Journal of X-Ray Science and Technology 11 (2003) 133–139 133IOS Press
Cardiovascular ultrasound imaging –A survey of technical development
Zheng F. Lu
Radiology Department, College of Physicians & Surgeons of Columbia University,177 Fort Washington Avenue, MHB 3-265B, New York, NY 10032, USATel.: +1 212 305 9020; Fax: +1 212 342 0927; E-mail: zfl1@columbia.edu
Abstract.
This article reviews the physics fundamentals in cardiovascular imaging using ultrasound and discusses the currenttechnology and advances in clinical practices. Challenges in future development are included at the end of the article.
1. Pros and cons of ultrasound in cardiovascular imaging
The proportion of ultrasound studies is estimated to be more than one out of every four medicalimaging studies in the world [1]. The reasons for its popularity are numerous. Perhaps the mainreason is derived from the safe nature associated with ultrasound and the fact that the equipment islow cost, mobile, and convenient to use. Compared to other imaging modalities, such as MRI and CT,ultrasound imaging offers a superior temporal resolution that is crucial in cardiovascular studies. Theultrasoundtechnologyhasbeenwidelyappliedincardiovascularimaginginassessingmorphologicalandhaemodynamic processes. For example, volumetric echocardiography provides quantitative diagnosticinformation, or at least semi-quantitative diagnostic information, such as cardiac function assessment;Doppler ultrasound has been utilized to analyze blood flow patterns and has played a crucial role inassessing cardiovascular diseases.The main disadvantageof ultrasound is its difficulty in the presenceof bone or gas. Since the acousticimpedanceof bone or gas is significantly different from the acoustic impedance of soft tissue, a majorityof the ultrasound is reflected at any interface encountering bone or gas. A so-called “acoustic” imagingwindow is needed where no bone or gas is in the path of the ultrasound beam. Such an acoustic imagingwindow is not always available. In cardiovascular imaging, small footprint transducers (see Fig. 1a) areutilized to fit in the space between the ribs for the acoustic window. Consequently, the visualizationof the heart is limited from certain angles due to the restricted acoustic window. There are alternativeways for ultrasound transducers to approach the heart. For example, a transesophageal transducer canbe intubated through the esophagus (see Fig. 1b) [2]. This type of transducer, however, is relativelyinvasive, and the procedure can be time-consuming.Another disadvantage of ultrasound is its operator and instrumentation dependence. Since ultrasoundtechnique is extremely interactive, both image acquisition and interpretation require a high level of skill.Although there may be “presets” on the system, adjustment has to be made in order to optimize imagequality according to each individual exam condition.
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