Medical Ultrasound Imaging
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Contrast Harmonic Imaging
(CHI) Contrast harmonic imaging is an ultrasound technique to improve the measurement of blood perfusion or capillary blood flow. Based on the nonlinear properties of contrast agents, CHI transmits at the fundamental frequency but receives at the second harmonic. Contrast enhanced echo signals contain significant energy components at higher harmonics (bubbles acts as harmonic oscillators), while tissue echoes do not. Caused by that contrast signal can be separated from tissue echoes by the characteristic signal.
In combination with the pulse inversion technique, CHI promises very high contrast agent sensitivity with high spatial resolution.

See also Ultrasound Contrast Agent Safety and Hemoglobin.
Non-Linear Propagation
The propagation of high amplitude ultrasound waves is inadequate described by a linear wave equation. Non-linear propagation is to expect if the power levels are high enough to make non-linear effects significant. A non-linear propagation results in the distortion of the transmitted waveforms, resulting in the generation of harmonics of the initial frequency components transmitted by the transducer.
In the near field of ultrasound probes, the occurring diffraction and focusing effects make this process complex. The distortion of a wavefront propagating in a medium in which the compressional phase moves slightly faster than the rarefactional phase, results is the conversion of some wave energy into higher harmonics of the fundamental frequency. The effect increases strongly with increasing wave amplitude.
Ultraharmonic Imaging
Ultraharmonic is an oscillation at a frequency that is a rational multiple of that of its fundamental sinusoidal oscillation, for example 1.5 or 2.5 times the fundamental frequency. Ultraharmonic imaging is a method to eliminate tissue artifacts and therefore increase contrast to tissue ratio.
Also called Superharmonic Imaging.

See also Power Modulation.
Ultrasound Technology
Ultrasound technology with its advancements is vital for delivering high-quality patient care. Innovations including high-frequency ultrasound, 3D//4D imaging, contrast enhanced ultrasound, elastography, and point-of-care ultrasound, have expanded the capabilities of ultrasound imaging and improved diagnostic accuracy.
B-Mode imaging, also known as brightness mode, is the fundamental technique in ultrasound imaging. It produces two-dimensional images based on the echoes received from tissues and organs. Understanding the principles of B-Mode imaging, such as gain adjustment, depth control, and image optimization, is crucial for obtaining diagnostically valuable images. M-Mode imaging, on the other hand, allows for the visualization of motion over time, enabling assessment of cardiac structures and function, as well as fetal heart rate.
High-frequency ultrasound refers to the use of ultrasound waves with frequencies greater than 10 MHz. This technology enables improved resolution, allowing for detailed imaging of superficial structures like skin, tendons, and small organs. High-frequency ultrasound has found applications in dermatology, ophthalmology, and musculoskeletal imaging.
Traditional 2D ultrasound has been augmented by the advent of 3D ultrasound technology. By acquiring multiple 2D images from different angles, this technique construct a volumetric representation of the imaged area. The addition of 4D ultrasound in real-time motion adds further value by capturing dynamic processes.
Doppler imaging employs the Doppler effect to evaluate blood flow within vessels and assess hemodynamics. Color Doppler assigns color to different blood flow velocities, providing a visual representation of blood flow direction and speed. Spectral Doppler displays blood flow velocities as a waveform, allowing for detailed analysis of flow patterns, resistance, and stenosis.
Contrast enhanced ultrasound employs microbubble contrast agents to enhance the visualization of blood flow and tissue perfusion. By injecting these agents intravenously, sonographers can differentiate between vascular structures and lesions. Elastography is a technique that measures tissue elasticity or stiffness. It assists in differentiating between normal and abnormal tissues, aiding in the diagnosis of various conditions such as liver fibrosis, breast lesions, and thyroid nodules.
Fusion imaging combines ultrasound with other imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). By overlaying or merging ultrasound images with those obtained from other modalities, the user can precisely locate and characterize abnormalities, guide interventions, and improve diagnostic accuracy. Fusion imaging has proven particularly useful in areas such as interventional radiology, oncology, and urology.
See also Equipment Preparation, Environmental Protection, Handheld Ultrasound, Portable Ultrasound and Ultrasound Accessories and Supplies.
Echogenicity
Echogenicity is the ability of a medium to create an echo, for example to return a signal when tissue is in the path of the sound beam. The ultrasound echogenicity is dependent on characteristics of tissues or contrast agents and is measured by calculating the backscattering and transmission coefficients as a function of frequency.
The fundamental parameters that determine echogenicity are density and compressibility. Blood is two to three orders of magnitude less echogenic than tissue due to the relatively small impedance differences between red blood cells and plasma. The tissue echogenicity can be increased by ultrasound contrast agents. Encapsulated microbubbles are highly echogenic due to differences in their compressibility and density, compared to tissue or plasma.
Microbubbles are 10,000 times more compressible than red blood cells. The compressibility of air is 7.65 x 10−6 m2/N, in comparison with 4.5 x 10-11 m2/N for water (on the same order of magnitude as tissue and plasma). This impedance mismatch results in a very high echogenicity. An echo from an individual contrast agent can be detected by a clinical ultrasound system sensitive to a volume on the order of 0.004 pl.

See also Isoechogenic, Retrolenticular Afterglow, and Sonographic Features.
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