Essentials of U James A. Zagzebski, PhD Professor Department of Medical Physics, Human Oncology, and Radiology University of Wisconsin Madison, Wisconsin with 369 illustrations NA MosbyCopyright ©1494 All rights reser stored i a ret means, electron} without write Permission to use is permitte Clearance Cem per paxe is pail Steet, Salem, M of copying. such as copy promational purposes, for creating Praneed in the Mosby—Year Bk 11830 Westline St. Louis, Missy ISBN 151-985 16 by Mosby-Year Book, Inc sd. No patt of this publication may be reproduce val system, oF transmitted, in any form or by anv fc, mechanical, phorocopying, recording, or otherwise, permission of the publisler jorocopy oF reproduce solely for internal or personal for libraries or other users registered with the Copyright +, provided that the base fee of $4.00 per chapter plus $.10 dizeedy w de Coprvight Clearance Cener, 27 Congres JA 011970. This consent does not extend to other kinds ng for general divribution, for adverssing or ollected works, or for resale. inited States of America jox. Inc. Inicuserial Drive ai 63146 3 jo 98 7H543YP RD ) ) VIF IRIS 2 VIIDIIO ) Te Hewnens, oh walled many miles around the capa of od Coaval Sere Clee me coky Age ori~ Preface ‘What an exciting time to be in the field of medica! ls sound! Technical innoxstions are rapidly producing da matic improvements in the performance capabilities of clinical instruments, Although basic ultasound imaging, hhas not changed substantially over the past 25 years, today's ultrasound devices provide image quality and nostic capabilities that go way, way beyond what was even thought possible in carlcr ultrasound days. Linear andi phased arrays, for example, certainly: were available in commercial instruments during the early 1970’, But today’s"1"/2 D linear and shased arrays, made of “cos posite piezoelectric materiah” produce images with vastly improved spatial resolution compared to images produced by their older cousins. The newer trausducers abo are much more sensitive to weak echoes and are much more verstile chan their predecesors, even enabling the ame transducer to be used at multiple imaging frequencies. Similar stories are emerging for most major components of a diagnostic ultrasound instrument. “Leaner and meaner” ultrasound imaging devices are emerging 36 ‘manufacturers take advantage of modern digital wechrol- ogy, new fabrication techniques and an ever expanding, ‘knowledge base of biozcoustcs and digital signal provess- ing. More accurate and mere cost-efectve patient care will be the beneficial outcome of this equipment and sci- entific evolution, and most of you will ply important roles in its applicaion, Escenials of Ultrasound Physic is abowr wlesasound technology and ultrasound instrumentation, This text book is intended for sudent, sonographers. and tech= nolagists who need s thorough understanding of physics and instrumentation in this field, There‘ore. the book starts with the basis, covering all copies wally found in beginning courses and board exams. "There are multiple choice questions and problems at the end of each chap ter to help you evaluate your level of uaderstanding. An additional set of questions in cae form: oF exam” is provided a: the end of the book. This practice ‘exam allows you to evaluate your stengihs and weak- nesses before taking the physics portion of the certifi- cation exam given by the American Registry of Diagnosite Medical Sonographers, Answers and expla- nations to questions can be found in she appendices. A comprehensive glossary of technical tersw is also fond in the appendix, Earlier versions of some of the chapzer in this hook ‘were port of Sandia Hagen-Ansert’ third edition of the Diagnostic Uirasonography, aso published by Mosby-Vear Book, Compiling these newly updated and expanded chapters plus several new ones into the Essentials of Utaasound Physic pesmits & complece presen tation of ultrasound physics, -ettification> Acknowledgements Lam indebted ro John Parks, Director of the Univesity of Wisconsin School of Diagnostic Medical Sonography, for his help and encouragement during the production of this book. Joln also assisted in designing figures and review~ ing early versions of some of the chapters. Chris Labinsky, Jackie Cassiday, Rhonda Arbogast, Dana Walker, Tim Heyser, Patty Kiel, and Nancy Bell all were very generous ‘with their rime by assisting with scanners and image archiving equipment, allowing interruptions desing busy clinical ultrasound imaging schedules, and supplying interesting ultrasound amages, | am gratefl to theo» as well as to Drs, Myron Porniak, Fred Lee Jr., Kathy Scanlan, and Peter Rahko who staff the wtlrasound el at University of Wisconsin Hospital and provided helpful discussions and interesti Lam al th Bony True and Irene Golembiewski Sor exp: producing the illustrations and co Lisa Potts and Kathy ‘Teal from Moshy who helped immensely Finally thanks to Ann Marie 2 g7ebski, Kat Zazrebeks and Lynn Zagzehski for their enduring apport and ceeowragement>| ~ BE Contents 1 Pais of Diagnoste Utrauund, 2 Fhyses of Diag Uracund, 20 3 Poboetsho Ulvesound Instumetatin, as 4 Image Storage and fisqlay 5 Lappe Wstiumenation, 7 = PF 2 I2IIIIAIPIIADI 6 Color Copland alr Flow iain, 100 7 Image Cherectistcs and Ate, 420 8 llvasound Equipment Queltyssuame, 148 © Bioeels and StetyConsdertios, 163 a Appendixes A Devin of Math Canes, 128 Aas ta Review esto: x PPT PID ST FD B Tel ouster D Oltsay, 199PIMPS IDI PDH IRI HISD RHP IDI HIP IIR) HI HD SF DeedChapter Pays of igus Sound ic mechanical ergy ransaited by presume woe in 3 moan, Sows ras ube fregusy i ws tha 20 Ain ts teed stead, Digi sas ils Finquenciee vv the 1 Ms to 20 AML cage NATURE OF SOUND Definition of sound Nearly all of us have an idea of what sound is because of our ability to hear. However, familiar definitions such as “sound is the sensation perceived by the sense of hear- ing”! are too limited in describing medical ultrasound, in which frequencies much higher than those wwe can hear are used. Ata fundamental level, sound is mechanical energy Inanseitaed by pressure waves in 8 material medium. This gen tal definition encompasses all types of sound, including audible sound, low-frequency seismic waves, and ula sound used in diagnostic imaging Lets examine this definition more closely. Fist i Geseribes sound a8 a form of energy. Energy is the eapacity to do work, whether by moving an object. heat= 2 3 room, of lighting electrically. When sound travels from one location fo anotker it carries energy: that i, it can cause slight back-and-forth displacements of objects its path. Sound striking a ear, for example, causes the cardrum t vibrate, prodvcing the sensation of audible sound (Figure 1-1), Sound energy is ssid to be mechamital,sveansng it ‘esis in the form of phisical movements of the molecules and particles in the medium. This distinguishes sounc ‘energy fium other forms of energy, such as eleceo nen. Sound waves ahvays involve rapid back-and-forth displacements, or vibrations, of malecules in the me. Another important ides in the definition of sound is that #¢ involves propazation through a material scum Sound waves only exst in media Containing molecules or particles, ait, wate, tues it ‘bods: ari many cther examples, Sound waves suum wichaine ber where there ino medium un which to propagate anne ease ehrough a vac juter space oF in an experim=ntal vam Sources of sound Sound production requires a vibratirg object. A amine fork in air ic good cxample (Figure 1-2. A). It vibrates when struck by a hammer. As the tuning fork vibrates pushes and pulls against adjacent air molecules, causing them to vibrate as well (Figure [-2, B). These vibrations ‘cause still further molecules to vibrate. and so forth. Thus this disturbance spreads through the air a a wave Other ‘examples of sources of sound include the reed of a moss figse Sounds tran by mkecles ibang sounds when anergy i these ations 6 rod esough ae heir stabi nvsttes to the cove The eardrum’ vibrations result n the sonsition of wound2 Essentials of Ultrasound Physics cal instrument, ap udio speaker system, and a person's voice box. All sopirces involve some sype of vibration to produce The source of sound waves in medical ultrasound isa piezoelectric tajsducer (Figore 1-3). In response to an electrical impulse it vibrates someshat like a piston, pro- ducing sound v placed contact, Piezpelectric transducers can be made to vibrave a che vety high frequencies needed in an ula sound exami 2 sound wave. ves in the tssue with which ign. Wave motion (Oar definition indicated that sound travels in the form of awave. A wave js a coordinated disurbance movin, fixed speed through a medium Sourdl was fast and generally do not produce visible changes in a medium, so itis dificul: to * visualize” them. Therefore we Je patterns in water rate properties of wave motion, ave may be produced by dropping an object into a quiee pond. The wave spreads outwanl at a speed deter i | gue HD Soxnd gcerated by a fork cause sir molgcules to vibrate. The wbeason Pa a } op - figue 13, Uierasound cransees Jenene vibrates wh mined by the water sutface and density “People-waves” in the stadiuns ata football or soecer game travel around the stadium at a speed that depends on the make-up (and enthusiasm) of the crowd. Sound waves in air ravel at a speed that depends om the pressure and temperature of the air. Typically the speed of sound in air is about 330 m/s (Figure 1-5), or a litle over 1000 ft/s ‘A wave catries energy through 3 mediom without actual passage of the molecules and particles of the medium. Affer the wave moves through the medium, the particles return to their normal positions. A familiar example that helps illustrate this is when s small eating object is “siruck” by waves in water. The wave motion. carries the abject up and down as the wave travels by However, after the wave panes, the object i in the same spot as before the wave arrived Several rypes of waves exit th general categories Sound is ant example of a mechanical wave, requiring a mole Other examples of mechanical waves include ocean bax on p.3 gives avo sr medium for transmission, waves, vibrations of a string, and seismic waves. The sec ond type listed 1m the box is cleetromagnetics waves, fork, A, The suming fork vibrates wher struck by the Hatnener B, Vibrations of the caning jnurhance teavels away ftom che runing fork as 2 save Figse Lippe patern in a quiet port ject is dropped nto the waterwhich include radio waves, x-rays, and light. Elecero- magnetic waves do not require a molecular mediom for propagation. In fact, they travel through the vacuum of fuer space. Electromagnetic waves have much higher propagation speeds than mechanical waves, Longitudinal versus transverse waves Sound waves that tavel thmugh sue are longitudinal ‘waves. The sound source aets ke a piston, vibrating back and forth (Figore 1-6). The wave uavels away fiom the soutee more or less parallel to the direction the particles vibrate. Other types of mechanical waves are posible in some media, For cxample, transverse vibrations or shear ‘waves may he cransmitted through solid materia, These ate characterized by pasticle vibrations perpendicular to the direction of propagation (Figuce 1-6). Transverse waves can propagate easily throngh some solid materials, such 36. steel and bone. However, transverse waves do aot travel effecavely through soft cssne. Only longitudinal sound ‘vaves are important in diagnostic ultrasound imaging itu TS. Sound waves wave sn aie ata speed of 330 s/s, bo this cartoon