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UltarSound Machine Dr Fadhl Alakwaa [email protected]

UltarSound Machine Dr Fadhl Alakwaa

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UltarSound Machine Dr Fadhl Alakwaa. [email protected]. What are the first things to account when purchasing new US equipment. Clinical application Operation Modes Transducers OTHERS DISOM & STORAGE PRINTER NETWORKING. EXCELLENT RESOURCES. - PowerPoint PPT Presentation

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Page 1: UltarSound  Machine Dr  Fadhl Alakwaa

UltarSound MachineDr Fadhl Alakwaa

fadlworkgmailcom

What are the first things to account when purchasing new US equipment

bull Clinical applicationbull Operation Modesbull Transducersbull OTHERS

ndash DISOM amp STORAGE ndash PRINTERndash NETWORKING

EXCELLENT RESOURCES

bull Ultrasound Machine Comparison An Evaluation of Ergonomic Design Data Management Ease of Use and Image Quality

bull httpwwwcompareultrasoundcombull Objective measurements of image qualitybull Ultrasound Equipment Evaluation Project

CLINICAL APPLICATIONS

bull Breast Imaging of female (usually) breastsbull Cardiac Imaging of the heartbull Gynecologic Imaging of the female reproductive organsbull Radiology Imaging of the internal organs of the abdomenbull Obstetrics (sometimes combined with Gynecologic as in

OBGYN) Imaging of fetuses in vivobull Pediatrics Imaging of childrenbull Vascular Imaging of the (usually peripheral as in peripheral

vascular) arteries and veins of the vascular system (called lsquolsquocardiovascularrsquorsquo when combined with heart imaging)

bull (Note that lsquolsquointrarsquorsquo (from Latin) means into or inside lsquolsquotransrsquorsquo means through or across and lsquolsquoendorsquorsquo means within)

bull Endovaginal Imaging the female pelvis using the vagina as an acoustic window

bull Intracardiac Imaging from within the heartbull Intraoperative Imaging during a surgical procedurebull Intravascular Imaging of the interior of arteries

and veins from transducers inserted in thembull Laproscopic Imaging carried out to guide and

evaluate laparoscopic surgery made through small incisions

bull Musculoskeletal Imaging of muscles tendons and ligaments

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 2: UltarSound  Machine Dr  Fadhl Alakwaa

What are the first things to account when purchasing new US equipment

bull Clinical applicationbull Operation Modesbull Transducersbull OTHERS

ndash DISOM amp STORAGE ndash PRINTERndash NETWORKING

EXCELLENT RESOURCES

bull Ultrasound Machine Comparison An Evaluation of Ergonomic Design Data Management Ease of Use and Image Quality

bull httpwwwcompareultrasoundcombull Objective measurements of image qualitybull Ultrasound Equipment Evaluation Project

CLINICAL APPLICATIONS

bull Breast Imaging of female (usually) breastsbull Cardiac Imaging of the heartbull Gynecologic Imaging of the female reproductive organsbull Radiology Imaging of the internal organs of the abdomenbull Obstetrics (sometimes combined with Gynecologic as in

OBGYN) Imaging of fetuses in vivobull Pediatrics Imaging of childrenbull Vascular Imaging of the (usually peripheral as in peripheral

vascular) arteries and veins of the vascular system (called lsquolsquocardiovascularrsquorsquo when combined with heart imaging)

bull (Note that lsquolsquointrarsquorsquo (from Latin) means into or inside lsquolsquotransrsquorsquo means through or across and lsquolsquoendorsquorsquo means within)

bull Endovaginal Imaging the female pelvis using the vagina as an acoustic window

bull Intracardiac Imaging from within the heartbull Intraoperative Imaging during a surgical procedurebull Intravascular Imaging of the interior of arteries

and veins from transducers inserted in thembull Laproscopic Imaging carried out to guide and

evaluate laparoscopic surgery made through small incisions

bull Musculoskeletal Imaging of muscles tendons and ligaments

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 3: UltarSound  Machine Dr  Fadhl Alakwaa

EXCELLENT RESOURCES

bull Ultrasound Machine Comparison An Evaluation of Ergonomic Design Data Management Ease of Use and Image Quality

bull httpwwwcompareultrasoundcombull Objective measurements of image qualitybull Ultrasound Equipment Evaluation Project

CLINICAL APPLICATIONS

bull Breast Imaging of female (usually) breastsbull Cardiac Imaging of the heartbull Gynecologic Imaging of the female reproductive organsbull Radiology Imaging of the internal organs of the abdomenbull Obstetrics (sometimes combined with Gynecologic as in

OBGYN) Imaging of fetuses in vivobull Pediatrics Imaging of childrenbull Vascular Imaging of the (usually peripheral as in peripheral

vascular) arteries and veins of the vascular system (called lsquolsquocardiovascularrsquorsquo when combined with heart imaging)

bull (Note that lsquolsquointrarsquorsquo (from Latin) means into or inside lsquolsquotransrsquorsquo means through or across and lsquolsquoendorsquorsquo means within)

bull Endovaginal Imaging the female pelvis using the vagina as an acoustic window

bull Intracardiac Imaging from within the heartbull Intraoperative Imaging during a surgical procedurebull Intravascular Imaging of the interior of arteries

and veins from transducers inserted in thembull Laproscopic Imaging carried out to guide and

evaluate laparoscopic surgery made through small incisions

bull Musculoskeletal Imaging of muscles tendons and ligaments

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 4: UltarSound  Machine Dr  Fadhl Alakwaa

