Medical Ultrasound Imaging
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Thyroid Ultrasound
A thyroid ultrasound evaluates the size and shape of the thyroid gland and parathyroid glands. A thyroid ultrasound can show nodules, cysts, tumors, and an enlargement, but a sonogram cannot determine the function of the thyroid. Ultrasound guides the placement of the needle during a thyroid fine needle aspiration biopsy.

See also Sonographic Features, Ultrasound Imaging Modes, Anechoic, Beam Width Artifact and Enhancement Artifact.
Ultrasound Imaging
(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:
noninvasiveness;
safety with no potential risks;
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.
Ultrasound Machine
Ultrasound machines, widely used in medical imaging, are essential tools in the field of diagnostic ultrasound. These devices utilize high-frequency sound waves to create real-time images of internal body structures. Ultrasound machines consist of several key components that work together to generate diagnostic images. These include:
The transducer is a handheld device that emits and receives sound waves. It converts electrical energy into sound waves and captures the returning echoes to create images.
The control panel houses the interface where the sonographer adjusts imaging parameters such as depth, frequency, and gain. It allows for customization of imaging settings based on the clinical requirements. The transducer pulse controls change the amplitude, frequency and duration of the pulses emitted from the transducer probe.
The central processing unit (CPU) serves as the brain of the ultrasound machine, processing the acquired data and transforming it into images. It handles complex calculations, image optimization, data storage and contains the electrical power supplies for itself and the transducer probe.
The display monitor (oscilloscope, tablet, computer monitor, etc.) showcases the real-time ultrasound images produced by the machine. It provides visual feedback to the sonographer, aiding in the interpretation and analysis of anatomical structures. Handheld ultrasound devices and mobile ultrasound probes can be connected wirelessly to a smartphone or tablet via Bluetooth or WiFi. These end device serves then as the ultrasound monitor.
Data input and measurements are done with the keyboard cursor (trackball). Ultrasound devices used for handheld point of care ultrasound (HPOCUS) are operated via the touch screen of the control panel.
Images are captured, reviewed, stored and transmitted digitally, using a standard format for digital imaging and communications in medicine (DICOM). Disk storage devices (FDD, HDD, CD, DVD) are outdated, but may be used in older machines to store the acquired images if no picture archiving and communication system (PACS) connection is possible.
The displayed ultrasound pictures are usually digitally stored in a PACS. The images from portable ultrasound machines can be stored and conveniently managed on the end device itself, the inserted memory card or in the cloud. With a QR scanner, the images can be accessed via the Internet in the cloud. Often there is also the possibility to get a picture of a baby sonography as a printout.

B-mode machines represent the vast majority of machines used in echocardiology, obstetrical scans, abdominal scans, gynecological scans, etc. B-mode ultrasound machines usually produce the sector (or pie segment-shaped) scans. These ultrasound scans require either a mechanical scanner transducer (the transducer moves to produce the sector scan), or a linear array transducer operated as a phased array.


Ultrasound machines come in different types, each catering to specific clinical needs. The two primary types are stationary and portable ultrasound machines:

Stationary units are typically larger in size and are installed in dedicated imaging rooms. These machines offer advanced imaging capabilities and a wide range of specialized features. They are commonly found in hospitals, clinics, and university medical centers where comprehensive imaging services are provided.
Portable units (see Portable Ultrasound Machine), as the name suggests, are compact and lightweight, designed for on-the-go imaging. These machines are highly versatile and offer excellent mobility, allowing healthcare professionals to bring the ultrasound system directly to the patient's bedside. Portable ultrasound machines are particularly useful in emergency settings, rural healthcare facilities, and point-of-care applications.

See also Handheld Ultrasound, Ultrasound System Performance, Equipment Preparation, Coaxial Cable, and Microbubble Scanner Modification, Environmental Protection and Ultrasound Accessories and Supplies.
Ultrasound Phantom
A phantom is used to control the imaging performance of ultrasound transducers. The spatial resolution, dead zone, linear fidelity, depth of penetration and image uniformity is important for the image quality. For the axial and lateral resolution, the standard definition is the resolution of objects parallel and perpendicular to the path of the sound beam. Ultrasound pictures created by scans of specially designed ultrasound phantoms can quantify the imaging quality and transducer performance.
Phantoms contain one or more materials that simulate a tissue in its interaction with ultrasound. Several phantoms are available specifically for quality control. Transducer characterization consists of a standard pulse echo analysis and insertion loss measurement for each probe. The quality variation from the baseline should be tracked over a period.
Ultrasound Physics
Ultrasound physics is based on the fact that periodic motion emitted of a vibrating object causes pressure waves. Ultrasonic waves are made of high pressure and low pressure (rarefactional pressure) pulses traveling through a medium.

Properties of sound waves:

The speed of ultrasound depends on the mass and spacing of the tissue molecules and the attracting force between the particles of the medium. Ultrasonic waves travels faster in dense materials and slower in compressible materials. Ultrasound is reflected at interfaces between tissues of different acoustic impedance e.g., soft tissue - air, bone - air, or soft tissue - bone.
The sound waves are produced and received by the piezoelectric crystal of the transducer. The fast Fourier transformation converts the signal into a gray scale ultrasound picture.

The ultrasonic transmission and absorption is dependend on:
refraction.

See also Sonographic Features, Doppler Effect and Thermal Effect.
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