depicrion.a stopwtch messures the tine fons chen 4 sound is prndacal (he hat srking a baeshll) wh the sound reaches listeners car. [e takes 1 second for sound ‘waves to travel 330 m2 (about 1000 feet about 5 mle) in ac Physic of Daguesic Uitasound 3 Compressions and rarefactions ‘A sound wave travels away ftom the sourée, filing the affected medium with vibrational energs If we could view 4 “snapshot” of the molecules in the medium at an instant when a sound wave is present. the results m be as shown in Figure 1-7. The hack-and-forth displace~ rent of the source squeezes and pullson the particles in the medium, which push and pull on neighboring mol- ecules, etc. Places where the molecules are pushed together when our snapshot is caken ate called regions of compression. Here the density of dhe medium (ie, the ‘mass per unie volume, in g/cm’) is slightly greater than ic ‘woul be if the wave were absent. Areas where the mol- ecules axe deawn apart at the instant of our snapshot are called regions of rarefaction. The density is slightly lower in these regions Acoustic pressure ‘An acoustic quantity used fiequently by engineers and physicists to quantify the strength of a wave is the acoustic pressure. We are all familiar with the concept of “atmospheric pressure” the steady pressure due to the ‘weight of air at a point on earth. Atmaspheric pressure is about 14.7 ps.'The pressure in an automnotile tire can be increased by pumping air into the tre. We often elevate the pressure in a tie to about 32 psi cbove atmospheric pressure. Ina sound wave, the regions af compression are accompanied by elevations in the pressure compared to atmospheric pressure; the regions of =arelaction eorre~ spond to spots where the pressure is Iower than atmos- spheric pressure Longitudinal wave +Oe 40% 40% 20% 0% ls +0+ +0~ +0+ -0- +0+ Wave direction a> ‘Tranevorse wave 729 2 8 ' 22 ¢ & ‘Wave direction > Fie 8 Longstsdinal and tamer Longitudinal waves have partite vi ple! wo the perpendicular co i sound waves can propagate through so tissue4 Essentials af Uteagound Physics Compression paretaction iE finite 17. "Snapshpe” of the mediuon at an instant yn che ‘presence of a souhd wave. Compression: ate negions where a ta yen ceed wh ope ‘backgrounds rarefactions are regions where these quantities are less that thesd of the background The lower trace i the acoustic pressure vs. distance. The acousic wavelength i given by A and che prassuze amplitude by P Iie were possible to measure the prussure a different points in'a sound wave at the instant corresponding tothe Schematic diagram, the results would appear asim the lower part of Figure 1-7. Here O refecs to atmospheric prrssre,and we se the increased and decreased presure Te regions of cpmpression and rareition. The maximum pressure elevation is called the prosie amplinde, Be The Figher the magnitude of the wave the greater the pressure amplitude. In Heraonics, presure s expressed in pascal, ‘bbreviated Da, For reference, dhe 1.7 psi of atmospheric ‘presiure is equal to about 10° (109,000) Pa. Some diag- osc ulatound beams have bees “clocked” with pres- Sure amplitadts exceeding 1 MPa (1,000,000 Pa), oF 10 tim armospHferie presse. acoustic PRESSURE Is meatured in PASCALS. ‘As the solid source vibrates, he pressure wave ra als (to the rig in the diagram). Thus the paternillas- Grated in Figupe 1-7 changes with rime, Figure 1-8 com- pares the original presure distibecion with what might be found ata Nightly later time. The pattern i simular, but hited, with fhe compressions and raefactions appearing in alighdy diferene pices As the sound wave taves the prestre itoton continous ans Period and frequency Asef way of expresing the tempor behavior of a Band wave f to plot the per versus Hie a a gle fine he pedi, The west cuve raze ota ine weve (Figur 19) The mumber nf mes per second the rnabance fo epeated a ay point called the fre~ Queney.Thd Gequency ofa sound waves determine by ARS uaber pf oscilanons per second made by the sound pase Appendix Aon pT faut time" time" a Pressure Tie HL Comparison of to presute v distince corvesat Sight deren. figwe 14. Change in pressore vs. time in the presence of “sound wave Such a curve would be obtained ac = fixed point in space when the sound source vibrates Continuously The period, thet i the dame for tcyde of ‘osillation to occur is laveled ‘The cime it takes for the disturbance to repeat itself that is, t0 ge through one complete cycls is the period. Period is labeled ‘Tin Figure 1-9 Frequency. jj and periog, T; are inversely related that i, vay Example: Suppose the frequency of a wave is 10) cyeles/+. Calculate the period. ution: Using the above equation, we find: 10 cyeles/s =04e Example: Suppose the peried is 1 1s (0.000001 3) What is the frequency? "You can rearrange Equation 1-1 by muuluipiying bot sides of the equation by fand dividing both sides by Z-The result isHigher frequency Time Fitue M1 Presse vs tinue representation for we diffrent ffequencies The higher frequency hasa shorter period, 1 Substituting gives f= Saonars 7 1,900,000 cycles/s In other words, if the period is 1 is, the frequency is 4 million eyeles/s (1 MEL) The important relationship expressed here is that ee quency and period are invencly related (Figure 1-10).As the frequency increases, the period decreases, and vice versa, Ifthe frequency douiles, the pertod halves; if i quadruples, period is reduced o 1 the original vale, and so forth Ee PERIOD fs the INVERSE of the FREQUENCY. ULTRASOUND ‘The fequeney is the number of oscillations per second that the particles in the medium make as they vibrate about thei resting position. Frequency is determined by the sound source, thats, bythe numberof oscillations per second it makes. The unit for frequency i cycles per second (eyeles/s) or lurt= (He). Commonly used muleiples of 1 hertz area: follows hertz = 1 Hz 1000 eyeles/s = 1001) heree = 1 kilohertz = 1 kHz 1,000,000 cyeles/s = 1,000.00 bette = I megahertz = 1 MHz (Appendix A gives common metric prefixes and theie decimal equivalents ) Physics of OagnesicUtrasound 5 90,000,000 Hz PINES aeieoce: 41,000,000 Hz ===" Ultrasound ~ Pte shes ig as neit 20,000 Hz. ‘Audible sound 20Hz Figte 1. Chusifcation of sounds according co frequency. ‘A clasifcation scheme for acoustic waves according to their frequency is given in Figure 1-11, Mose humans can hear sound if c has a frequency in the range of 20 Hy co approximately 20 kHz. This range is referred to as the audible flequency rage. Sound whose frequency is greater than 20) kHz. is termed ultraonic. Mechanical vibrations whose frequencies are below the audible range are termed. infesonic. Examples of infrasonic trarsmissions include vibrations introduced by air ducts, ocean waves, and sei The ultrasonic frequency range is used extensively, both in differenc types of instruments ard by animals, Diagnostic ultrasound involves mainly frequencies in the [-MHe tw 20-MHe range. ‘SPEED OF SOUND What determines the speed? The speed of sound in any medium is determined pri marily by the characteristics of the medium. (There are slight dependencies on other factors such asthe ultrasonic fequency, bur chese are so small thar they cza generally b ignored.) Specifically, for longitudinal sound waves in either liquids oF body tissues, an expresion for che speed of sound, [a ve 7 In this equation B is a property of the mediusn called the bulk modulus, It is a measure of the stiffness of che material, that is, the resistance of dhe matzrial co being compressed. The syinbol p is the densicy, given in. grams per cubic centimeter (g/cm) or kilagranis per cubic never (kg/m). Equation 1-2 tells us that the speed of sound in a medium depends both on the “silfuess” of the sniedium and on its densicy.15 Essentials of Utrespund Physics ‘Speeds in nonbiological media Appropriate units|for speed are meters per second (o/s) or centimeters per fecond (cm/s), The speed of sound in some nonbiologi¢al materials is given in Table 1-1. ‘Sound speed in tissue “The speed of sourtd in biological fssuesis an important para- etcr in imaging applications. Values that have been mea- ssred in different human risues are given in Table 1-225 The lowest jound speed shown is that for Tung tis- suezthe low value is due to air-filled alveoli in this tissue. Most tisses of doncern 0 us (1, those through which sound can be readily propagated in the megaherte fre~ quency range) hive speed-of-sound values in the neigh: borhood of 150) ro 1600 m/s, Fat i on the low end of the range for soft nssue and muscle tissue on the high end. Measurements of the speed of sound in bone tissue resultin values Wo to three times those recorded in mnost soft issues, “The average) speed of sound in soft tissues (excluding the lung) is 1540 m/s, and range-measuring crcuits on most diagnestic ultrasound insruments are calibrated on this basis. Closd inspection of the biological tissue list above reveals thde the propagation speed in every soft rs- 1us in diagnostic uitrasound i within a few percentage points of 1540 m/s Title. Speed of sound in some nonbiological “From Wells PNT: Biowadia wliasoni, New York, 1977, ‘Academic Pres Te 12 speed sound in selected dssues?S ‘The following are equivalent designations for the average speed of sound in sof iste: “Average speed of sound in soft tissue 1540 m/s 134,000 em/s 1.54 m/s = 0.154 em/ns WAVELENGTH The wavelength isthe distance berweea two peas, valleys, or other corresponding points on the wave (Figure 1-7), Ieis the diane the sound wave trave daring ane com plete cycle of the wave, Wavelength i usually designated by the symbol A “The acoustic wavelength depends on the frequency. J and the speed of sound in che mediuon,« tee given by the following relationship: a ‘Thus the wavelength is simply the speed of sound divided by the ultrasonic frequency: The impartart rela~ tionship to keep in mind here is the inverse relanonship between the wavclenggh and the ulmsound fiegiency ‘The higher the ultrasonic ffequency, the smaber will be the wavelength Example: Calculate the wavelength for a -MHz ultrasound beain in soft tissue. Assume the speed ofsound is 1540 m/s, Solution: The wavelength can be calealated ditectly using Equation 1-3, with ¢= 1540 m/s and 2 MHz ~ 2X 10F eycles/s. Thus 40 ms 1540 mS — 9.09077 m = 0.77 mam 2x 10s Appendia A reviews metric conversions. Ie also con~ tains examples of addition, suberaction, mulkiplicarion, and division 1m which numbers are expresed as exporentiaks (Le., 2,000,000 eyeles/s = 2 * 10" cveles/s). “There tsa simple way to calculate the wavelength in soft tissue, assaming the speed of sound is 1540 m/s. Call the soft tissue wavelength A. If we expres the speed of sound in mm/ps and the frequency in MHz 1.54 mm da = iat) (4) th (in millinneters) equals 1.54 divided by the frequency (in Mexabvert2) ‘Example: Calculate the wavelength in sof tinue if the frequency is 10 MEH. | | |Solution: Using Equation 1-4, 54mm _ 154mm. Ae Fqan) ~~ 10 = 0154 mm Uluasonographers rournely select the ultrasound frequency when they choose transducer of a probe con trol setting. Whe you change frequencies, the wave= length also changes. As the frequency increases the wave length decreases. Doubling the frequency halves the wavelength, haiving the frequency doubles the wave length, ane so fosth. The wavelength is impertant in ultrasound physics because itis related vo imaging factors such 2s spatial res= olution (sce Chapter 2). In addition, the physical size of an object (ex., reflecting surface or 3 transducer surface) is signifcane only when we compte it to the