Medical Ultrasound Imaging
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2D Ultrasound
2D ultrasound imaging is a widely used technique in medical imaging that provides two-dimensional visual representations of internal structures. A handheld device known as a probe or transducer contains piezoelectric crystals that emit and receive ultrasound waves which penetrate tissues and bounce back as echoes. The echoes are detected and converted into electrical signals. These signals are processed and displayed on a monitor, creating a real-time 2D grayscale image, with different shades of gray representing various tissue densities. The brighter areas on the image correspond to structures that reflect more ultrasound waves, while darker areas represent structures that reflect fewer waves or are attenuated by intervening tissues. The 2D-mode (or B-mode) provides cross-sectional views of the scanned area, showing a single plane or slice of the scanned area at a time.

Key Features and Uses of 2D Ultrasound:
One of the primary advantages of 2D ultrasonography is its ability to provide real-time imaging. This feature allows medical professionals to observe moving structures, such as the beating heart or fetal movements in real-time.
2D ultrasound is excellent for visualizing anatomical structures and detecting anomalies. It is widely used in obstetrics, gynecology, abdominal imaging and vascular examinations.
Due to its real-time capabilities, 2D ultrasound is utilized to guide various procedures, including biopsies, injections, and catheter insertions.
2D sonography can incorporate Doppler technology to assess blood flow in vessels, aiding in the diagnosis of vascular conditions and evaluating fetal circulation.

Comparison with 3D and 4D Ultrasound:
Unlike 2D ultrasound, which generates a series of 2D images, 3D ultrasound creates a three-dimensional volume of the scanned area. This allows for more detailed visualization of complex structures, such as fetal facial features or organ morphology.
4D ultrasound adds the dimension of time to 3D imaging, resulting in dynamic three-dimensional videos. It enables the visualization of fetal movements and provides a more immersive experience. However, a 4D sonogram is not typically used for diagnostic purposes and is often employed in baby ultrasound examinations for bonding and enjoyment purposes.

See also Ultrasound Technology, Sonographer, Ultrasound Elastography, Obstetric and Gynecologic Ultrasound.
Berlex Laboratories, Inc.
www.berleximaging.com Berlex Laboratories has been integrated into Bayer HealthCare, and operates as an integrated specialty pharmaceuticals business under a new name, Bayer HealthCare Pharmaceuticals.
The company is developing and making specialized medicines for treating multiple sclerosis, dermatological disorders, female health concerns, cancer and is creating new diagnostic imaging techniques. Berlex Laboratories, Inc. was a pioneer in the imaging market. It introduced a broad range of imaging agents. Its contribution began in 1988 with the introduction of the world's first magnetic resonance imaging agent, Magnevist® (gadopentetate dimeglumine) injection. Berlex Laboratories, Inc. was an US affiliate of Bayer Schering Pharma AG Germany.

Ultrasound Accessories and Supplies
Common ultrasound supplies that are often used in conjunction with ultrasound imaging:
Ultrasound Gel:
A water-based gel used as a coupling agent between the transducer and the patient's skin. It helps eliminate air pockets and ensures good sound wave transmission.
Probe Covers:
Disposable covers designed to maintain hygiene and prevent cross-contamination. These covers are placed over the transducer before each examination.
Cleaning Wipes:
Alcohol-based or disinfectant wipes used for cleaning and disinfecting the transducer and other equipment surfaces. Specific cleaning solutions are recommended by the ultrasound equipment manufacturer for thorough cleaning of transducers.
Gel Warmers:
Devices used to warm ultrasound gel, providing patient comfort during the examination.
Needle Guides:
Attachments or brackets that assist in accurate needle placement during ultrasound-guided procedures such as biopsies or injections.
Positioning Aids:
Cushions, wedges, or straps designed to help position patients correctly and comfortably during ultrasound exams.

Common ultrasound accessories that are often used in conjunction with ultrasound imaging:
Transducer Storage Rack:
A dedicated rack or holder to store transducers safely when not in use, helping to prevent damage.
Storage and Archiving Solutions:
External hard drives, network storage, or cloud-based systems for long-term storage and backup of ultrasound images and reports. Possibly specialized printers that produce hard copies of ultrasound images for immediate documentation and patient records.
Power Supply and Transducer Cable Extenders:
Extension cables used to increase the length of transducer cables for more flexibility during examinations. Adequate power sources or uninterrupted power supply (UPS) to ensure continuous operation of the ultrasound machine during power outages or fluctuations.
Reporting Templates and Software:
Customizable reporting templates and software solutions that facilitate efficient and standardized reporting of ultrasound findings.
Phantom Devices:
Artificial tissue-like structures or phantoms used for training, calibration, and quality assurance purposes to evaluate image quality and system performance.