CLINICAL APPLICATIONS

bull Breast Imaging of female (usually) breastsbull Cardiac Imaging of the heartbull Gynecologic Imaging of the female reproductive organsbull Radiology Imaging of the internal organs of the abdomenbull Obstetrics (sometimes combined with Gynecologic as in

OBGYN) Imaging of fetuses in vivobull Pediatrics Imaging of childrenbull Vascular Imaging of the (usually peripheral as in peripheral

vascular) arteries and veins of the vascular system (called lsquolsquocardiovascularrsquorsquo when combined with heart imaging)

bull (Note that lsquolsquointrarsquorsquo (from Latin) means into or inside lsquolsquotransrsquorsquo means through or across and lsquolsquoendorsquorsquo means within)

bull Endovaginal Imaging the female pelvis using the vagina as an acoustic window

bull Intracardiac Imaging from within the heartbull Intraoperative Imaging during a surgical procedurebull Intravascular Imaging of the interior of arteries

and veins from transducers inserted in thembull Laproscopic Imaging carried out to guide and

evaluate laparoscopic surgery made through small incisions

bull Musculoskeletal Imaging of muscles tendons and ligaments

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 5: UltarSound  Machine Dr  Fadhl Alakwaa

bull (Note that lsquolsquointrarsquorsquo (from Latin) means into or inside lsquolsquotransrsquorsquo means through or across and lsquolsquoendorsquorsquo means within)

bull Endovaginal Imaging the female pelvis using the vagina as an acoustic window

bull Intracardiac Imaging from within the heartbull Intraoperative Imaging during a surgical procedurebull Intravascular Imaging of the interior of arteries

and veins from transducers inserted in thembull Laproscopic Imaging carried out to guide and

evaluate laparoscopic surgery made through small incisions

bull Musculoskeletal Imaging of muscles tendons and ligaments

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 6: UltarSound  Machine Dr  Fadhl Alakwaa

bull Intracardiac Imaging from within the heartbull Intraoperative Imaging during a surgical procedurebull Intravascular Imaging of the interior of arteries

and veins from transducers inserted in thembull Laproscopic Imaging carried out to guide and

evaluate laparoscopic surgery made through small incisions

bull Musculoskeletal Imaging of muscles tendons and ligaments

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 7: UltarSound  Machine Dr  Fadhl Alakwaa

bull Small parts High-resolution imaging applied to superficial tissues musculature and vessels near the skin surface

bull Transcranial Imaging through the skull (usually through windows such as the temple or eye) of the brain and its associated vasculature

bull Transesophageal Imaging of internal organs (especially the heart) from specially designed probes made to go inside the esophagus

bull Transorbital Imaging of the eye or through the eye as an acoustic window

bull Transrectal Imaging of the pelvis using the rectum as an acoustic window

bull Transthoracic External imaging from the surface of the chest

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 8: UltarSound  Machine Dr  Fadhl Alakwaa

What do you need to know to be professional in US

bull Advantage of US OVER other modalitiesbull US developmentbull US physicsbull Ultrasound Terminology bull US clinical applicationsbull US componentsbull US Transducer typesbull US modesbull US specifications

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 9: UltarSound  Machine Dr  Fadhl Alakwaa

Advantage of US OVER other modalities

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 10: UltarSound  Machine Dr  Fadhl Alakwaa

US development

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 11: UltarSound  Machine Dr  Fadhl Alakwaa

What is Ultrasound machine

bullUltrasound or ultrasonography is a medical imaging technique that uses high frequency

sound waves and their echoes bullBut what is the ultrasound waves

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 12: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

Spectrum of sound

Frequency range Hz Description Example

0 - 20 Infrasound Earth quake

20 - 20000 Audible sound Speech music

gt20000 Ultrasound Bat Quartz crystal

Medical ultrasound frequency is 1Mhz-10Mhzوعرضية طولية نوعيين صوتية الفوق الموجات

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 13: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

Direction of oscillation

Direction of propagationLongitudinal wave

Sound propagation

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 14: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

Direction of propagationTransverse waveDirection of oscillation

Sound propagation

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 15: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

Wave propagation

AirWater

Steel longSteel trans

330 ms

1480 ms

3250 ms

5920 ms

Longitudinal waves propagate in all kind of materialsTransverse waves only propagate in solid bodies Due to the different type of oscillation transverse wavestravel at lower speedsSound velocity mainly depends on the density and E-modulus of the material

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 16: UltarSound  Machine Dr  Fadhl Alakwaa

Difference between EM and soundbull Material through which wave movesbull Medium not required for all wave types

ndash no medium required for electromagnetic wavesbull radiobull x-raysbull infraredbull ultraviolet

ndash medium is required for soundbull sound does not travel through vacuum

Talk louder I canrsquot hear

you

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 17: UltarSound  Machine Dr  Fadhl Alakwaa

How to produce sound wave

bull By applying voltage on some material face likendash Quartzndash PZT

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 18: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