nltexonic wavelength, For example, an element im an array erans- ducer produces 2 beam that spresds ost if the element is about the size of the wavelength: a tansducer element whose dimensions are much larger than the wavelength produces a well-defined, directed beam. It might be said then that the wavelength is our “acoustic yardstick” (igure 1-12). Objects are lage or sunall relative to the ‘wavelength. In soft tissue, wavelengths for diagnostic ultra~ sound are on the onder of 1 mm or less, with 0.77 mm ‘wavelengths for 2-MHe beans and proportionally smaller ones for higher frequencies. ‘AMPLITUDE AND INTENSITY ‘When discussing reflection, sttenuation, and scatter, we often must make a quanditstive statement regarding de ‘magnitude of strength of a sound wave. One variable that can be used here is the pressure amplitude. The acoustic pressure amplitude was Mlusirted i Figure 1-7 and was defined as the maximum increase (or decrease) in the pres- sure relative to ambient conditions in the absence of the sound wave. A wave of higher magnizade is accompsnied bby a greater pressure amphiide than one of a lower mag: nituelc, For audible sounds, amplirude 4s astocsated with the Nloudness” of the sound In some applications, particuliely when discussing biologreal effects of ultrasound (see Chapter 9}, it is use specify the acoustic intensity The intensity ata location anultasaond beam, J, is proportional to the square of the pressure amplitude, P The actual welationship is: 2p iD} Again. p is the density of the medium and c the speed fof sound, Thus, if the amplitude w Intensity at that location would quadruples if it were te re to double, the Physics of Diagoste Unrascund 7 ie 22M 2 aM Fit V2, ‘The wanetength i “acne ani” ‘eiue ompuied sso erie ex to the wavelength increase by three, the intensity would increase by nine, ete, Acoustic intensity will be dicussee in greater detail in Chapter 9. REFLECTION AND TRANSMISSION AT INTERFACES: Acoustic impedance ‘An important property of tissues that influences the strength or amplitude of reflected echoes is a quantity led the acoustic impedance. Ir is defined in advanced ultrasound texts as the acoustic pressure divided by the resultant particle velocity. For our purposes. the acoustic impedance (or the characteristic impedanct) of « material, Z, ss equal to the product of the mediums deasty (p) and its speed of sound (9. That is, 2= 9 () ‘Table 1-3 shows a compilation of acoustic impedance values for both nonbiological and biological tissues. The units for expressing these are kilograms 3er wquare meter per second (kg’m?/}, which vesult alter nuuliplying den- sity times speed, Somerimes we find impecian rayls. One rayl is the same as | hg/e/s. Air or an aircfiled structure sich as ys hang, has 3 veey low acoustic impedance compared to tissue, For other tissues, except for bon the range of acoustic imped ances iy relatively narrow, idence Reflection—perpendicular i Whenever an ultrasound beam is ineigent on an inte face f waterial having saffetene acous impedances. some of the energy in the beam will be r remainder eransmitted. The amplitude lof the reflected wave depends on the med by two. lected and d 1ce between{Essentials of Utrasound Physics ic impedances of selected tissues Angedace (rays) 0.0004 10% oe i the acoustic impedances of the rwo materials forming the interface Comided first the case of normal or perpendicular beam inciderice on a large at incerfice (Figure 1-13). large smooth) interface such as depicted here i termed a specular rflecipr We Was dimensions that are much greater than the trisonic wavelength. The ratio of the selected presure amplitude, Po the incident pressure amplitude, Pais called he amplinede flection veicen, R. Ris giver aah “th ta where Z; is the acoustic impedance on the distal side of the interface and Z, is the impedance on the proximal side. me 1-7 ensphasizes that the reflected wave amplitude depends on the difference im impedances ofthe {ovo suateriah forming the imerace Some authors usc the intensity reflection coefficient rather chan the amplitude reflection coefficient to quanti the reflection process. The mathenacical expresion for the reflection lopks simular to Equation 1-7, excepe that the {quantity involving the acoustic impedances is squared. In other words ifs the reflected incensity and 8 the inci- dent intensity then: kf a-% | aclas ry “The rao of the reflected intensiry co dhe ince intensity a dn ieertace is ea othe square ofthe rato tf the selec ampliode wo te incident amplcade This fe ey om ht hat te mes Shona wo the square ofthe amplinde Exam! ‘Using the valucs for acoustic impedance je gen lube the amplnie reflection coecient for 2 faclver fertce Solutign: The acoustic ray tha of liver 1.63 % 1 ppedance of fat is 1.34 % 108 is. From Equation 1-7; Tissue Tissue? Impedance Z, Impedance Z, ry Trarsmited ’, bear fipwe HL. specular reflection a a smooth interfive. The incident wave amplitude is P, and the relected ware amplitude & P, Z; isthe impedance of the material on the presimal side Of the interface while Zp the Jmpedance on the dual side of the incerface. 1,65 % 106 rays ~ 1.34 X 106 rays 1,65 % 10° rayk + 134% 10% rays Factoring out 10 rayls gives ex GSS = LS) X 10 rays (1.65 = 134) (165 F134) 10 rays (1.654 1.34) oat £3) 0.10 209° ‘We see from the example thatthe ratio ofthe reflected to the incidene amplitude is quite sal In fact, at mou 308 tisiue-soft sue interfaces in the body the tellection coef ficiene is fairy small and most ofthe sound is transmitted throigh che interface. If his were not the cas, it would be difficult ro wse diagnostic ultssound fer examining comical seructutes at significant tssne dep Example: Calculate the reflection coefficient for a smuscle-air imteriace. Solution: From the acoustic impedances given in Table 1-3, calculate ones x 108 0,004 108 = 1 0.0004 0.0008 + — 099 In this ease the beam is almost completely reflected as the magnitude of the reflecnon coc (The mmus sign has to do wich the pluse of the reflec but has no bearing on the size of the reflection.) ‘This example illustrates the difficcley in transmitting, ultrasound beyond any tissue co-ait interface (Figure 1- jent nearly 1!fige 4 Reflection aca disuosisive interface and ata rise LiF interface. No sound travels beyond the tisue-air interface because of complete selection, 14)-The complete reflection ata interfaces aso explains the need for a coupling medium, such as gel or oil, between the ultrasound transducer and the parient dur- ing ultrasound examinations. The coupling material ensures that no ar is rapped between the transducer and the skin surface, thereby providing good sound transmis: sion into the patient. Examples of amplimde reflection coefficients (P,/P) and intensity reflection coefiicients (J/1) for specular reflecting interfaces are given in Table 1 ‘The data presented here show that 2 soft tissue-to-bone interface alse isa failly song reflector Because of this, whenever posible, transmission through bone is avoided in diagnostic ultrasound. (Another diffi- culty with bone is that it distorts ulteasound beams, spreading them out and decreasing spatial resolution.) Most soft tissue interfices of importance ae fairly weakly ‘electing, just as we calculated in the first example. In suuramary, reflection of a sound beam occurs when ever the beam is incident om an interface formed by ewo nnssues having diferent acoustic impedances. The acoustic impedance difference could be caused by a change in speeds of sound, 2 change in densities, or both. The mag nitude of the reflected wave and the percentage of the beam energy that is reflected depend on the acoustic impedance difference at the interface. Interfices where there is a large difference in acoustic impedance reflect more of the incident beam chan do interfaces where the npedance difference (mismatch) is small. For interfaces formed by two soft tissues, the impedance mis- match is small and the reflection coetficient is almost always much less than 0.1 Nonperpendicular sound beam incidence For nonperpendicelar beam incidence on «specular reflec tor the situation changes somewhat. First, the reflected bbeam does not tavel back toward the souree (Figure 1-1 bor instead travel oi’ an angle, By which is equal co incident angle, only in the opposite direction. This has an effect on echo detection fom interfaces As we shall ee in Chapter 3, in mos applications of ultaiound a single Physics of Diagodic Utrasound Incident } Fi HE. election an trantnision a a gece interfce sehen the Bea i incident wan ange. tefl bearn teach off tan anal, shown. The eansautodbeata undergoes refraction ithe speeds of sound inthe meds forming the intercede Tle Reflected ampinide ratios and intesiy fatios _leertae sransducer serves both a the source ofthe sownd eu aad the detector of echoes from reflectors in the beam. Therefore the amplitude of a detected ache depends on the orientation of the interface relative to the incident beam (Figure 1-16). Because of this significant angular dependence on the detection ofan echo,specular reflectors are sometimes dificult to visualize because cheir orienta- tion usualy is not perpendicular wo the ultssound bear. A second factor that arises when the incident beam is ‘not perpendicular to an intertixe is che possibilty of reffaction of the tanszitted beam. Refinetion refers t0 8 “bending” of the sound beam. that is, change in the dhrection of the transmitted heim, at the interface. Tihs rests in the transmitted bean emerging direction fron the scien bes and transmitted beam cizeetions an Figure 1-15) Most of us ae falar with the eee of reaction of light waves; for example, dae t0 relation a «winning soo appears shallower dhan i acully is and the location of objects may be somewhae darted when viewed from compare the i10. Essontas of U Fique VIB, The rel Fimre Mi. Ob above the surf athe water air from 2 certain d fies the bower ‘come from ash above the foceuirs becats rgsound Physics back to she sourd prada 4 lag perpendicular, m transducer yy + = fected wave fom a specular interface travels transducer for perpendicular incidence, echo signal When the beam is not fst of the ech does nat retura so the Perceived depth Actual depth fs and distances in a pool of water seen from inerfice. Beca leh, such a the container. wer dep re 1-17] cr (Fign tna than in ater appear ditorted because of refaction of light ‘of mfeation, ight com the loci of the fish oF to the observer | Light wave refraction the velocity of light is significantly greater ‘Two conditions ate required tor refiaction of a sourtd save to occu 1. ‘The sound beam must be incident an the interface a sn ample that is not perpendicular 2, Thespecth ofsound mus b ent 8 the 19 sides of the intace Both condicions must be met. If tl 1 the interface. no matt perpendicular tpeed deren | ee is bervveen the incident beam is wwo materials Forming, the interface, no refraction will occur. Likewise, even for Sb very oblique angle af incidence, ifthe sound speed does not change across the interface, no refraction will “The amount of refiaction is predicted by Smell’ law. Sells law relates the transmitted beam direction :0 the ineident beam direction and the speeds of sound in the {evo materials forming the interface. Let «be the speed of Sound on the incident beau side ofthe interface ane ¢ the speed of sound on che transmitted beam side, 8 de the sneident beam angle in Figure 1-15 and 6, the transmitted ‘beatm angle. Snel law states that: q cl “The angles abo shown in Figure 1-15. Equation 1-9 is 2 statement of Sells law. Engineers sometimes use Snell law to exieulace exactly the transmitted beam direction given the direction of the inedent beam and the propagation speeds on either side of the interface. We ean gain insight into reffaction ané Snel’ Taw without detailed computaions. The relationship herween i angle and is trigonometric sie (sin) is diseased in ‘Appendix A. For angles between 0 and 90 degrees 5 the dnigle evens sine also incteases. With this in mind, inspection of Equation 1-9 reveals the following: if cs treater than the transmied beam angle will be greater fhan the incident bear angles if i es than =the tan mitted beam angle will be less than the incident beam ingle. These to conditions are illustrated in Figure 1-18, ‘How much reraccion (or, how big a change in beam dixection) might be aneicipated in vltrasonograpiy? Lets ‘ply Equation 1-9 for several hypothetical iaterfaces We'll assume the ultrasound beam is incigent at a 30 degtee angle with the interface. First, consider what we ight expect to be a fairly extreme situation, one where the incident beam is traveling through bone and encoun: ters 2 bone soft tissue interface. Assuming she speed of ound sm bone is 4080) m/s and in sof dsc is 1540 m/s, iFebe incident beams angle fs 30 degrees, ehe large speed of Sound chanue resalts #8 a erausmited beam angle of just 1019 degrees. 