(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:

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.

(IVUS) For intravascular ultrasound a small IVUS catheter with a probe is introduced into the artery. The transducer transmits and receives acoustic energy through this catheter. The reflected acoustic energy is used to build a picture of the inside of the vessel. A IVUS image consists of three layers around the lumen, the intima, media and adventitia.
In addition, elastography or palpography could be used to evaluate the local mechanical properties of tissues (e.g. lipid pools in high-risk vulnerable atherosclerotic plaques). These techniques use the deformation caused by the intraluminal pressure generated by the probe.
A high strain region at the lumen vessel wall boundary has 88% sensitivity and 89% specificity for identifying vulnerable plaques. There are high strain values of 1% in soft plaques with increased strain up to 2% at the shoulders of the plaque, while calcified material shows low strain values (0-0.2%). The radial strain in the tissue is obtained by cross-correlation techniques on the radio frequency signal. The strain is color-coded and plotted as a complimentary image to the intravascular ultrasound echogram.

See also Interventional Ultrasound, Vascular Ultrasound.

Ultrasound technology with its advancements is vital for delivering high-quality patient care. Innovations including high-frequency ultrasound, 3D//4D imaging, contrast enhanced ultrasound, elastography, and point-of-care ultrasound, have expanded the capabilities of ultrasound imaging and improved diagnostic accuracy.
B-Mode imaging, also known as brightness mode, is the fundamental technique in ultrasound imaging. It produces two-dimensional images based on the echoes received from tissues and organs. Understanding the principles of B-Mode imaging, such as gain adjustment, depth control, and image optimization, is crucial for obtaining diagnostically valuable images. M-Mode imaging, on the other hand, allows for the visualization of motion over time, enabling assessment of cardiac structures and function, as well as fetal heart rate.
High-frequency ultrasound refers to the use of ultrasound waves with frequencies greater than 10 MHz. This technology enables improved resolution, allowing for detailed imaging of superficial structures like skin, tendons, and small organs. High-frequency ultrasound has found applications in dermatology, ophthalmology, and musculoskeletal imaging.
Traditional 2D ultrasound has been augmented by the advent of 3D ultrasound technology. By acquiring multiple 2D images from different angles, this technique construct a volumetric representation of the imaged area. The addition of 4D ultrasound in real-time motion adds further value by capturing dynamic processes.
Doppler imaging employs the Doppler effect to evaluate blood flow within vessels and assess hemodynamics. Color Doppler assigns color to different blood flow velocities, providing a visual representation of blood flow direction and speed. Spectral Doppler displays blood flow velocities as a waveform, allowing for detailed analysis of flow patterns, resistance, and stenosis.
Contrast enhanced ultrasound employs microbubble contrast agents to enhance the visualization of blood flow and tissue perfusion. By injecting these agents intravenously, sonographers can differentiate between vascular structures and lesions. Elastography is a technique that measures tissue elasticity or stiffness. It assists in differentiating between normal and abnormal tissues, aiding in the diagnosis of various conditions such as liver fibrosis, breast lesions, and thyroid nodules.
Fusion imaging combines ultrasound with other imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). By overlaying or merging ultrasound images with those obtained from other modalities, the user can precisely locate and characterize abnormalities, guide interventions, and improve diagnostic accuracy. Fusion imaging has proven particularly useful in areas such as interventional radiology, oncology, and urology.
See also Equipment Preparation, Environmental Protection, Handheld Ultrasound, Portable Ultrasound and Ultrasound Accessories and Supplies.

From Hitachi Medical Corporation (HMC), sales, marketing and service in the US by Hitachi Medical Systems America Inc.;
Powerful, flexible, and fast, the HI VISION™ 8500 - EUB-8500 diagnostic ultrasound scanner combines leading edge technologies with user-oriented operation for exceptional imaging and functionality.
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