Piezoelectric Effect

Piezoelectrical Crystal (Quartz)

Battery

+

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 19: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

+

The crystal gets thicker due to a distortion of the crystal lattice

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 20: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

+

The effect inverses with polarity change

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 21: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

An alternating voltage generates crystal oscillations at the frequency f

U(f)

Sound wave with

frequency f

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 22: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

A short voltage pulse generates an oscillation at the crystallsquos resonantfrequency f0 OPERATING FREQUNCY

Short pulse lt ( 1 micros)

Piezoelectric Effect

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 23: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

How to receive sound waves

A sound wave hitting a piezoelectric crystal induces crystal vibration which then causes electrical voltages at the crystal surfaces

Electrical energy

Piezoelectrical crystal Ultrasonic wave

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 24: UltarSound  Machine Dr  Fadhl Alakwaa

Krautkramer NDT Ultrasonic Systems

N

Near field Far field

Focus Angle of divergenceCrystalAccoustical axis

D0

6

Sound field

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 25: UltarSound  Machine Dr  Fadhl Alakwaa

Transducer array

bull Transducer = ARRAY OF PIEZOELECTRICAL ELEMENTS Typically 128 to 512

bull SPECFICATIONndash Materialndash ARRAY LENGHTndash Frequency rang

bull resolutionndash Depth CMndash Type

bull LINEAR ARRAYbull PHASED ARRAY

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 26: UltarSound  Machine Dr  Fadhl Alakwaa

Ultrasound Display

bull One sound pulse producesndash one image scan line

bull one series of gray shade dots in a line

bull Multiple pulsesndash two dimensional image

obtained by moving direction in which sound transmitted

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 27: UltarSound  Machine Dr  Fadhl Alakwaa

Real-time Scanning

Each pulse generates one lineExcept for multiple focal zones

one frame consists of many individual scan lines

lines framesPRF (Hz) = ------------ X--------------

frame sec

One pulse = one line

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 28: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Curved linear array Phased arraysectorEndocavitary Intraoperative

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 29: UltarSound  Machine Dr  Fadhl Alakwaa

Transducer ArraysbullVirtually all commercial transducers are

arraysndashMultiple small elements in single housing

bullAllows sound beam to be electronicallyndashFocusedndashSteeredndashShaped

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 30: UltarSound  Machine Dr  Fadhl Alakwaa

Electronic Scanning

bullTransducer ArraysndashMultiple small transducersndashActivated in groups

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 31: UltarSound  Machine Dr  Fadhl Alakwaa

Electrical ScanningPerformed with transducer arrays

multiple elements inside transducer assembly arranged in either

a line (linear array)

concentric circles (annular array)

Curvilinear Array Linear Array

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 32: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Array ScanningTwo techniques for activating groups of linear

transducersSwitched Arrays

activate all elements in group at same timePhased Arrays

Activate group elements at slightly different timesimpose timing delays between activations of elements in group

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 33: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Switched ArraysbullElements energized as groups

ndashgroup acts like one large transducer

bullGroups moved up amp down through elements

ndashsame effect as manually translating

ndashvery fast scanning possible (several times per second)

bullresults in real time image

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 34: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Switched Arrays

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 35: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Phased ArraybullGroups of elements energizedndashsame as with switched arraysbullvoltage pulse applied to all

elements of a groupBUT

bullelements not all pulsed at same time

1

2

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 36: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Phased Arraybulltiming variations allow beam to

be ndashshapedndashsteeredndashfocused

Above arrows indicate timing variations

By activating bottom element first amp top last beam directed upward

Beam steered upward

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 37: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Phased Array

Above arrows indicate timing variationsBy activating top

element first amp bottom last beam directed

downward

Beam steered downward

By changing timing variations between pulses beam can be scanned from top to bottom

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 38: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Phased Array

Above arrows indicate timing variations

By activating top amp bottom elements earlier than center ones beam

is focused

Beam is focused

Focus

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 39: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Phased ArrayFocus

Focal point can be moved toward or away from transducer by altering timing variations

between outer elements amp center

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 40: UltarSound  Machine Dr  Fadhl Alakwaa

Linear Phased ArrayFocus

Multiple focal zones accomplished by changing timing variations between pulsesbullMultiple pulses requiredbullslows frame rate

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 41: UltarSound  Machine Dr  Fadhl Alakwaa

Listening ModebullListening direction can be steered amp

focused similarly to beam generation

ndashappropriate timing variations applied to echoes received by various

elements of a groupbullDynamic Focusing

ndashlistening focus depth can be changed electronically between pulses by

applying timing variations as above

2

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 42: UltarSound  Machine Dr  Fadhl Alakwaa

15 Transducerbull~3 elements in elevation directionbullAll 3 elements can be combined for thick slicebull1 element can be selected for thin slice

Elevation

Direction

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 43: UltarSound  Machine Dr  Fadhl Alakwaa

15 amp 2D TransducersbullMultiple elements in 2 directionsbullCan be steered amp focused anywhere in 3D

volume

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 44: UltarSound  Machine Dr  Fadhl Alakwaa

Remember me to explain why we use the backing block and matching layer

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 45: UltarSound  Machine Dr  Fadhl Alakwaa

