INTRODUCTION TO ULTRASOUND AND DOPPLER

* Sound waves are longitudinal waves.

* The term longitudinal wave means that, the motion of particles in the medium is parallel to the direction of wave propagation.

Velocity of sound is independent of frequency & depends primarily on Physical make up of the material through which sound is being transmitted.

Imp characteristics of transmitting medium are 1.COMPRESSIBILITY 2. DENSITY

GAS

LIQUID

SOLID

Velocity of sound in some Biological Materials Material Air Fat Water Average Human ST Brain Liver Velocity of Sound 330 1450 1480 1540 1540 1550 Impedance (Rayl x 10 -6) 0.0004 1.38 1.48 1.63 NA 1.65

Kidney
Blood

1560
1570

1.62
1.61

Muscle
Lens of eye

1580
1620

1.7
NA

Skull Bone

4080

7.8

* Ultrasound

by definition has a frequency of greater than 20,000 cycles per sec.

* Audible sound has a frequency between 15 20,000 cycles/sec

* The sonic beams that we use in diagnostic imaging have frequencies from 10,00,000 to 20,00,000 cycles per sec.

* Transducer is a device that can convert one form of energy

into another.

* Ultrasonic transducers are used to convert an electric signal into ultrasonic energy that can be transmitted into tissues, & to convert ultrasonic energy reflected back from the tissues into an electric signal.

PULSE

ECHO

Based upon the pulse-echo principle occurring with ultrasound piezoelectric crystals, ultrasound transducers convert: Electricity into sound = pulse Sound into electricity = echo

* Piezoelectric effect Certain materials are such that ,the application of an electric field causes a change in their physical dimensions, & vice versa.( first described in 1880)

The reverse of the piezoelectric effect converts the energy back to its original form.

* Piezoelectric crystals are made up of innumerable dipoles arranged in a geometric pattern.

*When an electric field is applied, the dipoles realign themselves & in the process there is a mild change in the dimension of the crystal.

* Voltage between the plating electrodes produces the

electric field, which in turn causes the crystal to change shape.

* Piezoelectric

points.

crystals behave as a series of vibrating

* Wave

fronts are not uniform close to the crystal.

*The distance at which the waves become synchronous depends on their wavelengths.

* Between

pulses, the transducer serves as a receiver.

* Commonly used rate is 1000 pulses /sec.( range of between 500 3000) * At this rate the total time available for each pulse is 0.001 sec. Approx one millionth of a sec is devoted to transmission, so the transducer is a receiver almost thousand times longer than it is a transmitter.

* Intensity
* Parallel

of ultrasound varies along the length of the beam.

component is near zone or Fresnel zone. * Diverging portion of the beam is far zone or fraunhofer zone.

Near zone increases in length with increasing frequency.

Near zone increases in length with larger transducers.

High frequency

Low frequency More penetration

Depth resolution is better,Fresnel zone is longer Less penetration Tissue absorption increases with increasing frequency

1.Reflection

2.Refraction

3. Absorption

As sound waves pass from one tissue plane to another, the amount of Reflection is determined by the

1. Differences in the impedance of the two tissues. 2. Angle of incidence

Specular reflection is responsible for bright appearance of boundaries between tissues. It occurs at tissue interfaces

Scatter gives rise to characteristic echo texture of image. Occurs at small boundaries that occur within tissues.

Bending of waves as they pass from one medium to another is called refraction

Absorption in ultrasound is a result of frictional forces, that oppose the motion of particles in the medium.

DISPLAY

Digital
Data is stored / converted For display

PULSE GENERATOR

AMPLIFIER

The frequency, f, is the number of cycles of displacements passing through a point in the medium during 1 second (s)

The unit of frequency is the hertz (Hz), with 1 Hz being one complete cycle per second

PULSE =Set Of Frequencies

Acoustic Impedance
The acoustic impedance of a medium is the impedance (similar to resistance) the material offers against the passage of the sound wave through it and depends on the density and compressibility of the medium

Beam shape
The shape of the ultrasound beam produced by a transducer will depend on the shape of the element(s), on the transmitted frequency and on whether the beam is focused. The shape of the beam will affect the region of tissue that will be insonated and from which returning echoes will be received.

