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info@ultrasound-scanners.co.uk
+44(0) 7860 637522
London — Nottingham
yiannis
December 21, 2024
Ultrasound imaging, also known as sonography or diagnostic medical sonography, is a widely used and invaluable medical imaging technique that utilizes high-frequency sound waves to visualize soft tissues and organs inside the body. The term “ultrasound” refers to sound frequencies above 20,000 Hz, which is higher than what humans can hear.
In an ultrasound exam, a transducer probe is placed on the patient’s skin which emits sound waves that propagate through the body tissues. As the sound waves encounter interfaces between different tissues, part of the sound wave is reflected back to the probe. These reflected waves are detected by the probe and processed by the ultrasound machine to produce a real-time visual image showing the structure and movement of internal body organs and tissues.
Compared to other medical imaging modalities like X-ray, CT or MRI scans, ultrasound offers numerous advantages – it is radiation-free, non-invasive, portable, cost-effective and capable of creating real-time dynamic imaging. Ultrasound imaging is routinely used in a wide range of clinical applications including obstetrics, gynecology, cardiology, vascular surgery, urology and more.
The foundations of ultrasound technology were established in the early 20th century based on the piezoelectric effect, whereby certain materials generate an electric voltage when pressure is applied on them. During World War II, the principles of ultrasound were adapted for SONAR systems to detect enemy submarines.
After the war, medical researchers recognized ultrasound’s potential for safely visualizing anatomical structures. In the 1950s, Ian Donald, a Scottish obstetrician, pioneered the diagnostic use of ultrasound in clinical medicine. Donald helped develop the first medical ultrasound machines which used A-mode ultrasound to examine abdominal tumors and detect fetal head measurements.
Over the next few decades, rapid technological advances were made in ultrasound instrumentation like the introduction of B-mode grayscale imaging, real-time scanners, Doppler techniques and more. By the 1980s, ultrasound technology had been fully integrated into clinical medicine for an ever-expanding range of diagnostic and therapeutic uses.
An ultrasound system consists of several key components –
Transducer Probe – The transducer contains piezoelectric crystals which convert electrical voltages into pressure waves and vice versa. Transducers are available in different shapes and frequencies for various applications.
Pulse Generator – Generates and amplifies the electric pulses sent to excite the transducer so it emits ultrasound waves.
Display – Displays the ultrasound images in real-time. Modern ultrasound systems use high-resolution LCD monitors.
Processor – Controls overall functioning of device and performs signal and image processing algorithms on the received echoes.
Data Storage – Archival storage for ultrasound data and images.
During an ultrasound examination, the sonographer first applies an ultrasound gel on the patient’s skin overlying the body part to be imaged. This gel serves as an acoustic coupling medium between the transducer and skin.
The transducer probe is then maneuvered over the area of interest by the sonographer. Pulses of ultrasound waves propagate through the body tissues. At each acoustic interface where there is a change in tissue density or compressibility, some of the sound gets reflected back as echo signals towards the transducer.
The time interval between pulse emission and receiving the echo signals is used to calculate the depth of the tissue boundary causing that echo. The amplitude and properties of received echoes determine the brightness of dots in ultrasound image.
As the probe is moved, the ultrasound beam scans across the area of interest line by line. The ultrasound system processes signals from multiple lines to produce a two-dimensional image depicting the tissue structures, organ boundaries and their motion in real time.
Transducers
Transducers are hand-held probes which play the dual role of emitting ultrasound pulses and receiving the reflected echo signals. Based on their constrution and working principle, medical ultrasound transducers are of three types:
Key transducer parameters that characterize its performance are – operating frequency, bean width, scanning mode and application.
Frequencies – Transducers typically operate in 2 – 15 MHz range. Higher frequencies yield better resolution but lesser penetration. Abdominal scans use 3-5 MHz, while small parts like thyroid/breast use 5-12 MHz transducers.
Display Monitor
High resolution LCD monitors clearly display the scanned ultrasound images. Advanced monitors also have tools for image optimization, patient data interface and reporting features.
Beamformer
The beamformer is the signal processing unit which controls transmission and reception of signals from multiple piezoelectric elements in a transducer array to successfully focus, steer and scan the ultrasound beam.