What we will use the returned or received ultrasound waves ldquoechoesrdquo

bull NO ECHOES = NO IMAGING bull WE WILL BACK TO THAT

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 46: UltarSound  Machine Dr  Fadhl Alakwaa

Perpendicular Incidence

bull Sound beam travels perpendicular to boundary between two media

90o

IncidentAngle

1

2Boundarybetween

media

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 47: UltarSound  Machine Dr  Fadhl Alakwaa

Oblique Incidence

bull Sound beam travel not perpendicular to boundary Oblique

IncidentAngle

(not equal to 90o)

1

2

Boundarybetween

media

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 48: UltarSound  Machine Dr  Fadhl Alakwaa

Perpendicular Incidence

bull What happens to sound at boundaryndash reflected

bull sound returns toward source

ndash transmittedbull sound continues in

same direction

1

2

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 49: UltarSound  Machine Dr  Fadhl Alakwaa

Perpendicular Incidence

bull Fraction of intensity reflected depends on acoustic impedances of two media 1

2

Acoustic Impedance= Density X Speed of Sound

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 50: UltarSound  Machine Dr  Fadhl Alakwaa

Intensity Reflection Coefficient (IRC)amp

Intensity Transmission Coefficient (ITC)IRC

Fraction of sound intensity reflected at interface

lt1ITC

Fraction of sound intensity transmitted through interface

lt1

Medium 1

Medium 2IRC + ITC = 1

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 51: UltarSound  Machine Dr  Fadhl Alakwaa

IRC Equation

bull Z1 is acoustic impedance of medium 1

bull Z2 is acoustic impedance of medium 2

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

For perpendicular incidence

Medium 1

Medium 2

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 52: UltarSound  Machine Dr  Fadhl Alakwaa

Reflections

Impedances equal no reflection

Impedances similarlittle reflected

Impedances very different (boneair interference)virtually all reflected

2 reflected intensity z2 - z1

Fraction Reflected---------- = ------------------------ = incident intensity z2 + z1

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 53: UltarSound  Machine Dr  Fadhl Alakwaa

Why Use Gel and matching layer

Acoustic Impedance of air amp soft tissue very differentWithout gel virtually no sound penetrates skin

2 reflected intensity z2 - z1

IRC---------- = ------------------------ = incident intensity z2 + z1

Acoustic Impedance

(rayls)

Air 400Soft Tissue 1630000

Fraction Reflected 09995

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 54: UltarSound  Machine Dr  Fadhl Alakwaa

THE BASICS US IDEA

bull The returned echoes represent gray levels in ultrasound images

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 55: UltarSound  Machine Dr  Fadhl Alakwaa

What does your scanner know about echoed sound

What was the time delay between sound broadcast and the echo

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 56: UltarSound  Machine Dr  Fadhl Alakwaa

What Does Your Scanner Assume about Echoes

(or how the scanner can lie to you)

bull Sound travels at 1540 ms everywhere in bodyndash average speed of sound in soft tissue

bull Sound travels in straight lines in direction transmitted

bull Sound attenuated equally by everything in bodyndash (05 dBcmMHz soft tissue average)

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 57: UltarSound  Machine Dr  Fadhl Alakwaa

Distance of Echo from Transducer

bull Time delay accurately measured by scanner

distance = time delay X speed of sound

distance

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 58: UltarSound  Machine Dr  Fadhl Alakwaa

What is the Speed of Sound

bull scanner assumes speed of sound is that of soft tissuendash 154 mmmsecndash 1540 msecndash 13 usec required for echo object 1 cm from

transducer (2 cm round trip)

distance = time delay X speed of sound

1 cm13 msec

Handy rule of

thumb

bullB AND M-modebullColor spectral power DopplerbullTissue harmonic imaging (detection of harmonics signals abdominal and liver)bullContrast agent imaging (detection of subtle parenchymal change and metastases in the liver abdominal and vascular)bull3-D imaging

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 59: UltarSound  Machine Dr  Fadhl Alakwaa

So the scanner assumes the wrong speed

bull Sometimes

soft tissue ==gt 154 mm msecfat ==gt 144 mm msecbrain ==gt 151 mm msecliver kidney ==gt 156 mm msecmuscle ==gt 157 mm msec

bullLuckily the speed of sound is almost the same for most body parts

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 60: UltarSound  Machine Dr  Fadhl Alakwaa

Attenuation Correction

bull scanner assumes entire body has attenuation of soft tissuendash actual attenuation

varies widely in body

bull Fat 06bull Brain 06bull Liver 05bull Kidney 09bull Muscle 10bull Heart 11

Tissue Attenuation Coefficient( dB cm MHz)

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 61: UltarSound  Machine Dr  Fadhl Alakwaa

Gray Shade of Echo

bull Ultrasound is gray shade modality

bull Gray shade should indicate echogeneity of object

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 62: UltarSound  Machine Dr  Fadhl Alakwaa

How does scanner know what gray shade to assign an echo

bull Based upon intensity (volume loudness) of echo

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 63: UltarSound  Machine Dr  Fadhl Alakwaa