Consult with ultrasound equipment vendors or professionals in the field to determine the specific accessories and supplies that best suit your imaging needs and specialty. See also Equipment Preparation, Environmental Protection, Portable Ultrasound Machine, Ultrasound Technology, Ultrasound System Performance and Sonographer.
SonoVue®
www.bracco.com/Bracco/Internet/Imaging/Ultrasound/ From Bracco Diagnostics, Inc.
SonoVue® was first launched in October 2001 and is now available in all European countries.
SonoVue is a second generation USCA, designed and optimized with regard to the resistance to pressure. SonoVue is an example of an important family of microbubbles whose membrane consists of phospholipids. SonoVue microbubbles are filled with sulfur hexafluoride (SF6), a gas which has a low solubility and diffuses slowly in blood for the gaseous phase of the microbubbles.
In particular, the SonoVue microbubbles, thanks to the high flexibility of their shell, are strongly echogenic in a wide range of frequencies and acoustic pressure and therefore can be used with both destructive and conservative contrast bubble specific imaging methods.

See also Coherent Contrast Imaging.
Drug Information and Specification
RESEARCH NAME
BR1
DEVELOPER
INDICATION -
DEVELOPMENT STAGE
APPLICATION
Intravenous
TYPE
Microbubble
Lipids: Macrogol 4000, DSPC, DPPG, Palmitic acid
CHARGE
Negative
Sulfurhexafluoride
MICROBUBBLE SIZE
99% < 11μm
PRESENTATION
Presentation 01(with integral Bio-Set transfer system) -25 mg of dry, lyophilized powder in an atmosphere of sulphur hexafluoride in a colorless Type I glass vial, with elastomeric closure and integral transfer system.Type I glass pre-filled syringe containing 5 ml sodium chloride 0.9%w/v solution for injection. - Presentation 02 (with separate MiniSpike transfer system)
STORAGE
No special precautions for storage
PREPARATION
Reconstitute with 5 ml saline
DO NOT RELY ON THE INFORMATION PROVIDED HERE, THEY ARE
NOT A SUBSTITUTE FOR THE ACCOMPANYING PACKAGE INSERT!
Distribution Information
TERRITORY
DISTRIBUTOR
USA, EU
Microbubble Scanner Modification
Standard scanners allow visualizing microbubbles on conventional gray scale imaging in large vascular spaces. In the periphery, more sensitive techniques such as Doppler or non-linear gray scale modes must be used because of the dilution of the microbubbles in the blood pool. Harmonic power Doppler (HPD) is one of the most sensitive techniques for detecting ultrasound contrast agents.
Commonly microbubbles are encapsulated or otherwise stabilized to prolong their lifetime after injection. These bubbles can be altered by exposure to ultrasound pulses. Depending on the contrast agent and the insonating pulse, the changes include deformation or breakage of the encapsulating or stabilizing material, generation of free gas bubbles, reshaping or resizing of gas volumes.
High acoustic pressure amplitudes and long pulses increase the changes. However, safety considerations limit the pressure amplitude and long pulses decrease spatial resolution. In addition, lowering the pulse frequency increases destruction of contrast bubbles. However, at low insonation power levels, contrast agent particles resist insonation without detectable changes. Newer agents are more reflective and will usually allow gray scale imaging to be used with the advantages of better spatial resolution, fewer artifacts and faster frame rates.

Feasible imaging methods with advantages in specific acoustic microbubble properties:
Resonating microbubbles emit harmonic signals at double their resonance frequency. If a scanner is modified to select only these harmonic signals, this non-linear mode produces a clear image or trace. The effect depends on the fact that it is easier to expand a bubble than to compress it so that it responds asymmetrically to a symmetrical ultrasound wave. A special array design allows to perform third or fourth harmonic imaging. This probe type is called a dual frequency phased array transducer.

See also Bubble Specific Imaging.
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