User Interface
Console with control panel, touchscreen, trackball/mouse and keyboard allows the user to adjust machine settings, select scanning modes, enter annotations and patient data as well as archival and networking functions.
Image Processor
Specialized circuits and signal processors carry out essential image reconstruction operations –
Data Storage
Ultrasound scanners have in-built hard drives and ports for external storage devices to archive patient scans and backup image databases. Networks allow storage on central hospital servers.
During an ultrasound test, the patient lies down on an examination table. The sonographer applies a water-based conductive gel on the skin over the body region to be studied. This gel eliminates air gaps between skin and probe, allowing smooth transmission of ultrasound waves.
The transducer probe is then placed over the gel coating and slid across the body surface. The ultrasound system displays images in real-time as the probe is moved. The sonographer may press the probe harder or manipulate its orientation to improve image quality.
The key operational steps are:
Imaging Presets – Select optimized presets for type of exam being conducted. For example, abdomen vs cardiac vs musculoskeletal exams have different settings.
Orientation – Identify the scanning location and orient the ultrasound image accordingly.
Adjustment – Optimize gain and other parameters to achieve better visualization of anatomical characteristics and pathological abnormalities.
Measurement – Take precise quantitative measurements of structures like fetus size or tissue lesions.
Recording – Save representative high quality scan images and video loops for each region. Maintain patient reports.
Post-processing features allow detailed study of recorded images to take measurements and analyze specific clinical findings.
Obstetric and Gynecologic Imaging
Ultrasound is routinely used in antenatal care for –
It is also used to assess female reproductive organs like ovaries and uterus.
Abdominal Imaging
Abdominal ultrasound exams are frequently performed to diagnose –
Cardiac Imaging
Cardiac ultrasound, also called Echocardiography, is used to –
Vascular Imaging
Vascular ultrasound helps identify –
Musculoskeletal Imaging
MSK ultrasound is employed to examine –
Some major advantages ultrasound offers over other medical imaging techniques are:
Medical ultrasound encompasses a variety of specialized modalities beyond basic 2D grayscale imaging.
A-Mode
The earliest ultrasound scans produced one-dimensional spikes corresponding to echoes from tissue interfaces. This enabled measurement of distances which helped in ophthalmic and prenatal applications.
B-Mode
This two-dimensional grayscale imaging is the most common ultrasound scanning technique. The image is comprised of numerous scan lines fanning out across region of interest. Bright dots mark tissue interfaces while grayscale indicates echo strength.
M-Mode
It is quantitative temporal mode which graphs echo signals from structures over time for detailed analysis of moving organs. Most widely used in echocardiography.
PW Doppler
Pulsed wave Doppler utilizes the Doppler effect to visualize velocities of moving reflectors like red blood cells to quantify blood flow in vessels and heart chambers.
CFM – Color Flow Mapping
A color scale is used to depict velocities and directions of blood flow across 2D scan plane for clear visualization of normal circulation patterns versus abnormalities.
Tissue Harmonic Imaging
This technique uses non-linear harmonic frequencies generated as ultrasound waves propagate through tissue. Harmonic imaging reduces artifacts and noise, improving image clarity drastically.
3D Ultrasound
3D ultrasound acquires volumetric data to construct three dimensional images allowing thorough assessment of anatomical structures. Useful in obstetrics and vascular imaging.
Elastography
Specialized elastography techniques assess mechanical strain properties of tissues to help characterize abnormalities since diseased tissues are stiffer compared to normal tissues.
Some exciting recent innovations that have enhanced ultrasound’s diagnostic capabilities are:
In summary, ultrasound imaging has progressed tremendously from early 1D scans to latest real-time 4D volumetric scans thanks to revolutionary advances.
It has grown into an indispensable, safe and cost-effective imaging tool with extensive diagnostic capabilities which has led to ultrasound scanners becoming ubiquitous in hospitals, clinics and point-of-care settings across the world today.
Rapid technological innovations combined with AI will greatly expand ultrasound’s clinical applications in the coming decade for precision diagnosis and image-guided interventions – thereby improving patient care and health outcomes.
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