How to reconstruct the image from echoes

bull US MODESndash B AND M-modendash Color spectral power Dopplerndash Tissue harmonic imaging (detection of harmonics

signals abdominal and liver)ndash Contrast agent imaging (detection of subtle

parenchymal change and metastases in the liver abdominal and vascular)

ndash 3-D imaging

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 64: UltarSound  Machine Dr  Fadhl Alakwaa

M Modebull Multiple pulses in same

locationndash New lines added to right

bull horizontal axisndash elapsed time (not time within a

pulse)bull vertical axis

ndash time delay between pulse amp echobull indicates distance of reflector from

transducer

Elapsed Time

Each vertical line is one pulse

Echo Delay Time

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 65: UltarSound  Machine Dr  Fadhl Alakwaa

M-Mode (left ventricle)

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 66: UltarSound  Machine Dr  Fadhl Alakwaa

Scanner Processing of Echoes

AmplificationCompensationCompressionDemodulationRejection

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 67: UltarSound  Machine Dr  Fadhl Alakwaa

Amplification

bull Increases small voltage signals from transducerndash incoming voltage signal

bull 10rsquos of millivolts

bull larger voltage required for processing amp storage

Amplifier

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 68: UltarSound  Machine Dr  Fadhl Alakwaa

Compensation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 69: UltarSound  Machine Dr  Fadhl Alakwaa

Need for Compensationbull equal intensity reflections from

different depths return with different intensitiesndash different travel distances

bull attenuation is function of path length

Display without compensation

time since pulse

echointensity

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 70: UltarSound  Machine Dr  Fadhl Alakwaa

Equal Echoes

VoltageAmplification

VoltageAmplitude

afterAmplification

Equal echoesequal voltages

Later EchoesEarly Echoes

Voltagebefore

Compensation

Time within a pulse

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 71: UltarSound  Machine Dr  Fadhl Alakwaa

Compensation (TGC)bull Body attenuation varies from 05 dBcmMHzbull TGC allows manual fine tuning of compensation vs

delay bull TGC curve often displayed graphically

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 72: UltarSound  Machine Dr  Fadhl Alakwaa

Compensation (TGC)

bull TGC adjustment affects all echoes at a specific distance range from transducer

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 73: UltarSound  Machine Dr  Fadhl Alakwaa

Compression

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 74: UltarSound  Machine Dr  Fadhl Alakwaa

Compression1000

1 10 100 1000

3 = log 1000

1 10 100 1000

2= log 100

1 = log 10

0 = log 10

100000100001000100101

543210

Input LogarithmCanrsquot easily distinguish

between 1 amp 10 here

Difference between 1 amp 10 the same as

between 100 amp 1000

Logarithms stretch low end of scale compress high end

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 75: UltarSound  Machine Dr  Fadhl Alakwaa

Demodulation

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 76: UltarSound  Machine Dr  Fadhl Alakwaa

Demodulationbull Intensity information carried on ldquoenveloperdquo of

operating frequencyrsquos sine wavendash varying amplitude of sine wave

bull demodulation separates intensity information from sine wave

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 77: UltarSound  Machine Dr  Fadhl Alakwaa

Demodulation Sub-steps

bull rectifyndash turn negative signals

positivebull smooth

ndash follow peaks

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 78: UltarSound  Machine Dr  Fadhl Alakwaa

Rejection

bullAmplificationbullCompensationbullCompressionbullDemodulationbullRejection

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 79: UltarSound  Machine Dr  Fadhl Alakwaa

Rejectionbull also known as

ndash suppressionndash threshold

bull objectndash eliminate small amplitude

voltage pulsesbull reason

ndash reduce noisebull electronic noisebull acoustic noise

ndash noise contributes no useful information to image

Amplitudes below dotted line reset to zero

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 80: UltarSound  Machine Dr  Fadhl Alakwaa

Image Resolution

bull Detail Resolutionndash spatial resolutionndash separation required to

produce separate reflectionsbull Detail Resolution types

Axial

Lateral

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 81: UltarSound  Machine Dr  Fadhl Alakwaa

Resolution amp Reflector Sizeminimum imaged size of a reflector in each dimension

is equal to resolutionObjects never imaged smaller than systemrsquos resolution

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 82: UltarSound  Machine Dr  Fadhl Alakwaa

Axial Resolution

minimum reflector separation in direction of sound travel which produces separate reflections

depends on spatial pulse lengthDistance in space covered by a pulse

HEYHEY

Spatial Pulse Length

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 83: UltarSound  Machine Dr  Fadhl Alakwaa

Axial Resolution

Separationjust greaterthan half thespatialpulse length

GapSeparate

Echoes

Axial Resolution = Spatial Pulse Length 2

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 84: UltarSound  Machine Dr  Fadhl Alakwaa

Axial Resolution

Separationjust lessthan half thespatialpulse length

OverlapNo GapNo SeparateEchoes

Axial Resolution = Spatial Pulse Length 2

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 85: UltarSound  Machine Dr  Fadhl Alakwaa

Spatial Pulse LengthSpat Pulse Length = cycles per pulse X wavelength

Wavelength = Speed Frequency

Duty Factor = Pulse Duration X Pulse Repetition Freq

CYCLES

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 86: UltarSound  Machine Dr  Fadhl Alakwaa