19.1-degree shift Tribe 173 lists results for some sot tise interFces, where relaction effses are not as drastic ay is bone-soft {iste interfaces, For the three soft cswne-solt tse ster faces, musle-to-fit presents the severest refraction. Thi i Ibocaive this intestace has the greatest change in speeds of sound at the interface. In fet, ft and adipose iste often ove dificulty to ultrasound imaging some of this difi- Eley is believed to by ffona reaction that 2ccurs at adi pose tissue interface. An amomobile traveling from a smooth (Yas) sue~ vice versa, can provide face 40 2 rough ("slow") surfaceON 2 SS w@ x Fast refracted Slow YS, ae \S baad Figwe VL. Refacton when cys greater than (ki and when eq las hare igh Title I$. Change in beam direction for a 30 degree angle of incidence ection of refzaction. an analogy to help remember the di In Figure 1-19 a car is moving from the fast to the slow surface at an angle. The whcel passing the interface first, ‘would move more slowly thin the one soll on pavement, forcing the car to turn. The direction it turns i lightly to the car’ right in the diagram, Once both front wheels are in the “slowes” material they both turn atthe same specd and the automobile moves stright ahead: however, the path has changed ffom the original direction. This is anal- ‘ogous to a wave entering 3 medium having a lower wave speed. (Compare with Figure 1-18) If the automobile ‘were traveling from the slower surface to the faster surface the opposite effect would ocrur, again analogous co sound wave reffaction Diffuse reflection Many times echo signals are produced in the body fiom interfaces that are not perfectly specular. For example, small vessels whose dimensions are on the order of the acoustic wavelength fill into this category. So do many larger interfaces, such a5 the collecting system of the kidney, the walls of the heart chamipers. and some organ boundaries, which are generally nor perfectly smooth Interfaces that possess a degree of roughness, as illus- trated schematically on the right in Figure 1-20), a referred (0 as diffuse reflectors. Au echo from a di Physics of Diagnosic Uitaxound 11 Fite 18. Analogy to help remember the direction 2 bears wil be refracted An attornile raving fom "at egion (eat, sold pavement inte a “slow” region fea plowed ficld) swonld be chinged int diection 2 shown, Moving fora 3 flow to fue medium has the opponte ect. the automobile approaches the inmerace perpeniclty, no diversion occurs fuse reflector decected with a single pube-echo uans- ducer, hough perhaps weaker, is not as sensitive wo the orientation of the reflector as an echo from a smooth, specular eeflector. Evidence of specular and diffuse reflectors Diffuse and specular reflection: are most closely associated with echoes from houndaries of objects, wich a6 the dispheag The dependence of the echo signal strength o: the ultrasound wave makes with the he appreciated. ‘The sean em 2 sector transducer, wihich transmits ané receives Hom the zm and the kidney surface shown in Figure 1-21 ie 1-21 wasobrained wit location shown in the diagram. Wher the sound best fiom the transducer is nearly perpendicr torliver interfiec, a strong echo signal to the kidney « detected. This iof the display. The echo from ted from the upper margins e beam angle. ‘evident from of the kid Echoos from scattering Perhaps the moft important sources of echo signals in the body are those jarising from a process called acoustie scr ring. Acoustic| scattering is a term used for reflections from small objqcts, the size of the wavelength or smaller. The parenchyma of most organs seems to be loaded with such reflector, a8 gray scale images usually exhibit ges from the interiat of an organ (Figure 1-22). More will be said in Chapter 7 on of the echo pattern Waves thae are seattered cend to travel off in al directions, as juggested in Figure 1-22. This has bot 1d pffects. The bad effect is that echoes from ood and Specular rellecon ne direction Many svections er —— Fique V2. Companson of specular and dit ddfse reflector, waves eavel the ineriace se] an echo would not be 28 dey entation a fora specular reflector. ‘fection. For « sway fort dent on Figu 121, An jiltrasound image of deliver and kidney a taken with a Ipw receiver yain and displaying only son phases specu and difusely reflecting scattering tend to be weaker than echoes fiom reflec tions at organ boundaries. Fortunately, modern ultra sensitivity to detect and dis isto make heavy sou rs have enous play these weak echo signal tse of them in imaging and Doppler applicx good effect of havi us directions is that there is litle orientation dence of the echo signal strength. No matter what the ident ultrasound beam on a region of signals are of about, cattered waves travel of an organ, usually the scattered ec! the same amplitude. The exception to this is ifthe organ interior varies in ech another. Therefore an orgau’s interior will appearhomo~ cous on an ultrasound image. The echo signals from 25 tend to be less of the incident bean direct jentation dependence magnitude his is in cont seen for fig 172 catering by small reflectors sdrectious fiom each interface. Therefore the iacident beam, ddrecton lus litle effect on dhe strength of the deteced echo Figue 123. sume gain and the Signals resung fom scattering 4 asin Figuse 1-21, oniy now the that weaker echo display range ae ering does ne { |Ultasonic scattering gives rise to much of the diay nostic information seen in ultrasound imaging. In our earlier exam 23, much of the detail of the liver, fat pad surrounding the kidney, and kidney results from changes in the scattering from one entity to another. On an image of 2 fvirly mature fetus the lungs lungs are igure 1-24) are delineated from liver because the hyperechoic Countless other examples are generated daily in ultra sound imaging centers Charges in scatvering amplicede from one region to thanges on an ultrasound Image and therefore are useful in delineating abnormal «= hyperechoic aad hypoechoi used often in clinical imaging to describe structures on B. mode images. Hyperechoic regions result from increases in the ultrasound scattering level compated to the stir rounding tissue. Hypoechoic refers to the opposite condi tion, where the scattering level is lower than in the sur= rounding tissue fFor cxample,a liver hemangioma (Figure 1-25) is visualized because of the increased echogenicity that resulted from higher seatering of this eumor. For very sinall scatterers, echo signals depend on the following: compared to fetal liver ( another result in brigh structures, The L. The mumnber of seatterers per unit volume, 2. The acoustic impedance chan, interfaces, 3. The size of the scatterer. (Scattering usually increases ‘with increasing radius for very small scatterers) i at the scatterer Physis of Diegrodie Utvasound 19 4. The ulerasoni jreases with in frequency. (Scattering uswall sing frequency for very small The de; idence on frequeney can sometimes be used 1m ultrasound imaging. Since specular yendent buc scattering enhance reflection is frequency inde increases with fiequeney, it is often possible to scattered signals over specular echo signals by using hi ulteasonic frequencies Rayleigh scatterers. Scattering from red blood cells (Figure 1-26) gives rise to echo signals from blood for Doppler and color flow imaging applications. Red blood cells are sometimes called Rayleigh scatterers, This term is used when the dimensions of scattering objects ate much less than the ultrasonic wavelengch. (Recall, a 5 MHz ultrasound beam has a wavelength of 0.3 mm, or 300 wm, is much larger than the 8pm sized red blood cel.) Scattering from Rayleigh scatterers ink with frequency, the intensity heing proportional to fe ‘quency raised to the fourth power! This mzans that dou- bling the frequency, for example, switching from 2 to 4 MH, increates the scattered intensity by 16 times. Of tors, including the strength of scarcered waves, Sound 2eam attenuation, which also increases with fequeney (sce section on attenuation) can more than offiet the incressed echo sig- nal strength fiom blood if the vessel is a long distance from the transducer. course other fa Fue 12. Uxrasound scan showing 2 fetal thorns, abdomen, The keng appeste brighter (or more e an the liver b ue scattering level. (Courees of Diasonies Ultrasound, Milpitas CA.) fine 125, (brighter region level (Courtesy of Acuton Corporation, Mo image of the liver where a sumo visulized because ofits devated seat ntsin View, CA.14. Essetiae of Uasound Physes FiQMa 26. Seatgcing from red blood cells Although the echoes ave swcak, they spe seaponsibe for Doppler signals, Becanse red ‘ood cels are fery small compared te the wavelength, chey are called Rayleigh fatten DECIBEL NOTATION Let us digrest at this point and discuss a frly standard method for quantifying intensites, or power levels in qnedical ltraspund.’The decibel notation provides 2 com parison af twp signal leveh, such as wo amplitudes oF two itensites. t fs used primarily to express changes in these (quantities resping, for example, from attenuation, signal imphificason, signal compression to vary dynamic range lng instrumehe power contol variations Suppose hve have two echo signals, he amplitude of cone designated by 4p and of the other by Ay. f we want (0 sdeacribe the felative amplitudes of these sigaals, we simply take the ratio|of one to the other. However, using decibel, the relationship between Ay and 4 is exprested 26 follows: babe snl int eo)=20ing yy Sometimes decibels are used co compare two sigaal i Sites: for example, the ourpuc power consrol of many sean hicts is ealibpwed in decibels Ifthe power or intensity is given sather than the ampliende. tae expression for the rel- ive differetce in decibels appea's somewhat different: Refi intensity tes 8) = 10 Nog 1 7 hw | where [ refefe co an intensity Iu fact, Equation 1-11 can be shown to be equivalent to Equation 1-10.To do this we make use ofthe fat that the logarithm of 2 number raised to any power (eg. log 102) equal to that power times the logarsthm of the ssuinber alone: Jog 10 = 2 X log, 10 we use the expression for decibels employirg the inten sities (Equation 1-11): b Signal level (db) = 