INTERACTION OF ULTRASOUND WITH SURFACES

When the ultrasound beam meets a boundary between two media, some of the ultrasound will be transmitted some will be reflected. A:

When the two media have similar acoustic impedances, the majority of the ultrasound will be transmitted across the boundary. B:

When the two media have different acoustic impedances, most of the ultrasound will be reflected.

Specular reflections

Specular reflections occur at large smooth interfaces (A), whereas ultrasound is scattered by rough surfaces (B) and small structures (C).

Learning to use knobs effortlessly is an important part of the art of ultrasonic scanning.

GAIN

Controls the degree of echo amplification or brightness of image

ZOOM

TIME GAIN COMPENSATION ( TGC)

Attempts to compensate for acoustic loss by absorption, reflection & scatter & to show structures of same acoustic strength with the same brightness no matter what the depth.

Operator controlled adjustment to compensate for the attenuation of sound as it travels into the tissue

DYNAMIC RANGE Refers to range of intensities from the largest to the smallest echo that a system can display.

60 db

30 db

CALIPERS

DEPTH

*Artifacts related to instrumental problems *Technique dependant artifacts *Artifacts due to the way tissues affect sound.

ARTEFACTS RELATED TO INSTRUMENTAL PROBLEMS

1. Artifactual noise

2. Calibration artifacts

2. Main Bang artifact

3.Veiling Artifact

4.Side lobe artifact

ARTEFACTS CAUSED BY TECHNIQUE

1. Noise

2.TGC problems
3. Banding 4. Contact problem

ARTEFACTS CAUSED BY SOUND TISSUE INTERACTIONS

1.Artefacts from strongly reflective structures

2. Enhancement artifact

3 Mirror image artifact

4. Reverberation Artifact

5. Comet tail artifact

U/S CONTRAST AGENTS

microbubble contrast media - to improve ultrasound signal backscatter is known as contrast-enhanced ultrasound. This technique is currently used in echocardiography, and may have future applications in molecular imaging and drug delivery

3D ULTRASOUND

3D ultrasound medical ultrasound technique pregnancy, providing three dimensional images of the fetus. Often these images are captured rapidly and animated to produce a "4D ultrasound". In 3D fetal scanning, however, instead of the sound waves being sent straight down and reflected back, they are sent at different angles. The returning echoes are processed by a highly sophisticated computer program resulting in a reconstructed three dimensional volume image of fetus's surface or internal organs; allowing one to see width, height and depth of images in much the same way as 3D movies but no movement is shown.

3D Ultrasound was first developed by Olaf von Ramm and Stephen Smith at Duke University in 1987.[2] 4D baby scans are similar to 3D scans except that they show fetal movement.

US - Advantages
Excellent soft tissue contrast resolution Dynamic No radiation Safe in pregnancy Available, cheap

OTHER USES
The ability to stimulate bone-growth Potential to disrupt the blood-brain barrier for drug delivery. Ultrasound is used in UAL (= ultrasound-assisted lipectomy), or liposuction.

Doppler ultrasound is being tested for use in aiding tissue plasminogen activator treatment in stroke sufferers. This procedure is called Ultrasound-Enhanced Systemic Thrombolysis. Low intensity pulsed ultrasound is used for therapeutic tooth and bone regeneration.

Acoustic Targeted Drug Delivery

High frequency ultrasound (from 1 MHz to 10 MHz) intensities from 0-20 watts/cm2. The acoustic energy is focused on the tissue of interest to agitate its matrix and make it more permiable to therapeutic drugs Enhanced drug uptake

DISADVANTAGES
Trouble penetrating bone. Performs very poorly when there is a gas between the transducer and the organ of interest, due to the extreme differences in acoustic impedance.

The depth penetration of ultrasound is limited, making it difficult to image structures deep in the body, especially in obese patients. The method is operator-dependent.