WavelengthCalculate SPL for 5 MHz sound in

soft tissue 5 cycles per pulse

(Wavelength=031 mmcycle)

SPL = 031 mm cycle X 5 cycles pulse = 155 mm pulse

Spat Pulse Length = cycles per pulse X wavelength

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 87: UltarSound  Machine Dr  Fadhl Alakwaa

Improve Axial Resolution by Reducing Spatial Pulse Length

bull increase frequencyndash Decreases wavelengthndash decreases penetration

limits imaging depthbull Reduce cycles per

pulsendash requires damping

bull reduces intensitybull increases bandwidth

Spat Pulse Length = cycles per pulse X wavelength

Speed = Wavelength X Frequency

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 88: UltarSound  Machine Dr  Fadhl Alakwaa

Lateral Resolution

bull Definitionndash minimum separation between reflectors in

direction perpendicular to beam travel which produces separate reflections when the beam is scanned across themLateral Resolution = Beam Diameter

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 89: UltarSound  Machine Dr  Fadhl Alakwaa

Lateral Resolution

bull if separation is greater than beam diameter objects can be resolved as two reflectors

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 90: UltarSound  Machine Dr  Fadhl Alakwaa

Lateral Resolution

bull Complicationndash beam diameter

varies with distance from transducer

ndash Near zone length varies with

bull Frequencybull transducer

diameter

Near zone lengthNearzone

Farzone

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 91: UltarSound  Machine Dr  Fadhl Alakwaa

Contrast Resolution

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 92: UltarSound  Machine Dr  Fadhl Alakwaa

Contrast Resolution

bull difference in echo intensity between 2 echoes for them to be assigned different digital values

89

88

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 93: UltarSound  Machine Dr  Fadhl Alakwaa

Pre-Processing

bull Assigning of specific values to analog echo intensities

bull analog to digital (AD) converterbull converts output signal from receiver

(after rejection) to a value

89

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 94: UltarSound  Machine Dr  Fadhl Alakwaa

Gray Scalebull the more candidate values for a pixel

ndash the more shades of gray image can be stored in digital image

ndash The less difference between echo intensity required to guarantee different pixel values

bull See next slide

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 95: UltarSound  Machine Dr  Fadhl Alakwaa

1234567

1 2 6 6 4 4 5 3 2 3 7 7 6 4 2 5 5 2

1234567

2 4 11 11 7 8 10 6 3 6 14 14 11 6 4 8 12 4

89

1011121314

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 96: UltarSound  Machine Dr  Fadhl Alakwaa

Display Limitationsbull not possible to display all shades of gray

simultaneouslybull window amp level controls determine how pixel

values are mapped to gray shades bull numbers (pixel values) do not change window amp

level only change gray shade mapping

17 =

65 =

Change window

level

17 =

65 =

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 97: UltarSound  Machine Dr  Fadhl Alakwaa

Presentation of Brightness Levelsbull pixel values assigned brightness levels

ndash pre-processingbull manipulating brightness levels does not affect

image datandash post-processing

bull windowbull level

125 25 311 111 182 222 176

199 192 85 69 133 149 112

77 103 118 139 154 125 120

145 301 256 223 287 256 225

178 322 325 299 353 333 300

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 98: UltarSound  Machine Dr  Fadhl Alakwaa

Block Diagram

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 99: UltarSound  Machine Dr  Fadhl Alakwaa

B Mode

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 100: UltarSound  Machine Dr  Fadhl Alakwaa

Color flow imaging (mode)Color Doppler (mode)

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 101: UltarSound  Machine Dr  Fadhl Alakwaa

Continuous wave (CW) Doppler

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 102: UltarSound  Machine Dr  Fadhl Alakwaa

M-mode

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 103: UltarSound  Machine Dr  Fadhl Alakwaa

Power Doppler (mode)

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 104: UltarSound  Machine Dr  Fadhl Alakwaa

Pulsed wave Doppler

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 105: UltarSound  Machine Dr  Fadhl Alakwaa

Transducerfrequency MHZ

Depth cm Mode Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 106: UltarSound  Machine Dr  Fadhl Alakwaa

Transducerfrequency MHZ

Depth cm Mode

Min Req

Abdominal liver spleen kidney gallbladder pancreas and retroperitoneum

LCAPA2-7 min2-10 req

15 18 B

LCAPA2-515-4

10 15 Spectral Doppler

LCAPA2-5 min15-4 req

10 15 Flow imaging

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 107: UltarSound  Machine Dr  Fadhl Alakwaa

Small parts LA7-10 min5-15 req

6 8-10 Dynamic imaging

LA4-5 min4-8 req

6 8-10 Spectral Doppler

LA4-5 min4-8 req

6 8-10 Flow imaging

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 108: UltarSound  Machine Dr  Fadhl Alakwaa

Vascular LACLA2-8 MIN2-10 REQ

6 8 Dynamic imaging

LACLA2-8 MIN2-10 REQ

6 8 Spectral Doppler

LACLA3-5 MIN3-6 REQ

6 10Flow imaging

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 109: UltarSound  Machine Dr  Fadhl Alakwaa

DOPPLER US

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 110: UltarSound  Machine Dr  Fadhl Alakwaa