10 log 7 and note ffom Equation 1-5 that the intensiy is propor tional to the amplitude squared, we ean write Ay 0 og Signal evel (4B) ~ 10 tog (AE which is identical to Equation 1-10. Authors usually pre tent the decibel notation in either of these two forms. This tcxercie shows that both forms are essentially the same. “The amplitude and intensity ratios correspording to 3 raven docibel level can be caleulated fairly easly: Some examples are presented in Table 1-6. Column one in this table presents selected smmplitude racios, and column two gives the computed logarithm for tach ratio. Multiplying the logarithn of the rao by 20 ‘elds the decibel relation between the «wo arnplitudes, Shown in column three, Intensity ratios corresponding to cach amplitude and each decibel value are shown in col tum four. Here are a couple of examples where the decibel notation 16 used on ultrasound instruments. Suppose, for ‘example, that the gain of an amplifier is increased by 20 4B, (Cain is discussed in Chapter 3,) lispection of Table 16 shows that 20 dB corresponds to an amplitude ratio of 10. Therefore, a 20 4B increase is equivalent to increasing the ampligcation by 10.TThe displayed echo dynamic ange cof an imager is usually given in decibels. the dynamic range is 40 dB, the ratio of the largest to the smallest echo Signals that ate displayed without distortion is 100 (Dynamic range also 1 defined in Chapter 3.) Teofien happens that when we are comparing signal amplitudes or intensities, the ratio (Column ene oF cola fout) isa faction. This s generally the ease when consid ering effces of attenuation, discussed in the next section. The decibel notation allows us to acceunt for such changes conveniently —sienply by using the fact that if mis ny number them: rag lng Lets say the amplitude is eediteed to |/i0 its original value because of atenuation, The log "Ap is equal @ “log 10.TOEHL Amplitde and intensity catios, thei Foaridoms and their equivalent values expresied in decibels This corresponds to ~20 dl signal change. Ifthe ampli- tude is reduced to 1 its original valu, this is che same as 8-6 dB change, etc Table 1-6 is expanded in the lower rows to provide decibe! levels corresponding to fractional amplitude and intensity ratios. ‘One of the conveniences of decibel notation i that it compresses the range of numbers that must be used when large differences in amplirade or intensity ate found. This compression of the number sale should be apparent in Table 1-6. ‘The 3-4B rule Another noteworthy fact from the table: whenever the intensity changes by 3 dB, this corresponds to a doubling of the intensity. Ifthe original intensity produced at some point in the beam of a transducer is 20 mW/em?,a 3+-dB increase in the ousput of the machine results in a new: intensity of 40 mW/em?; another 3-dB increase results in an intensity of 80 mW /em2, ete, Conversely, whenever the intensity or the power decreases by 3 dB, this halves th quantity. Ifthe original intensity were 20 mW/em?, a 3 AB decrease results in an intensity of 10 mNW/em?, another 3-dB decrease halves the intensity again, this time to 5 mW em, ete A 3-dMl increase (decrease) in the intensity and the power multiplies (divides) the intensity © spowor by 2 Tn summary, decibels do not represent absolute sig~ nal levels but quantitatively describe the ratio of wo amplitudes or intensities, The decibel novation is used to express the amplification or gain of an amplifier Decihels are also used to calibrate ouput power con trols on instruntents and to express ulrasonie Physics of Diagnosis Utrasound 15 ATTENUATION OF ULTRASOUND BEAMS IN TISSUE ‘As a sound beam traverses tissue, its amplitude and inten= sity are reduced as a function of distance (Figure 1-27) The general verm for this decrease in amplitude with increasing distance caveled is attenuation, Sources of attenuation There are ewo sources of sound beara attenuntion in body susoues: (1) reflection and scatter at interfaces, and (2) sbsorption. Reflection and seater of sound a cies intenfaces can contribute (0 attemuaton. Ip some situations (ein the presence of small calcifications or stoaes) reflective lowes may contribute substantial: For lage ongins, however, reflection and scatter apparently contribute less signfi- cantlakdhough their exact contribution zo the total at uation fis not yet been determined exactly. ‘An important source of attenuation in tisiue is absorption, whereby acoustic energy is converted to hheat encryy. (Under ordinary circumstances with diagnos ‘ic ultrasound, the amount of heat prodced is too small to cause a measurable temperature change ) This means the sound energy is lose and cannot be recosered, ‘Attenuation coetficient The degree of sound beat attenuation in a ekene i vs ally given in decibels per centimeter |AB/em). This i ‘stated in Figure 1-28. Echoss from two reflectors sep- arated by 2 distance of 1 cm are shown. A sound beam seri travel twice thi distance, or 2 on, im ie back and forth journey berween the relectors. If he selectors are equal," that isi they are of equal size, hive the same ori= entation, and have the same reflection: evciicient, they would produce about che same sized echo in the abence of attenuation, However, atenuation hac eavied the echo fromm reflector 2 to be a certain dB level smaller than the echo from reflector 1. The attenuation saefieient far a ‘se, expressed in dB/em, quantifies this change sn sig sal amplitude. Typical values reported for the ultrasonic attenuation coefficients in sof dssues ae gwen Table 1-7. Mote complete compilations ate provided by Goss Joliston, and Dunn? The valves in Table 1-7 are tor 3 frequency of | MHz. At this trequency the attenuation Coefficient of waters very low: hat of organ parenchstia fg. the liver) is intermediate, and chat oF muscle is somewhat higher Much of the present information om attention in tissues is based on measurements of excived organs, Techniques are being develope. to allow mieetremenes in vivo, Results abrained weit these techniques suxgest that in vivo attenuation coeffciens may be somewhat lower than the above talues16. Esoenite of Uigatound Physics Echo Amplitude aes i fie 121. Redaddon of echoes with ecresing depth in tse dhe ro atte Fire 128. Tihg attenuation coefficient is specified in UB/cm. ‘As a rough guide, we find that for most soft cssues the attenuation copficient is near 0.3 to 1 dBi/em at 1 MEZ>> | Frequency dependence of attenuation [Attenuation jo soft tisues is highly dependent on the Slrasonic frequency. In most cats areruaion is neat proportional |e fesucncy, uacing out curs 2s shown fh Figure I-24. Thus ifthe atemuanon coefficient [or ats sue given aja Bequency of 1 Mz x doubles at 2 M2 Guinnuples ar MHz, and so on Figure 1230 prevents two imigés ofthe same region inv an adul Iherz one image is obtained using a 5-MH2 tanducer, the other using 2 3.3-MHz probe. The therened attenuation with inereng frequency results in poorer “penferation’ ing tues with the higher fe Mteney Phi fependence of ultiasone sensation on fre aeney represents one ofthe hmiotons iaposed on dig vate uae We shall see in Chaper 2 tha the bese | 10 Muscle _ fe £ Liver i 2 Blox — 1 6 6 0 Froquoncy (Mls) fique 128. Uitasound attenaation vs. frequency for several rises, Attenvation i approsimely proportional 10 equency, meaning the attenuation coefficient at 5 MH is two ses the arcemuation coefficient at 2.8 MHe, cha at 7 MHL is evo times the atrensation coelfcien® at 3.5 MHz, etc Titi 17. Ulrrasound attenuation coefficient of various spatial detail (spatial resolution) in ultrasound is obtained when imaging is dose at high ultrasound srequencies. However. it has just been pointed out that high ubrasound frequencies ae accompanied by high attemation loses. This prohibits dheie use a anything but very superficial i sue levels, The frequency range used in most scanning applications isa compromise between attensation loses in nse and spatial resolution requirements Calculating attenuation ‘To determine the amount of attenuation ocaurring when a sound beam passes chrough a given thickress of tissue, ‘simply iultiply the attenuation coefiicient (12 dB/em) by the distance traveled (em), Thus Axcenuation (a8) = acm) * een 0 where a is the attenuation coefficient and d the distance. Example: Calculate the attenuation for 2 1-Milz beam traversing 10 cm of water.figre 10 1-rode images nid += (8). Much better penetration is fn servation 3¢5 MHz Solution Attenua 2 dB/em X 10 em = 0.0 2 dB Example: Calculate the attenuation for a 1-MHz beam wversing 10 em of muscle Solution: Attenuation iB/em X 10 em = 12 48 Example: If the frequency were raised to 5 MHz, what would the attenuation in the previous example bi ficient at 5 MHz is 5 Solution: The attenuation coe times that at | MHz, so Attenuation = (1.2 dB/em) X 5 X 10 cm = 60 dB Its let as an exercise for you © use Table 1-6 to compare tude ratios for the two circumstances. The prob- requencies should by ‘considering th: lst ewo example Jem of beam penetration at higher apparent whe WAVE INTERFERENCE When waves are produced by more than one source, the interforence, The effec 3 amplituds depending may overlap) and produc point s 2 wave whose in that of either phase of the ro waves To see how this applies wave al she relative onsider the two sine wave in Figure 1-31. On th left, the waves are exactly in phase,altho: he same frequency dep taken with « Physics of Biagosts Utrasound 17 Miz suse of the higher bia transducer (A), and a 3. haa 5 ME b structive Destmctive figae 131, Addition of two sine waves of che same frequen; y: but 180 degrees ou and ph es are in phase and desmracaive safe aut of phase eft and of dhe same frequen rence o¢curs Whee tudes are sighthy different. Their net € point shown 1s just the sim of the indi s, add point by point. On the right part of che diagram the waves are com auit of phase. The positive part of the negative part of the one wave occurs exactly durin 1. This method by which w med interference. Interference m: iesinuti, depending on the relatis dual waves. Completely destructive ix ccurs on the right of Figure 1-31 Aeterences a Merriam Weber 2. Well PNT: Biomed ilmasaics, New York, 1977, Acader18. Esseatile of Utrasound Physics 3. Goss §,Johtston R, Duna F: Comprehensive compilation fof empitical ultrasonic propersis of maznmalian tssue, J ‘Aanast See Am 64423, 1978, 4, Ophir F Measurements of ultrasound atiemsation i thuman liver issue, Uric Imaging 1986 5. Robinson P, Wilton L, Kossoff G:Shadowing and ‘enhancement in ultrasonic echograms by reflection and reffaction, |) Clin Urasound 9:81, 1981 Pitti aaa 1) energy transitted by pressure waves in 2 ‘an accurate description for: A. Audiblg sound only B All eypes of sound C. Ulratotind waves only D. High-ehergy sound waves only 2, Sound wafes can (ravel though cach of the following except A Aic B Water C. Vacuur D. Steel 3, Which ofthe following propersts are commen to all sound sources? A They se Iaruer chan te waclenath 1B. They dase vibrations inthe edurn C. They produce transverse waves 1D. They annot move back and forth 4 The speed of sound depends om which one of the fllow- ing? A, Wavelfnggh 2 ren Medi D. Amplitde 5. Ina sound wave regions where the pressure is higher than moval fe cle eon 1 Rafcion B Ate comeaes Compare ieee 6, White te flings pe food wae ht et Porent thaoyh tel A Tafee wa coxph are C Shetfene D Rab wae 7.Uais fd pret Al 1 News Chad 1h Noof ot hese ite 8.The tid for one cyele of a wave i the * eat Wine duration D Phase 9, Afthe frequency is 1 MHz, he period is A 1,000,000 s B 1006 coms 1B, (.000001 « 10, Decie, enti, mill-, and micro- mean: AA. 100, 1,000, 0.1, nd 0.000401 B01, 100, 0.008, and 0.000001 .0.1,0.01, 001, and 0.00400 . 