Medical Ultrasound Imaging
Tuesday, 3 December 2024
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Radiology Information System
(RIS) Radiology information system means a computer system that stores and processes the information for a radiology department and can be linked to the hospital information system.
The principal purpose of a RIS consists of taking over the general functions of the administration inclusive planning, monitoring and communication of all data regarding patients and its investigations in the radiology. The correct images should reach, at the correct time, the correct users. For this reason the RIS must contain a workflow management in order to simplify and steer the data flow at the individual view stations or devices (laser cameras etc.). The Radiology Information System is optimally complemented with a Picture Archiving and Communication System (PACS).

RIS Tasks:
collection, storage and administration of patient master data;
archives administration;
treatment of requirements;
work scheduling;
account;
communication (with the hospital information system, MRI scanner, other devices etc.);
statistic evaluations.

Liver Sonography
A liver sonography is a diagnostic tool to image the liver and adjoining upper abdominal organs such as the gallbladder, spleen, and pancreas. Deeper structures such as liver and pancreas are imaged at a lower frequency 1-6 MHz with lower axial and lateral resolution but greater penetration. The diagnostic capabilities in this area can be limited by gas in the bowel scattering the sound waves.
The application of microbubbles may be useful for detection of liver lesions and for lesion characterization. Some microbubbles have a liver-specific post vascular phase where they appear to be taken up by the reticuloendothelial system (RES). Dynamic contrast enhanced scans in a similar way as with CT or MRI can be used to studying the arterial, venous and tissue phase.
After a bolus injection, early vascular enhancement is seen at around 30sec in arterialized lesions (e.g., hepatocellular carcinomas (HCC), focal nodular hyperplasia (FNH)). Later enhancement is typical of hemangiomas with gradually filling towards the center. In the late phase at around 90sec, HCCs appear as defects against the liver background. Most metastases are relatively hypovascular and so do not show much enhancement and are seen as signal voids in the different phases.
Either with an intermittent imaging technique or by continuous scanning in a nondestructive, low power mode, characteristic time patterns can be used to differentiate lesions.

See also Medical Imaging, B-Mode, High Intensity Focused Ultrasound, Ultrasound Safety and Contrast Medium.
Medical Imaging
The definition of imaging is the visual representation of an object. Medical imaging is a broad term that encompasses various imaging modalities and techniques used in the field of medicine to visualize and study the body's anatomy and physiology. It includes both diagnostic and non-diagnostic imaging procedures, where diagnostic imaging specifically refers to the subset of medical imaging techniques that are primarily focused on diagnosing diseases or conditions. Medical imaging techniques are employed to obtain images or visual representations of the internal organs, tissues, and structures, aiding in the diagnosis, treatment, and monitoring of medical conditions.
The field of medical imaging has significantly evolved since the discovery of X-rays by Konrad Roentgen in 1896. Initially, radiological imaging involved focusing X-rays on the body and capturing the images on a single piece of film within a specialized cassette. Subsequent advancements introduced the use of fluorescent screens and special glasses for real-time visualization of X-ray images.
A significant breakthrough came with the application of contrast agents, enhancing image contrast and improving organ visualization. In the 1950s, nuclear medicine studies utilizing gamma cameras demonstrated the uptake of low-level radioactive chemicals in organs, enabling the observation of biological processes in vivo. Currently, positron emission tomography (PET) and single photon emission computed tomography (SPECT) technologies play pivotal roles in clinical research and the diagnosis of biochemical and physiological processes. Additionally, the advent of the x-ray image intensifier in 1955 facilitated the capture and display of x-ray movies.
In the 1960s, diagnostic imaging incorporated the principles of sonar, using ultrasonic waves generated by a quartz crystal. These waves, reflecting at the interfaces between different tissues, were received by ultrasound machines and translated into images through computer algorithms and reconstruction software. Ultrasound (ultrasonography) has become an indispensable diagnostic tool across various medical specialties, with immense potential for further advancements such as targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The first use of ultrasound contrast agents (USCA) dates back to 1968.
Digital imaging techniques were introduced in the 1970s, revolutionizing conventional fluoroscopic image intensifiers. Godfrey Hounsfield's pioneering work led to the development of the first computed tomography (CT) scanner. Digital images are now electronic snapshots represented as grids of dots or pixels. X-ray CT brought about a breakthrough in medical imaging by providing cross-sectional images of the human body with high contrast between different types of soft tissue. These advancements were made possible by analog-to-digital converters and computers. The introduction of multislice spiral CT technology dramatically expanded the clinical applications of CT scans.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements, such as higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI has emerged as a real-time interactive imaging modality capable of providing detailed structural and functional information of the body.
Today, imaging in medicine offers a wide range of modalities, including:
X-ray projection imaging;
Fluoroscopy;
Computed tomography (CT / CAT);
Single photon emission computed tomography (SPECT);
Positron emission tomography (PET);
Mammography.

These imaging modalities have become integral components of modern healthcare. With the rapid advancement of digital imaging, efficient management has become important, leading to the expansion of radiology information systems (RIS) and the adoption of Picture Archiving and Communication Systems (PACS) for digital image archiving. In telemedicine, real-time transmission of all medical image modalities from MRI to X-ray, CT and ultrasound has become the standard. The field of medical imaging continues to evolve, promising further innovations and advancements in the future, ultimately contributing to improved patient care and diagnostics.

See also History of Ultrasound Contrast Agents, and History of Ultrasound.
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