Hemodynamics

bull Plugbull Laminarbull Disturbedbull Turbulent

Blood Flow Characterization

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 111: UltarSound  Machine Dr  Fadhl Alakwaa

Plug Flow

bull Type of normal flowbull Constant fluid speed across

tubebull Occurs near entrance of flow

into tube

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 112: UltarSound  Machine Dr  Fadhl Alakwaa

Laminar Flow

also called parabolic flowfluid layers slide over one anotheroccurs further from entrance to tubecentral portion of fluid moves at

maximum speedflow near vessel wall hardly moves

at allfriction with wall

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 113: UltarSound  Machine Dr  Fadhl Alakwaa

FlowDisturbed Flow

Normal parallel stream lines disturbedprimarily forward particles still flow

Turbulent Flowrandom amp chaoticindividual particles flow in all directionsnet flow is forwardOften occurs beyond obstruction

such as plaque on vessel wall

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 114: UltarSound  Machine Dr  Fadhl Alakwaa

Flow Pressure amp Resistancebull Pressure

ndash pressure difference between ends of tube drives fluid flow

bull Resistancendash more resistance = lower flow ratendash resistance affected by

bull fluidrsquos viscositybull vessel lengthbull vessel diameter

ndash flow for a given pressure determined by resistance

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 115: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Shift

bull difference between received amp transmitted frequency

bull caused by relative motion between sound source amp receiver

bull Frequency shift indicative of reflector speed

IN OUT

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 116: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Examplesbull change in pitch of as object approaches amp

leaves observerndash trainndash Ambulance siren

bull moving blood cellsndash motion can be presented as sound or as an image

>

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 117: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Angle

bull angle between sound travel amp flow

bull 0 degreesndash flow in direction of sound travel

bull 90 degreesndash flow perpendicular to sound travel

q

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 118: UltarSound  Machine Dr  Fadhl Alakwaa

Flow Components

ndash Flow vector can be separated into two vectors

Flow parallel to sound

Flow perpendicular to sound

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 119: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler SensingOnly flow parallel to sound

sensed by scanner

Flow parallel to

sound

Flow perpendicular to sound

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 120: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Sensing

Sensed flow always lt actual flow

Sensed flow

Actual flow

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 121: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Sensing

ndash cos(q) = SF AF

Sensed flow

(SF)

Actual flow

(AF)q

q

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 122: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Equation

bull wherefD =Doppler Shift in MHzfe = echo of reflected frequency (MHz)fo = operating frequency (MHz)v = reflector speed (ms)q = angle between flow amp sound propagationc = speed of sound in soft tissue (ms)

2 X fo X v X cosqf D = fe - fo------------------------- =

cq

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 123: UltarSound  Machine Dr  Fadhl Alakwaa

Relationships

bull positive shift when reflector moving toward transducerndash echoed frequency gt operating frequency

bull negative shift when reflector moving away from transducerndash echoed frequency lt operating frequency

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 124: UltarSound  Machine Dr  Fadhl Alakwaa

Relationships

bull Doppler angle affects measured Doppler shift

2 X fo X v X cosqf D = fe - fo------------------------- =

c

q

q

cosq

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 125: UltarSound  Machine Dr  Fadhl Alakwaa

Doppler Relationships

bull higher reflector speed results in greater Doppler shift

bull higher operating frequency results in greater Doppler shift

bull larger Doppler angle results in lower Doppler shift

q 77 X fD (kHz)

v (cms)-------------------------- = fo (MHz) X cosq

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 126: UltarSound  Machine Dr  Fadhl Alakwaa

Continuous Wave Doppler

bull Audio presentation onlybull No imagebull Useful as fetal dose monitor

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 127: UltarSound  Machine Dr  Fadhl Alakwaa

Continuous Wave Doppler

bull 2 transducers usedndash one continuously transmits

bull voltage frequency = transducerrsquos operating frequency

ndash typically 2-10 MHz

ndash one continuously receivesbull Reception Area

ndash flow detected within overlap of transmit amp receive sound beams

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 128: UltarSound  Machine Dr  Fadhl Alakwaa

Continuous Wave DopplerReceiver Function

bull receives reflected sound wavesbull Subtract signals

ndash detects frequency shiftndash typical shift ~ 11000 th of source frequency

bull usually in audible sound range

bull Amplify subtracted signalbull Play directly on speaker

- =

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 129: UltarSound  Machine Dr  Fadhl Alakwaa

Pulse Wave vs Continuous Wave Doppler

Continuous Wave Pulse Wave

No Image Image

Sound on continuously

Both imaging amp Doppler sound pulses generated

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 130: UltarSound  Machine Dr  Fadhl Alakwaa

Dangers of Ultrasound

bullThere have been many concerns about the safety of ultrasound

ndashBecause ultrasound is energy the question becomes What is this energy doing to my tissues

or my baby

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 131: UltarSound  Machine Dr  Fadhl Alakwaa

bullThere have been some reports of low birthweight babies being born to mothers who

had frequent ultrasound examinations during pregnancy

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 132: UltarSound  Machine Dr  Fadhl Alakwaa

bullThe two major possibilities with ultrasound are as follows

ndashdevelopment of heat - tissues or water absorb the ultrasound energy which increases their

temperature locally ndashformation of bubbles (cavitation) - when dissolved

gases come out of solution due to local heat caused by ultrasound

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 133: UltarSound  Machine Dr  Fadhl Alakwaa

bullHowever there have been no substantiated ill-effects of ultrasound documented in studies in

either humans or animals ndashThis being said ultrasound should still be used

only when necessary (ie better to be cautious)