10,100, 0.001, and 0.000001 11. Which of the flowing lists correctly arranges the maveri als according to their speeds of sound, from lowes to highest? AA. Waser, disue, bone ait Bone ar, rssue, water Air. bone, water, tissue 1D. Air, water, sue bone 12, ‘The average speed of sound inst rst takes tobe: A. 1300 avs 1460 m/s 1840 m/s 430s 1. The dizance 2 wave waves during ne period of ell tion of the source ste: A. Petiod 1B Veelenseh . Speed of sound D Depth of penetration 14:TThe wavelength fora 5 MH sound wave ints about: 4.03 am B3mm 15h D. 34mm 15. the tency doubles, che wavelength A. Dowtles B Hales C. oczeaes by four ines 1, Docs not change 16. The acoustic impedance is found by smn the: A. Autesuarion by the speed of sound 1 Denis by the speed of sound . Density by the wave amplitude D. Sped of sound by dhe partite placement AF he density of Materia B is 10% renter than that of Material A, and they have equal speed of sound ani atten duaton vali, the impedance of x___tha ofA. 4. Thesame as 3, 196 Bighes than (C1086 lower than 1. 20% higher than18, 20, 25. Smells law predicts Ifthe impedance on one side of an interfice is two eimes the impedance on the oxher the amplitude reiletion coe ficienc is: At B. 0.33 con 0.083 About what percent of the incident intersiy i elected at 2 soft tssue-bone sntrface2 A. 2% orles B, Between 10% and 66% 100% B 200% About what percent of the incident inten i reflected st 2 soft tisue-sofecisuc incriice? A. 2% or less B, Between 10% and 60% C109 D. 200% |. About what percent ofthe incident inten relleced st 2 soft cisue-airinerface? A. 2% or les 1B. Berween 1006 and Gti 100% D. 200% 22. In order to produce reaction what condition(s) mus be set at an interface? A. Perpendicular incidence, diferent sound speeds 'B. Perpendicular incidence, ame sound speeds ©. Nonperpendiculariacideace, different acoustic imped 1D. Nonperpendicular incidence dtérene sound speeds F. Perpendicular incidence, different acoustic impedances A. The direction ofthe reflected bear B. The amplitude of the incident beam C. The dizection of the tranimuted beam D, The amplitude of he wansmitted bean For angles bereeen 0 degrees and 90 deguoes asthe angle increases, the sine of chat ange A. Does not change DB. Incseases C. Decreases ‘The best way ro describe the sole of uleasanie a fn diagnostic imaging si A. Gives rise mo diagnostic iaformazon 1B Is sponsible for echo eubsncement (C. Must be clinuaated to pride clesr detail 1D, Restles in greater acoustic exposure to the Icerfaces that setter ultrasonic energy are usually consid cred those that: A Are mel larger than the ultrasaud best 1B. Are mech lager than the wavelengeh C. Are the size of or smaller than the wavelength 1D. Strroond cot resue-boie inter 2. 31 33 Physics af Diagnosis Uraseand 19 One advancage 4 difise reflector provides over s'specular reflector iit ‘A, Exhibits less angular dependence of die elletion 7B. Does not attenate the wlracound bea C, Exhibita greater acoustic impedance change 1D Ineersects only a sill action ofthe bean: Decibels provide a conveaicnt way co expres the co amples or incensities, A. Sum of B, Difference beween . Product of D. Ratio of ‘Which statement is INCORRECT regaing ultrasound absorption? A. fede par of attenuation B. Sound energy is converted to heat © eincreases when the frequency increases . Ie is greater in ud eavives than in soft essue |. The sate of amtenuaion, of dhe aenautin coeiient is cexpresed int A. Wien? Baw ©. atten D. diem? If tae attenuation cosficient of «tinue s 0.5 Bem at Mile, seis probably abour __ar 3 MHz A041 dB/en BOS dBem ©.25 4B/em D. 12.35 dB/em Echo “enbncemene” results fom a structure having 2: A. Higher spced of sound than adiacene material 1B. Higher acoustical impedance than adjacent material (C. Lower atenuntion chan surrounding material, 1D. Greater absorpcion rate than surreandding rise “The artenuition of an ultrasound puke traveling 12 cm in 4 teste thot has an attention coeficiome of dB/em i AaB Bie C1248 Disab Which of dhe fllowing conslions are MINIMAL REQUUREMENTS for 4 sound wave t» be easitied 3s tlrasound? A. Frequency above 10 kHe Frequency above 20 kHz CC. Brequency above 10 kHz; intensity grester than wns? D. A frequency above 20 kz lomstisial waves E, Frequency above 20 kHz: undersater propagationoT } Chapter | Spal sion ew how cacy pitt Wo ee slag regions con be and sill be denied ay sport wflons on an image The defn and operation of the nasound tanducer is the mot. npr fir i determining the spi resolution The general tern} transducer sefess 10 any device that is, used to convert signals or energy {re another, In medi¢ine many different types of transducers are used to measure patient or laboritory data, Most of these respond to the parimeter of interest (eg., presure, electrolyte levels, or movement) by converting detected values into electrical signals, which can be applied to elec- onic Smet ‘processing and displry. Ultrasonic ‘one form to transducers corivect acoustic energy 0 electrical sgnals (igure 2-1, A) aud electrical energy to acoustic energy (Figure 2-1, B) They aze used bath as detectors and as ezansmitters of ullasonic waves, PIEZOELECTRIC TRANSDUCERS: The piezoelectric effect Transducers used in medical ultrasound employ the piezo electric eft to generate sound waves and detect echo sig nals. The piezoelectric effect was disaeted in the 1880s by Pierre and JHeques Curie. They found that when a force is applied perpendicular w the aces of a quarte énystal, an electrical charge results. This charge can be cl amplified, producing a sell electrical sg- nual (Figure 2-2}, Conversely. if an electrical signal is applied to the crystal (Figuee 2-3), she crystal vibrates, sending a sound wave into the medium. Hence the dual senon of piezoelectric transducers as detectors and trans imiters of acoustic signals ‘A number of naturally occurring materials, inchiding quarts and a subjance These were wed for tcansducess in the cary days detected a ical ultrasound. Quartz is sill found in sransducers that are ‘used for precision acoustic measurements in the labora- tory and occasionally in cansducers intended for high- power applications. However, in diagnostic ulerasaund ‘quartz has been superseded by piezceectrc ceamic tans- ducer elements.! Cera Ceramic clement, such as lead zirconate titanate (PZT), consist of mixtures of microscopic crystals ran Gomly oriented throughout che volume of the element (Figure 2-4). Mechanically these materials are somewhat bcitle and may be damaged if deopped or pounded Doring manuficruring they can be shaped into various configurations, such 35 rectangular slabs, planar dists, or concave disks. The shape can be optimized for the san- head frequency. sie, and type To be usefil for transmitving and receiving wltea- sound waves, these ceramics must first be polarized This is done by heating che material above what is called the Curie tompersture (365° C for PZT), which frees the microscopic crystal, allowing them fo move ‘A fngh voltage is then applied across the element, pro ducing partial alignment, or polarization, of the microscopic crystals, as shown in Figure 2-4. The ele~ ment i then cooled with the voltage still applied. Ie will now remain polarized and exhibit the desired piezoelectric properties The element can lose its piezoelectric propsrties (become depolarized) if it is inadvertently hexted above the Curie temperature (See section om damage iats= ucers later i this chapter) elementsPropetes of Urasound Teaeducore. 24 ~ — Hil | Electrical signal s. Electrical signe! Figut 24. A, viczoclectric tramdacer a + receiver, When 2 sound wave is incident on the transducer, it produces an ¢ ecrcal signal B, Piezoelectric transucer as 4 ratsiter When an electrical signal is applied to the transducer, it vibrate, producirg aun waves, FUe22. The pczocecrc efect:a | 1 applied to a fine? Reverse | piczoclociric smcnt producss an electrical sigeal, applied to the lett effect, an electrical sgl ssc crystal causes to HbRFAMEDA. Cartoon depiction ofa pe transducer clement before polarzaon i and afer polarization fight) Polrzstion procs pata aligseat bf the microscope crystal (The size of the crystals s catgyerted in th depiction.) Composite piezoelectric materials ‘A new type gf transducer clement, 4 “composite ound scanheads2? The composi: is a mixture of a Epoxy Ieis formed by grinding grooves into the fae of 2 standard piezpclectric element, leaving behind rods or post. The spage between the rod is then filled with Epoxy (Figure 2-5). The resulting clement lighter i ‘weight than thf original ceramic. Cerarnie-epoxy com- posites appear fo have several advantages over ordinary piezoelerric ceramics, Fin, they have a lower acoustic tmpedance thin ordinary ceramic (Table 2-1). This takes it easied co match the impedance of € ducer o that of tissue, whichis important for ecient transmission of sound waves into tissue. (See later sec- tion regarding impedance marching ) Second, transduc~ ro have very Jide frequency bandwidths: the same transducer can operate at diferent reg be Sovealled mat tc impedance. broad bandsecth trani- ade to enfi pulses that have a very shore duration. ducers now available commercially usualy have piezo- Seems corp lw theetieceramie materials ne other typeof picvoseirc mares important in medial sla}sound enginesting. Polsvinyhdene dit tide (PVE) ipa piezoelectric snsal wash thin cmemieaney sf bok ke pic won. This tert thed for constucting minis bydrophones,® which ze small ule}sound transducers for measuring the couse output of medical ulmasound equipment (see Chapter 9), Te advanrage smal transduce detector, ing the beam of diagnostic transducts,can be made fe {e Unel now aly Hinited se has been mide of PV as th actual Wansmnit-receive transduce apparedy berate ofits uboptind seustivity Thied, in many cases com= tive than standard piero- this material is that very cfu tor probing and measur Piezoelectric rads Epoxy matrix FANELE Composite piezoelectric clement, costing of grooves tar imo the fixe ofa piezclerrs element leaing ieaoelertic ms Th space benvcen the css illed wah vox (The sie of and Gieance between the rods are rch Stuller andthe rods are mone ates han in th ato00 Title. Acoustic impedances of mate’ sransducer design. Material ‘Actual valves may clfer depending on manafaceacing techniques ‘TRANSDUCER CONSTRUCTION Basic components Soine general properties of manuducer design transducer used itt pube-echo work, a single-clement, noniocuse probe. In later sections focusing rechnigues, tramslucer arrays, and transducer dest Doppler applieations will he broughe out, ‘Simgle-elemient transducers are used in some M-mode ophthalmological, and puked Doppler applications A few are shown in Figure 2-6, 4.4 sketch of a single-dement nonfocused transducer is presented in Figare 2-6, 6, The piezoelectric element for this application #s a slat erelar disk. The elemene is mounted coaxially in a eylindrizal case and the ultrasound beam travels co che right Acousnic matlanon such as fubber of cork is mecessary co :soid coupling uleeionie energy to the case, A menFine A, Single-clement tran trical shi trical noe signals by the ransducer leads. Such signal because they contribute to excessive noise on a display dur- ing echo detection. Wires that connect to a tuning coil and then to the external conneciors provide electrical contact ransducer prevents pickup of extraneous = undesirable lement and th Resonance frequency Ap which it is most efficient in conn to acoustic energy and vice v quency is determined mainly by the dhickness of the piezoelectric element. Analogous to strings on 2. gu thin elements have high resonance frequencies, and i clements have lower resonance frequencies (Figote 2-7) electric transducer has a resomance frequency at ng electrical energy fe Transducers usually are openited at or near the resonance Thus th frequency of the elem within a high-fequency trausducer must be thinner than those in low-fiequency transducers Some broadbandwidih wansducers are designed 1 be operated at more than one frequency. With these s,the ultrasound instrument itself (Figure 2-8) deter sound wave frequency emitted, The operator ion frequency by selecting a control nent. This cas duc chooses the exan rransducer for to shape the cleccrical pulse applied to # the frequency selected: the amplifies in the receiver (see Chapter 3) alto may be tuned ro this frequency Backing material Pulse-echo transduce cited by short bursts of elec Properties of Ulrasoun!Tamsdacers 73 ‘Metal shold Plastic ease Tuning col . Backing rea Piezasiectic clement sketch ofa sngle-elemvent transduce ule” of sound into the medivr quency. This sends 2 For most applications ic is desirable to produce pulses of jon. This optimizes the axial resolvis transducer may be mininized by damping icely 1s possible fol- very short dur capabilities of th The pulse dura the vibration of the transduce lowing each excitation, The backing ataerial transducers plays a major role in damping ous the srans- ducer elemene’ vibrations. Juse as when you place your hand on a bell its ringing is quickly dampened, dhe back~ ing material stops the ringing of the trnsdcer after back terial needs to have two properties. Fits amped ance must be comparable to the impedance of the piezo- -1)."This reduces reflections ar xo that any excitation, To facilitate this role, sntent, Second, it must absor waves transmitted into it, heavy. sound-abs ing material serves to damp the vibrations ¢ , resulting iat shore duration acoust into the medi electric elemen pulses transmicte Figure 2-9 illus: light and heavy damping, We will ee later that for iniag ng applications, the “best” approaches a result in shore duration puss, such as shewn here heavy dampin pubes following those that Quarter-wave impedance-matching layers hive impedance-matehing layers mn cir ability to detest ver weak echoes, Impedance-matching lay lement to soft cissue and vice versa They do.Tower froquency Fique 27. resomange frequency and thickness of the tansducer clement I | Fine 24, sautateeqecncy operation fora broadbandwich tramdacer'The — ‘ofthe beam i determined by he frequency of the Chapter 3) ako be Inspection impedance of about 20 times lee, Tuning ofthe receiver (se is select the frequency. ferbig 2-4 swe there ses ezeleere enum, och a F2T i eines she tone Taka nificant mismatch, producing a reflection coefficient of (0.82 ifan element were used in contact with the skin sur face. Thos he large acoustic impedance differonee between transducer clement and skin would result in much of the enekgy produced by the rarsducer ected bck into the element. A plac proeenve liver covered the clement in| some older srinséuccr designs, This improved che tapmisson somewhat but di not provide the best ests posi ‘Transmission of sound into soft ussue is optimized shen impedange-natching liyers are atached to the transducer clem solid PZT clem zn typical matching Liver desiga for 2 int is shown in Figure 2-10. As sbowa in the diagram, the! layer is 1/s the wavelength of the ultra- sound be: n The layer makes it “appear” to the trans | all Ng, Fige24. rote of dumping material (or the buding le) ia producing short-dution ultmeound pokes clement / ‘Matching | layers Figge 2 Design of matching layers on the fice ofa wansduces ducer thar the tissue has the same impedance as the piczoeleccrie element (hence the term impedance ratch- ing). A single quarter-wave marching layer has the fol- lowing properties 1. tts acoustic smpedance, Za, is intermediate ‘between the impedance of the transdcer element, Z, and the impedance of soit essve, Z,. (Actually Zy = VEZ, % Z,isthe appropriate vale. Bur just remember that the matching layer impedance should be heeween the impedances of the element and the essue.) ts thickness exacly equals one fourth ofthe ula sonic wavelength in the layer ese properties ate presen, there is no reflection at 2 soft cinue-trnsducer interface: hence sound transmis sion is very eliient As wll be seen later in this chapter, a pulsed rans- ducer emits not a single ultrasonic frequency bur rather 2 ipecrum of frequencies. A single quarcer-wave matching layer i exaedy one-quarter wavelength only for one fe quency Thas al frequencies in a pulsed waveform are not efficiently transmitted with a single matching layer. Transducer manafacturers overcome this problem by designing transducers with multiple matehiag layers adhered to the face of the element Multiple matchinglayers provide efficient sound transmission between the piezoelectric element and soft tissue for a range, or spec- ‘rum, of ultrasound equencies, Beeat coustic impedance of composite piezo electric elements 's closer to that of soft rseue, impedance 1 efficiently matching is said to be carried out much ith these newer elements This is one of the significant secs of composite ti Well-designed matching layers can ease the require= is mentioned above far the backing layers. Heavy damping was suid to be important for a transducer to pro- vide short-duration pulses. The backing layer does this by removing ultrasonic, vibrational energy fiom the trans ducer element. Matching lyers actually help here also, because they efficiently traninit sound energy out of the transducer as well. Unlike the backing lyyer, which muse absorb the energy removed from the clement, thereby the marching layers provide very efficient use of the ultrasonic energy; the energy transmitted out the front of the transducer contributes to the useful ultra- sound beam. Transducer engincers vary the properties of both che backing layer and the matching layers in opei~ sizing their probe designs adda ‘TRANSDUCER FREQUENCY CHARACTERISTICS The damping material in a pubed transducer is somewhat analogous to having your hand on a bell after you ring in oxder to stop the vibrations of the bell, Wichout your bell its ringing produces a long, clean tone. hand on d Fiewe 21 2 sou dampen tke ringing of s bell. for Iding your hand on ia: shows, you heat ‘lick rather than a pre re Properis of Utrasount Transducers 25 However, with your hand on it, (Figure 2-11) the sound loses its tonal qualities and you hear only 2 short, dull when the bell is rang. The sound tonal qualies, thar i, the frequencies produced by dhe bell when se is heavy dampened, are very diffrent fem tose produ ‘when it is allowed to ting steadily ‘A dampened ultrasound transducer produces short puhe (Figure 2-12, A) or burst of sound each vie i is driven electrically Analogous 10 the dampened bells sound, the resuleine sound pulse # more like an sles sonic “click” than a steady sound at a single Frequency. This means the pulse of ultrasound enerey does not contain one pure fequency, buts composed of a range, or spectrum, ef frequencies. For example, the sound pulse transmitted by a 5 MHz pulsed wansducer contains energy nat only at 5 MH, but st fequences hoth above and below the nominal fequency of the ransdicer, cov ering a fairly wide spectrsm The frequency range represented in the pulse is deseribed in terms of the frequency bandwidth of the sltasound transducer: The bandwidth may be determined by spectral analysis of the sound pulse. gre 2-12. 1 shows atypical spectral plot The spectral display represents 4 plot of the fricnon oF signal within a guven frequency interval versus the fequeney.The curve usally peaks out at the resonance fequency of the eanscucer with a rad- ual decine on either side of the maximam value. The frequency bandwidth isa measure of the spread. f the plot. Another important measure of Z = : i 5 7 Freqeeny Mie FIWE22. A, short-daraton scout: pulse produce! i tuansducer.B, Spectral amlysis of disenbuion of uleasound fea degree of spread is desri alin Ay showing in the puke, The quency Banded‘Essa of Urasound Physics 4 pulse is its du ning to its end durations. It cy quency, the shot queney bandwidth, Conversely, she longer che pube: tion, the narroy depicted in Fi Another m| rraneducer Q, ratte of the ta For a fixed cet bandwidth, the higher che echo ultssoun ation, the length of time fom its bestin- Figure 2-13 depicts thee different puke ns out that for a given resonance fre- cer the pulse duration, the wider the fre- jr quality factor. The Q is defined as the jucer center fequency tos handwidth er frequency, the wider the frequency lower the Q The narower the bandwidth, Low Q wanstucers are used in puke applications, such 2s ulzasound imaging ‘TRANSDUCERS AND SPATIAL RESOLUTION Spatial detail in ultrasound A pub of ultgasound emitted by a transducer travels through the me jum in a Well-directed beam (Figuce 2-11), Tn ultrasound imaging, echo sigals are received from reflec~ cou tevin Wears jake digit soo ‘The de ate ree ecloue ion fie aeeieer Sound pee Shor beaxs VN 3 r : i Freeney imemedite =| ted é Fone Lona BE) nanew a a 2 ri él Teich Freeney Fgura 1 Relatiqnship between seguency bandwideh and iris oon: Al Dost duties quite walinne dear ta Eo afte Ropharprick ngracet hala emcy Seed A peo gi epo™ et ofthe snd ae of ocr twa die oq, An Sesueloe beh pe hesinacomnese ees lowing emission of the pulse depends on the reflector depth Reflectors a different depths are distinguished from one another because of their diferent echo arrival tiraes. ‘To produce an image, the ultasound beam is swept actos the region to be scanned, sore of lke a searchlight scanning the night sky. as shown by the lage arrow in Figure 2-14. The image is constructed using echo arrival times to determine reflector depths and beam axi posi- tions :o determine Iateral lacatione of reflectors. This process is discussed more completely in Chapter 3. Spatial resolution or rfeior resoluion refers w@ how closely positioned two reflectors oF scattering mens can he to one another and still be identified a: separate reflec tors on an image or other display We consider initially he axial resolution and the lateral resolution, and show thac they depend on different aspects of the imaging process Later we will consider the elevational reskstion, or “shee thickness” yet another importanc measure of spatial (20 Turion. In each case the design and operacion ofthe ul sound transducer are the most importane factors in deter= ‘mining the spatial resolution. Choice of ultrasound frequency Spatial resolution is closely rebated ta the ulrasound fre jqueney; it improves as the frequency is increased. On che other hand, sound beam attenuation ako increases when, Figs 214, Echo dita acquisition during production of «1 ultrasound image. pule of wlraound fom a grande traves in a welledefined beam and echoes ate tecened fous its path, During ioaging, ee sound beam i swept (hig arwi) across the region being imaged. Echces appear isdlorson the display’ his micthod of wleasound ine generation followed wath all eurremt realtime although the examyle specifically rave scanned beanthe frequency is increased, so beam penetratios decreases. The choice of ultrasound frequency for ‘examination is the result of compromise between reso lution requirements (where higher frequencies ane better and the ability w obtain sxisfactory sound beam pene tration (where lower frequencies are better) to image all the tissues of interes. Axial resolution Axial resolution reiers io tie mms reflector spas clog the xe of a aasuen oud bra tat arate, ditingushable echoes on the display. This ills trated in Figure 2-15. The ep two reflectors can be cis- tinguished on the display. However, ecies from the bot- tom two merge together chese selectors are too closcly spaced to be resolves. They ate closer than the aia reso Jusion bits of dhe seater. Anil resolution deterained by the pulte duration, that 1s the duration of the ullsaonie pubes ransmittes into che medism by the «ausducer. The pulse duration. ilasrated in I issimply the time required tor the transducer “ringing” w decrease to a negligible following each excitation. I s equal co che numer of cycles im the pube muliplied by the wlerasonnd wave period, that is, the amount of tinte for exch eyele This is expressed a: results in sep PD=N XT ray 2 Direction ofsean Properties of Ulrasoun! Transducers 27 where N, is the number of eycles and T is the wave period. The period in ps is equal to 1 over the frequency wwhen expressed in MHz, Therefore, we can also write: i) ae PD = Taig schere fis the frequency in MHz ‘Asan example, if N, 63 eyeles. 