Medical Ultrasound Imaging
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Histogram
The graphic representation of the ultrasound frequency shift or velocity range and amplitude can be depicted as a histogram.
History of Ultrasound
The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.
In 1880 the Curie brothers discovered the piezoelectric effect in quartz. Converse piezoelectricity was mathematically deduced from fundamental thermodynamic principles by Lippmann in 1881.
In 1917, Paul Langevin (France) and his coworkers developed an underwater sonar system (called hydrophone) that uses the piezoelectric effect to detect submarines through echo location.
In 1935, the first RADAR system was produced by the British physicist Robert Watson-Wat. Also about 1935, developments began with the objective to use ultrasonic power therapeutically, utilizing its heating and disruptive effects on living tissues. In 1936, Siemens markets the first ultrasonic therapeutic machine, the Sonostat.
Shortly after the World War II, researchers began to explore medical diagnostic capabilities of ultrasound. Karl Theo Dussik (Austria) attempted to locate the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Other researchers try to use ultrasound to detect gallstones, breast masses, and tumors. These first investigations were performed with A-mode.
Shortly after the World War II, researchers in Europe, the United States and Japan began to explore medical diagnostic capabilities of ultrasound. Karl Theo Dussik (Austria) attempted to locate the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Other researchers, e.g. George Ludwig (United States) tried to use ultrasound to detect gallstones, breast masses, and tumors. This first experimentally investigations were performed with A-mode. Ultrasound pioneers contributed innovations and important discoveries, for example the velocity of sound transmission in animal soft tissues with a mean value of 1540 m/sec (still in use today), and determined values of the optimal scanning frequency of the ultrasound transducer.
In the early 50`s the first B-mode images were obtained. Images were static, without gray-scale information in simple black and white and compound technique. Carl Hellmuth Hertz and Inge Edler (Sweden) made in 1953 the first scan of heart activity. Ian Donald and Colleagues (Scotland) were specialized on obstetric and gynecologic ultrasound research. By continuous development it was possible to study pregnancy and diagnose possible complications.
After about 1960 two-dimensional compound procedures were developed. The applications in obstetric and gynecologic ultrasound boomed worldwide from the mid 60's with both, A-scan and B-scan equipment. In the late 60's B-mode ultrasonography replaced A-mode in wide parts.
In the 70's gray scale imaging became available and with progress of computer technique ultrasonic imaging gets better and faster.
After continuous work, in the 80's fast realtime B-mode gray-scale imaging was developed. Electronic focusing and duplex flow measurements became popular. A wider range of applications were possible.
In the 90's, high resolution scanners with digital beamforming, high transducer frequencies, multi-channel focus and broad-band transducer technology became state of the art. Optimized tissue contrast and improved diagnostic accuracy lead to an important role in breast imaging and cancer detection. Color Doppler and Duplex became available and sensitivity for low flow was continuously improved.
Actually, machines with advanced ultrasound system performance are equipped with realtime compound imaging, tissue harmonic imaging, contrast harmonic imaging, vascular assessment, matrix array transducers, pulse inversion imaging, 3D and 4D ultrasound with panoramic view.

Hitachi Medical Systems America Inc.(USA)/Hitachi Medical Corp.(Tokyo)
www.hitachimed.com [This entry is marked for removal.]

Hitachi Medical Systems America, Inc. (HMSA) provides a complete range of ultrasound-based systems covering the entire spectrum from compact black and white systems at entry price level up to premium class systems for the most demanding users. As a full-line supplier of medical imaging equipment in Japan, Hitachi Medical Corporation (HMC) founded HMSA to provide a direct link to the U.S. marketplace. Hitachi consolidates his distribution channels in the US by transferring the Hitachi line of Ultrasound products to HMSA in October of 2002. HMSA is responsible for the sales, marketing and service of all Hitachi Ultrasound products in the United States.

Ultrasound Systems:
ImaRx LLC
www.imarx.com Founded in 1991, ImaRx Pharmaceutical Corp. designs, develops and markets pharmaceuticals for medical imaging (MRI, ultrasound and computed tomography) for the radiological imaging industry.
ImaRx Pharmaceutical Corp., announced 1999 that it has been acquired by E.I DuPont de Nemours & Co., Inc. The terms of the acquisition provide a royalty-free licensing arrangement with a newly-formed company, ImaRx LLC ('LLC'), to pursue and develop new products and technologies for drug and gene delivery independent from DuPont. Yamanouchi Pharmaceutical Co. Ltd., ImaRx' licensee for Asian territories for this product, will continue to develop the product in Asia as DuPont's licensee. ImaRx LLC will have ownership of all other targeted and therapeutic products previously owned by ImaRx, including imaging products outside of diagnostic ultrasound imaging and two other imaging products, SonoRx® and LumenHance®, which are both FDA approved and licensed to BRACCO Diagnostics.
See also Lantheus Medical Imaging and Definity®.


Ultrasound Contrast Agents:
Interventional Ultrasound
Interventional ultrasound, also known as ultrasonography, encompasses a range of invasive or surgical procedures guided by ultrasound imaging. While its widest application lies in intravascular ultrasound imaging for measuring atherosclerotic plaque, it has proven valuable in various medical fields.
In urology, ultrasound-guided interventions are employed for treatments like high intensity focused ultrasound (HIFU) in prostate conditions. The precise imaging provided by ultrasound aids in targeting the affected area and delivering therapeutic energy effectively.
In intraabdominal conditions, endoscopic ultrasound is frequently utilized. This technique combines ultrasound imaging with an endoscope to visualize and evaluate structures within the gastrointestinal tract, allowing for precise diagnoses and targeted interventions.
Ultrasound-guided procedures play a significant role in several medical specialties, including liver sonography, obstetric and gynecologic ultrasound, and thyroid ultrasound. These procedures involve interventions such as RF thermal ablation or biopsies, which are guided by real-time ultrasound imaging.
For instance, in liver sonography, ultrasound guidance is crucial for performing biopsies or RF thermal ablation, a technique used to treat liver tumors by delivering localized heat to destroy the abnormal tissue. The real-time imaging allows for precise needle placement and monitoring during the procedure.
In obstetric and gynecologic ultrasound, ultrasound-guided procedures, such as biopsies, can be performed to obtain tissue samples for diagnostic purposes. Additionally, ultrasound guidance is valuable during interventions like amniocentesis or fetal blood sampling, enabling accurate and safe procedures.
Thyroid ultrasound procedures often involve ultrasound-guided fine-needle aspiration biopsy (FNAB), which allows for the sampling of thyroid nodules for cytological examination. The ultrasound image helps guide the needle into the targeted area, ensuring accurate sampling and minimizing potential complications.
Overall, ultrasound-guided interventions provide minimally invasive and precise approaches to diagnosis and treatment. The real-time imaging capabilities of ultrasound contribute to enhanced accuracy, safety, and patient outcomes in procedures like biopsies, injections, and drainage.

See also Transurethral Sonography, Endocavitary Echography, and B-Mode Acquisition and Targeting.
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