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 134: UltarSound  Machine Dr  Fadhl Alakwaa

Ultrasound Terminology

bull Impedance resistancebull steered

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material
Page 135: UltarSound  Machine Dr  Fadhl Alakwaa

PZT is Most Common Piezoelectric Material

bullLead Zirconate TitanatebullAdvantages

ndashEfficientbullMore electrical energy transferred to sound amp vice-versa

ndashHigh natural resonance frequencyndashRepeatable characteristics

bullStable designbullDisadvantages

ndashHigh acoustic impedancebullCan cause poor acoustic couplingbullRequires matching layer to compensate

  • UltarSound Machine Dr Fadhl Alakwaa
  • What are the first things to account when purchasing new US equ
  • EXCELLENT RESOURCES
  • CLINICAL APPLICATIONS
  • Slide 5
  • Slide 6
  • Slide 7
  • What do you need to know to be professional in US
  • Advantage of US OVER other modalities
  • US development
  • Slide 11
  • What is Ultrasound machine
  • Spectrum of sound
  • Sound propagation
  • Slide 15
  • Wave propagation
  • Difference between EM and sound
  • How to produce sound wave
  • Slide 19
  • Slide 20
  • Slide 21
  • Slide 22
  • Slide 23
  • Slide 24
  • Sound field
  • Slide 26
  • Transducer array
  • Slide 28
  • Ultrasound Display
  • Real-time Scanning
  • Linear Curved linear array Phased arraysector Endocavitary
  • Transducer Arrays
  • Electronic Scanning
  • Electrical Scanning
  • Linear Array Scanning
  • Linear Switched Arrays
  • Linear Switched Arrays (2)
  • Linear Phased Array
  • Linear Phased Array (2)
  • Linear Phased Array (3)
  • Linear Phased Array (4)
  • Linear Phased Array (5)
  • Linear Phased Array (6)
  • Listening Mode
  • 15 Transducer
  • 15 amp 2D Transducers
  • Remember me to explain why we use the backing block and matchin
  • What we will use the returned or received ultrasound waves ldquoech
  • Perpendicular Incidence
  • Oblique Incidence
  • Perpendicular Incidence (2)
  • Perpendicular Incidence (3)
  • Intensity Reflection Coefficient (IRC) amp Intensity Transmission
  • IRC Equation
  • Reflections
  • Why Use Gel and matching layer
  • Slide 57
  • THE BASICS US IDEA
  • What does your scanner know about echoed sound
  • What Does Your Scanner Assume about Echoes (or how the scanner
  • Distance of Echo from Transducer
  • What is the Speed of Sound
  • So the scanner assumes the wrong speed
  • Attenuation Correction
  • Gray Shade of Echo
  • How does scanner know what gray shade to assign an echo
  • How to reconstruct the image from echoes
  • M Mode
  • M-Mode (left ventricle)
  • Scanner Processing of Echoes
  • Amplification
  • Compensation
  • Need for Compensation
  • Equal Echoes
  • Compensation (TGC)
  • Compensation (TGC) (2)
  • Compression
  • Compression (2)
  • Demodulation
  • Demodulation (2)
  • Demodulation Sub-steps
  • Rejection
  • Rejection (2)
  • Image Resolution
  • Resolution amp Reflector Size
  • Axial Resolution
  • Axial Resolution (2)
  • Axial Resolution (3)
  • Spatial Pulse Length
  • Wavelength
  • Improve Axial Resolution by Reducing Spatial Pulse Length
  • Slide 92
  • Lateral Resolution
  • Lateral Resolution (2)
  • Lateral Resolution (3)
  • Contrast Resolution
  • Contrast Resolution (2)
  • Pre-Processing
  • Gray Scale
  • Slide 100
  • Display Limitations
  • Presentation of Brightness Levels
  • Slide 103
  • Block Diagram
  • B Mode
  • Color flow imaging (mode) Color Doppler (mode)
  • Continuous wave (CW) Doppler
  • M-mode
  • Power Doppler (mode)
  • Pulsed wave Doppler
  • Slide 111
  • Slide 112
  • Slide 113
  • Slide 114
  • DOPPLER US
  • Hemodynamics
  • Plug Flow
  • Laminar Flow
  • Flow
  • Flow Pressure amp Resistance
  • Doppler Shift
  • Doppler Examples
  • Doppler Angle
  • Flow Components
  • Doppler Sensing
  • Doppler Sensing (2)
  • Doppler Sensing (3)
  • Doppler Equation
  • Relationships
  • Relationships (2)
  • Doppler Relationships
  • Continuous Wave Doppler
  • Continuous Wave Doppler (2)
  • Continuous Wave Doppler Receiver Function
  • Pulse Wave vs Continuous Wave Doppler
  • Dangers of Ultrasound
  • Slide 137
  • Slide 138
  • Slide 139
  • Ultrasound Terminology
  • PZT is Most Common Piezoelectric Material