2.Detectgradualchanges3.Minimizedowntime4.Reducednumberofrepeat
scans5.Shouldberoutinelyinspected.
Devicesusedinqualityassurance:
1.BeamprofilerAtankwithwiresimbeddedatincreasingdistancesfromthesurface.Whenwiresarescannedreturningechoesare
processedinAmodepattern.
2.AIUM100mmTestObjectHasapropagationspeedsimilartosofttissue1540m/s.Doesnothaveattenuationpropertieslikesoft
tissue.
DDeadzone
ALongitudinalresolution
AorCVerticalregistration(depth)
BHorizontalregistration
ELateralresolution
TISSUEEQUIVALENTPHANTOM
Containsamediumthatmaymimicssofttissue.Velocity1540m/sandattenuationcoefficientsimilartosofttissue.Usefulforthe
evaluationofgrayscale.Contains:
PinsMimiclikecystsMimiclikesolidmasses
DopplerphantomUsedtoassessaccuracyofpulsedandcontinuouswavesystemsbymimickingbloodvesselswithknownvelocities.
Performancemeasures
Sensitivityistheabilitytodetectlowlevelechoesinthefarfield.
DeadzoneAnacousticstandofforgelpackcanbeusedtoeliminatethedeadzonefrominterferingwithimagingimportantsuperficial
structures.
FocalzoneIntensityishighestwherethebeamisthenarrowest.
LongitudinalresolutionSmallestdistanceatwhichtwopinsaredisplayedastwoseparateechoesfronttoback.
LateralresolutionSmallestdistanceatwhichtwopinsaredisplayedastwoseparateechoessidetoside.
HydrophoneAsmallneedlewithPZTcrystalattheendofit.Theneedleisplacedinpathofultrasoundbeamunderwatercanquantitate:
AmplitudePeriodPulseRepitionPeriod(PRP)Pulseduration
Calorimeteratransducerthatturnsenergyintoheat.Heatmeasured=totalheatgain.
Thermocoupleimbeddedinanabsorbedmaterial.Measuresthechangeintemperature.
BIOLOGICEFFECTSANDSAFETY
Therearenoknowncausesofbioeffectsortissueinjuryindiagnosticimagingatcurrentintensitylevels.

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Pressure(MPa,mmHg)CompressionandRarefractionpeakpressures:Pressureishigher
inthemoredenseareaofthebeamortheareaofcompression.
HydrophoneUsedtomeasurePressures,Power,IntensitiesandAmplitudes.
Power(mW,Watt)Radiationforce(usedtodetermine
power)HydrophoneUsedtomeasurePower,Pressures,Intensitiesand
Amplitudes.
Intensity(mW/cm2,W/cm2)
Spatialconsiderations(distanceorspace)Beamdoesnothavethesameintensitylevelthroughoutthelengthofthe
beam.
Temporalconsiderations(timeortransmitandreceive)Beamdoesnothavethesameintensitylevelatdifferentpointsintime.
AverageIntensity(meanvalue)Averageintensityforallofpulse.
Peakintensity(maximumvalue)Areaofhighestintensitylevel.
HydrophoneUsedtomeasureIntensities,Pressures,Powerand
Amplitudes.
SPTPHighest
Im
SPPA
SPTATissueHeating
SATP
SAPA
SATALowest
AIUMintensitylimitisSPTA:100mW/cm2unfocused1000mW/cm2
focusedor(W/cm2)
TpmaximumintensityintimeImintensityaveragedoverthemostintense1/2
cyclePAintensityaveragedonlyduringpulsedurationTAintensityaveragedduringpulseduration
andofftime
ContinuouswaveTP&TAintensitiesareequal(beamisalwayson)SPTP=
SATASATP=SATA
ContinuouswavevsPulsewavevalues:IftheSPTPorSATPisthesameforbothvalues,continuouswillalwayshavethehigherSPTA.
BeamuniformityCoefficient(SP/SAfactor)Unitlessnumberwithvalueof1orgreater.Describesspreadofbeaminspace.
DutyfactorUnitlessnumberwithavaluebetween0and1.Describesbeamintensitieswithrespecttotime.

ACOUSTICOUTPUTLABELINGSTANDARD
ThermalIndex(SPTA)Anumberthatrelatestotissueheating(temperatureelevationviaabsorption)
Example:Boneisagreatabsorber.SPTAisrelatedtotissueheating
TIS

TIB
TIC
Unfocusedbeamscausetemperatureelevation.
Theintensityforatransduceris:100mW/cm2Unfocused1000
mW/cm2Focused(1W/cm2)
MechanicalIndexAnumberthatrelatestocavitation
CavitationGasbubblesshrinkandexpand(vibrate).Canleadtothermal/tissueinjury,occursat3500W/cm2SPTP
StablecavitationBubblesdonotburstbutundergoshearstressingandmicrostreaming.
TINcavitation(Transient,NormalorInertial)10%>thanstable.BubblesburstduetoincreasedMPa(pressure)fromultrasound
pulse.Bubblesundergohighlylocalizedviolenteffects.
ThermalSPTAintensityisrelatedtotissueheating.
Exposureproducingamaximumtemperatureof1degreescentigradecanbeusedwithoutanyeffects.
Exposureproducingatemperatureat41degreescentigradeorhigherisdangeroustothefetus.
Minimalcavitationoccursindiagnosticultrasound.
Undercontrolledconditions,bioeffectsareconsideredbeneficial.
Increaseintensity=damageorlethaltocellsDecreaseintensity=noknowneffects

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ALARA"Aslowasreasonablyachievable".Canbeachievedbyusinglowoutputpowerandhighreceivergain.

GuidelinesandRegulations
AIUMNoconfirmedbiologicaleffectsonpatientorinstrumentoperatorscausedbyexposureatintensitiesofpresentdiagnosticultrasound
instrumentshaveeverbeenreported.
Thebenefitsofdoinganultrasoundshouldoutweightherisks.Donotperformanultrasoundexaminationwithoutreason.
Minimizeexposuretime.Useminimumoutputpowerandhighreceivergainto
producegoodimages.

NEMA

FDA

ElectricalandMechanicalHazardstoPatient/Equipment
1.Crackedtransducerhousingcancauseelectricalshocktopatient2.Crackedtransducerhousingcancausepoorimage
quality3.Callserviceengineerifequipmentismalfunctioningorsuspectdamagetoprobe.
ExperimentalBiologicEffectStudies
EmpiricalapproachStudiestheexposureresponserelationship
Mechanistic/MechanicalapproachStudiestheCauseeffectrelationshipandtheheateffectifany.Couldproducebioeffects.
?
Invitrostudies:Nonliving(outofthebody).Shouldbeviewedwith
caution.Increasedintensity=lethalto
cellsDecreaseintensity=noeffects(bioeffectsarebeneficial)
Invivo:LivingAnimals,humansplants(Inthebody)
EpidimeologicalstudiesPopulationstudywithbioeffects.Limitationisthesmallertheeffecttheharderitisto
detect.
OtherlimitationsAge,smokingdrinking,drugs,alcohol,ambiguitiesretrospective.
Dosimetryscienceandpracticeofidentifyingandmeasuringthosecharacteristicsofanultrasoundfieldwhichareespeciallyrelevantto
itspotentialforproducingbiologicaleffects.
Veryhighintensitiescancausebiologicaleffects.
Therearenoknowncausesthebiologicaleffectsindiagnosticultrasoundatstandardintensities.Butthattherearelawsuits.

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