SIDE EFFECTS

Ultrasound energy produces a mechanical pressure wave through soft tissue. This pressure wave may cause microscopic bubbles in living tissues, and distortion of the cell membrane, influencing ion fluxes and intracellular activity. When ultrasound enters the body, it causes molecular friction and heats the tissues slightly. This effect is very minor as normal tissue perfusion dissipates heat. With high intensity, it can also cause small pockets of gas in body fluids or tissues to expand and contract/collapse in a phenomenon called cavitation

Doppler ultrasound Creation of a color flow image Blood flow and its appearance on color flow imaging Spectrum

Doppler effect
Austrian physicist named Christian Doppler in 1842.

The Doppler effect is the change in the observed frequency due to the relative motion of the source and the observer

DOPPLER EFFECT

A Doppler transducer placed on the skin and aimed at an angle, , towards a blood vessel, which contains blood flowing with a velocity of u m/s, at any instant.
The transducer emits ultrasound waves of frequency, fo, and echoes generated by moving reflectors in the blood, e.g. red blood cells, have a frequency, fr. The difference between these two frequencies, f, is related to the velocity of the flowing reflectors throught the following equation:

The detected Doppler shift frequency changes as the angle of insonation changes.

The Doppler shift frequency can then be extracted from the received signal by a process known as demodulation.

Here, the received signal is multiplied by the transmitted signal and the product is filtered to remove the high frequencies, thus providing the Doppler shift frequency.

The received signal has a different frequency from the transmitted frequency, owing to the Doppler effect, and a lower amplitude, owing to attenuation of the signal by overlying tissue. As mentioned earlier, once the Doppler shift frequency has been extracted (by demodulation) and amplified, it can simply be output to a loudspeaker or investigated using a spectrum analyzer

Demodulation

This is used to extract the Doppler frequency

The velocity of the blood cells will vary with time, owing to the pulsatile nature of arterial blood flow.

This means that the Doppler shift signal obtained from flowing blood will contain a range of frequencies, due to the range of velocities present, and the frequency content will vary with time.

Color flow

Overall view of flow in a region Limited flow information Poor temporal resolution/flow dynamics (frame rate can be low when scanning deep) color flow map (diferent color maps) direction information velocity information (high velocity & low velocity) turbulent flows

Factors affecting color flow image

Main factors Power: transmitted power into tissue *Gain: overall sensitivity to flow signals Frequency: trades penetration for sensitivity and resolution *Pulse repetition frequency (also called scale): low pulse repetition frequency to look at low velocities, high pulse repetition frequency reduces aliasing *Area of investigation: larger area reduces frame rate *Focus: color flow image optimized at focal zone*

EFFECT OF PRF

Spectral Doppler
Examines flow at one site Detailed analysis of distribution of flow Good temporal resolution can examine flow waveform Allows calculations of velocity and indices

Spectral analysis can be used to break down the Doppler signal into its component frequencies and to show how these component frequencies vary with time. a spectrum is displayed, with time along the horizontal axis and the Doppler shift frequency along the vertical axis. The third axis, the brightness of the display, shows the back-scattered power of the signal at each frequency (i.e., the proportion of the blood cells moving at a particular velocity).

Continuous wave (CW) Doppler

Continuous wave (CW) Doppler continuously emits a single frequency while the receiving element continuously detects any echoes from the sensitive region of the beam (i.e., where transmitted and received beams overlap) This region usually covers a depth of a few centimeters, and any flow within this area will be detected.

unable to provide information about the depth from which the Doppler signal is returning. CW Doppler is therefore said to have poor range resolution.
Veins often lie adjacent to arteries and so, in many cases, the CW Doppler will simultaneously detect arterial and venous flow.

Pulsed Doppler

The poor range resolution of CW Doppler can be overcome by using a pulse of ultrasound energy and only acquiring the returning signal at a known time after the pulse has been transmitted.
pulse of ultrasound is transmitted and the receiver then waits a given time before acquiring the signal over a short period of time.

Power/energy/amplitu de flow Sensitive to low flows No directional information in some modes Very poor temporal resolution Susceptible to noise

APPLICATIONS

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