Medical Ultrasound Imaging
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Ultrasound Gel
An ultrasound (US) scanning gel has the same conductivity as the human body and is applied between the transducer and the skin surface. Air is a bad conductor of US, so this acoustic gel is used to conducts the sound beam and allows the ultrasound probe to pass smoothly over the skin.
The gel will be removed after the examination, and it will not stain skin or clothing. The basic dermatological requirement of a scanning gel is that it be free of skin irritants or sensitizers. In addition, effective preservatives with low incidence of skin reaction are required to prevent microbiological degradation of the gel. The broad range of patients imaged with ultrasound, from pregnant women and infants to the infirm or elderly dictates that the risk of skin reaction must be minimized.
The effect of small bubbles in the ultrasound couplant under the transducer is to disperse the ultrasound which results in clouding of the image. This effect is most clearly seen on anechoic regions of the image which becomes cloudy. Air bubbles, regardless of their size, degrade the performance of ultrasound in all medical applications including imaging, Lithotripsy and physical therapy.
There are some chemicals, including mineral oil, silicone oil, alcohol, surfactants, and fragrances that can degrade the acoustic lens, destroy bonding, or change the acoustic properties of the lens. The use of scanning gels or lotions in diagnostic ultrasound containing these chemicals should be avoided. In therapeutic ultrasound, ultrasound transmission gels and lotions commonly contain oils and other chemicals not intended for use with diagnostic imaging transducers.

See also Ultrasound Therapy and Ultrasound Physics.
Equipment Preparation
Equipment Preparation is an essential step in ensuring optimal ultrasound imaging quality and maintaining a safe and hygienic scanning environment. The following considerations should be taken into account:
Ultrasound Machine Warm-Up:
The ultrasound scanner should be turned on and allowed to warm up for at least 5 minutes before initiating the examination. This allows the system to stabilize and ensures consistent performance.
Transducer Selection:
The appropriate pobe should be selected based on the type of examination required, as well as the patient's body size, weight, and habitus. Different transducer offer varying frequencies, field of view, and imaging capabilities, allowing for tailored imaging based on the specific clinical needs.
Power Settings and Techniques:
Prior to beginning the examination, it is crucial to verify and adjust the power settings and imaging techniques according to the examination protocol. This ensures that the ultrasound machine is optimized for the specific diagnostic requirements
Acoustic Couplant Application:
An adequate amount of acoustic couplant, such as warmed ultrasound gel, should be applied to the patient's skin or the transducer surface. This gel serves as a medium that promotes maximum transmission of the sound beam by eliminating air interfaces, leading to improved image quality.
Transducer Cleaning and Probe Covers:
All transducers should be cleaned and readily available for use with each patient. While endocavitary ultrasound probes are often protected by single-use disposable probe covers, it is important to maintain proper hygiene by performing a high-level disinfection of the probe between each use. Additionally, using a probe cover as an additional measure can help keep the probe clean and minimize the risk of cross-contamination.

By following these equipment preparation guidelines, healthcare professionals can ensure accurate and safe ultrasound examinations while promoting infection control measures and maintaining a hygienic environment for both patients and staff.
See also Environmental Protection, Portable Ultrasound Machine, Ultrasound Accessories and Supplies, and Ultrasound System Performance.
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