Medical Ultrasound Imaging
Thursday, 21 November 2024
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Reflection of the sound beam occurs when it hits a boundary between materials having different acoustic impedance. The reflection (echo) is the portion of a sound that is returned from the boundary. The reflection time (the time taken for the wave to return to the probe) can be used to determine the depth of the object.
The reflection within the body produces the ultrasound image, but should be minimized at an ultrasound couplant to skin boundary where the couplant acts as an acoustic window through which the image is seen. The amount of sound waves, which are reflected back at the interface between two tissues is depend on the angle of incidence and the difference between the acoustic impedance values of the two tissues. If the difference is great, a large part of the sound waves will be reflected back. If too much sound is reflected back and not enough waves are remaining to be able to penetrate the tissue, the imaging will be poor. If the difference is small, a small amount will be reflected back. Enough sound signal remains to continue with ultrasound imaging. If the ultrasound beam meets a rough surface or small object, the beam is scattered in all directions and only a small amount will be received by the probe. See also False Distance Artifact, Target Strength, and Snells Law. •
(dB) A customary logarithmic measure most commonly used (in various ways) for measuring sound. Decibel is a way to express the ratio of two sound intensities: dB=10log10I1/I2 being I1 the reference.
If one sound is 1 bel (10 decibel) 'louder' than another, this means the louder sound is 10 times louder than the fainter one. A difference of 20 decibel corresponds to an increase of 10 x 10 or 100 times in intensity. The intensity of ultrasound decreases during the propagation and is measured in db/cm. For sound pressure (the pressure exerted by the sound waves) 0 decibel equals 20 microPascal (μPa), and for ultrasonic power 0 decibel sometimes equals 1 picoWatt. See also dB/dt, Phon, and Logarithms. •
(MI) The mechanical index is an estimate of the maximum amplitude of the pressure pulse in tissue. It is an indicator of the likelihood of mechanical bioeffects (streaming and cavitation). The mechanical index of the ultrasound beam is the amount of negative acoustic pressure within a ultrasonic field and is used to modulate the output signature of US contrast agents and to incite different microbubble responses. The mechanical index is defined as the peak rarefactional pressure (negative pressure) divided by the square root of the ultrasound frequency. The FDA ultrasound regulations allow a mechanical index of up to 1.9 to be used for all applications except ophthalmic (maximum 0.23). The used range varies from 0.05 to 1.9. At low acoustic power, the acoustic response is considered as linear. At a low MI (less than 0.2), the microbubbles undergo oscillation with compression and rarefaction that are equal in amplitude and no special contrast enhanced signal is created. Microbubbles act as strong scattering objects due to the difference in impedance between air and liquid, and the acoustic response is optimized at the resonant frequency of a microbubble. At higher acoustic power (MI between 0.2-0.5), nonlinear oscillation occurs preferentially with the bubbles undergoing rarefaction that is greater than compression. Ultrasound waves are created at harmonics of the delivered frequency. The harmonic response frequencies are different from that of the incident wave (fundamental frequency) with subharmonics (half of the fundamental frequency), harmonics (including the second harmonic response at twice the fundamental frequency), and ultra-harmonics obtained at 1.5 or 2.5 times the fundamental frequency. These contrast enhanced ultrasound signals are microbubble-specific. At high acoustic power (MI greater than 0.5), microbubble destruction begins with emission of high intensity transient signals very rich in nonlinear components. Intermittent imaging becomes needed to allow the capillaries to be refilled with fresh microbubbles. Microbubble destruction occurs to some degree at all mechanical indices. A mechanical index from 0.8 to 1.9 creates high microbubble destruction. The output signal is unique to the contrast agent.  Further Reading: Basics:
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(US) Also called echography, sonography, ultrasonography, echotomography, ultrasonic tomography. Diagnostic imaging plays a vital role in modern healthcare, allowing medical professionals to visualize internal structures of the body and assist in the diagnosis and treatment of various conditions. Two terms that are commonly used interchangeably but possess distinct meanings in the field of medical imaging are 'ultrasound' and 'sonography.' Ultrasound is the imaging technique that utilizes sound waves to create real-time images, while sonography encompasses the entire process of performing ultrasound examinations and interpreting the obtained images. Ultrasonography is a synonymous term for sonography, emphasizing the use of ultrasound technology in diagnostic imaging. A sonogram, on the other hand, refers to the resulting image produced during an ultrasound examination. Ultrasonic waves, generated by a quartz crystal, cause mechanical perturbation of an elastic medium, resulting in rarefaction and compression of the medium particles. These waves are reflected at the interfaces between different tissues due to differences in their mechanical properties. The transmission and reflection of these high-frequency waves are displayed with different types of ultrasound modes. By utilizing the speed of wave propagation in tissues, the time of reflection information can be converted into distance of reflection information. The use of higher frequencies in medical ultrasound imaging yields better image resolution. However, higher frequencies also lead to increased absorption of the sound beam by the medium, limiting its penetration depth. For instance, higher frequencies (e.g., 7.5 MHz) are employed to provide detailed imaging of superficial organs like the thyroid gland and breast, while lower frequencies (e.g., 3.5 MHz) are used for abdominal examinations. Ultrasound in medical imaging offers several advantages including:
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noninvasiveness;
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safety with no potential risks;
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widespread availability and relatively low cost.
Diagnostic ultrasound imaging is generally considered safe, with no adverse effects. As medical ultrasound is extensively used in pregnancy and pediatric imaging, it is crucial for practitioners to ensure its safe usage. Ultrasound can cause mechanical and thermal effects in tissue, which are amplified with increased output power. Consequently, guidelines for the safe use of ultrasound have been issued to address the growing use of color flow imaging, pulsed spectral Doppler, and higher demands on B-mode imaging. Furthermore, recent ultrasound safety regulations have shifted more responsibility to the operator to ensure the safe use of ultrasound. See also Skinline, Pregnancy Ultrasound, Obstetric and Gynecologic Ultrasound, Musculoskeletal and Joint Ultrasound, Ultrasound Elastography and Prostate Ultrasound. Further Reading: Basics: News & More:
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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. Further Reading: News & More:
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