26 in Figure 2-16. and ifthe fequency is 3 MIlz, the pube dusatian is | ps. On. the other hand, ifthe frequency 7.3 MHz, dhe pube dhuration is 04 ps for a S-eyele pube. Generally higher fiequencies result in shorter puke durations than lower frequencies If the time-gap between when echo signals atrive fom two reflectors at ifevent positions along the beam, axis is greater than the puike duration, the so echoes ate distinguished ow dhe display. Figure 2-17 illustrates this The top panel depicss echo pulse: om the rwo elec tors (dark circles) approaching the stansducer. The length fof each echo pulse (soimetimes called the spatial pule length) is deteresined by the pulse duration, For his sca ation the two echo pulses are spaced far erough apart so they will arrive separately and be resolved, The middle panel represents a situation where the reflectors are mare’ losely spaced, With the same pulse duraton as for the sop panel, these echo pulkes everiip snd she reflectors cannot be resolved. However, if the pulse duration is somaller (lower panel) echo pulses even for this reflector spacing can be distinguished. Whatever the manufacturer cin do wo reduce the pulse duration leads to an improvement in the axial reso lucion. For a given transducer feequenes, shore pulses are dobgained by rapidly damping the “ringing” of che trans- chcer after ie 8 excited. making \ che musnber oF cycles in the pulse, small. This ss lustrsred in Figure 2-18. The asta resolution for 1 -cyele puke » better thas ‘cycle puke of the sime frequer Figue 218. Mhassation of axial esstcion, Axl resoluson i the imum listnce between two reflectors positioned of an uleasoatl bean thr allows both reecrrs to bbe wsalized as separate objects The two bottom refccton not resolved on the image Time fiMe21E Poise duration. PD-The p fio gual th amber f eysies tke pulse (chr 2 se foreach ovele Tis the78 Essontiats of Utrpsound Physics a a oe i+ oo a ee HEE fiowe 200. Asi seprevents echo pues arriving from ts Jotution and puke durstin. Each pane The length of each echo pulse depends on the pulse duration. In the top panel the echo pulses are well separated; how in the middle pang! the two reflecon are cloely positioned and the echo pulsts overlap. Ifa shorter pale duration is used (botton: pare), eveh dis closer spacing between reflectors ca be resolved Excellent damping — shor pulse ess damping — long pulse figst 218 Datoping and pabe ductoa. Dan the duration bi the pu, proving the axial re Af\n Low frequency patse High frequency pulse Fine212. Frequency and puke durtion. Inve frequency lads to shorts p axial esaton Because the pul sely proportional 10 the frequency, inereasing the lerssound frequency fe duration is inv shortens the pulse duration, as demonstrated in Figure 2-19. This also improves the axial resolution The easily demonstrated in 2 test phantom, Figur iflustrates a target acrangemen’ nce of axial resolution on frequency is 20, A 20mm 1.0mm Figie222 A, Reflecors in 2 tes object for stdying axl slution. By Image using 2 33 ME transducer. C, Image 7.0-MHe transPrPrrerrr) 22779 toms for estimating resolution. Figure 2-20, B shows an ulasound image of ths group of targets scanned using a 3.5-MHe transducer, while Figure 2-20, Cis for a 7.0- Miz probe. The improved clarity with the 7.0-MHz transducer is evident The best axial resolution is obtained with a short duration pulsc. However, we abo have learned that the shorter the pulse duration, he wider the frequency band= width of the pulse. Therefore, we can summarize a rela= tionship between pulse dunition, axial resolution, and fre~ quency bandwidth as follows: Pulse Axial Frequency: duration resolution bandwidth Loug Poorer Narrow Short Bere Wide Lateral resolution Lateral resolution refers to the ability to distinguish two closely spaced reflectors that are positioned perpendicular to the axis of che ultrasound beam. Lateral resolution #8 most closely related to the mansduicer heam wid ‘The relationship between lateral resolution and beam. wich i illustrated in Figure 2-2 Three small reflectors are being imaged. Each traces out a line on the display length of the line equals the widkh of the ultrasound & of lateral resolution and its fon bears wide, Laera soto refer to how clonels povitioned two rellectors can be perpendiculae to the bean axis and be seen as sepurate objects of an ukrasound snipe Echoes ffom redectors | and 2 blend togster andthe reflectors are nn resolved, Refectors 2 and 3 are reslved Properties ef UtrasouréTansdecers 23 Wthe reflectors are far enough apart that is they are sep arated more laterally than the beam width, then they ane resolved on the display. This isthe case for the two reflec toss on the right. On the other hand, the two reflectors on the left are closer than the beam with; ther images merge together om the display and the relectors ae not resolved. TRANSDUCER BEAM CHARACTERISTICS Beam directivity We savin the previous section that the beam width affects the lateral resolution in an ultrasound image. ln this section swe will examine the sound beam pattern for single-clo- ment, unfocused ransducers and study how the width of the beam at different depehs depends on the frequency and diameter of the ultasound transducer. Single-clement, unfocused transducers were used in many early scanners, though they are scidom used foxy. Hawever, the general properties of ulerasound beams studied in this section sec the sage for understanding beams from focused transduc~ cexsand beams from trnsiiicer arrays, discrse later ‘Many sources of audible sound appear as “point sources”; the sound energy emitted raciates onward in all directions (Figure 2-22) Bells, louckpeakers, the ringer in «telephone, and human voices all have this character. An ultrasound beam produced by a medical transducer, on the other hand, is very dimenional. With a single-element transducer, for example, most ofthe acoustic energy in the Jheam is confined to a region close to che ransducer axis, as suggested in the diagram in Figure 2-21, in the search Fite222 Audie source of sound sound waves spread cut in all sx You cin bear the wound30 Escentine of Uteasound Physice light analogy mentioned earlier and in Figure 2-14.This is fortunate because it jllows ultrasound images to be built tup by sweeping the Hear across the region to be damaged. Huygen wavelets _Engineers and physicists somerimes describe an nkrasound beam by conceptually dividing the transchicer face into a lange collection of point sources (Figure 2-23).A diverg- ing wave emanates ffm each source. The strength of the beam at any position in the eransdocer feld is found by. mathematically adding together the coneributions from each point source oft the transducer suiface. The point sources are referred tp as Hinge souncs, and the individ tal Gieplig week Hee ear ‘Near the end of Ghaprer 1 the phenomenon of interfer- ence of waves produged by wo diferent sources was dis ‘cused. It was mentioned that whenever ewo waves of the same frequency are i phase when they reach a spor, the amplitude a thae spot the sum of the indvual wave ampi= tudes IFthe saves ard ove of phe, desrsenve terrence ‘occurs, with the signals partlly or totally canceling each ‘other, depending on their relative amplitudes and phases, Interference among waves from different points on the surfice of the tansdi(cer plays a major role in shaping the resultant beam. In sone locations die fed varies siguili- ‘anti ffom one point to another; in over arcas, the beam is smooth and well bghaved. The point-to-point variations the field are most important in che mear field, that i, up close to the transducer, whereas the far-field beam is smoother and herter| behaved. These regions of a sound ‘beam ate discussed in|more detail in the next section, Near field versus far field The skeech in Figure 2-24 illustrates evo zones in the beam of a single-eldment, unfocused ulrasound trans fig 22. Conceptual pethod wed Kr caleulaing the properties of beam fhm a temducer Accord fe Bagger priocigle dv heam sear local se eld can be eaculsted by adling up sweets fom point sources Adiscributed al acros the tanscucer surface, Only thee of these soces are Ince inthe ducer. The near field is also ealled the Fresnel zone Ut is characterized by fluctuations im the amplitude and inten sity fiom one point in the beam to another. (The facta ations are represented im the figure by che wavy lines ia the near fied) The beam remains well collimated in the field, oven narrowing down 2 bit for asial pois approaching the NFL, the nearefild length The region of the beam beyond the near field of a single-element transducer is called the far-field, or Frawthofer, zone. Here the beam is smooth, as indicated by the smooth lines im the Figure. The beam in the far field ako diverges. Divergence is depicted here by the gradu! ‘widening of the beam with ineteasing distance from the wansducer. The length of the near field (NFL) depends om the diameter of the transcicer element. d, and on Avthe ultrz- sound wavelength, The NEL is NFL. a ro Thus if you have two transducers of the sante frequency bus diferent diameters, the larger diameter one will have longer near-field length. Ifyou have two cansducers of the same diameter but different frequencies. the higher fieguency cansduver, with its shorter watelength, will have a longer near-field length Ultrasound beam characterization is important to the equipment design engineer. One test these individuals do fequently is to probe the ultrasound beam with a reflec- tor and evaluate the distribution of energy in the hea Experimentally the process is fairly straightforward «tiny reflector attached to a translation device is positioned a given distance from the transducer, as n Figure 2 Starting outside the confines of the beam, the reflec: slowly wanslated perpendicular to the ultsound be: axis. At different positions che transduce: cansmits a sound puke, an echo signal from the relecto~ is receivee and a measure is obtained of the echo amplitde From this reflector The experiment is often dove with che reflector coy Fie 221 Beam pater tom a inglenclenent ducer The reat Held ao cles the Fe 1 field sa tue 38 the Fur = near fel enh NEL i theFigMe 228. Method used by rranscicer manufacturers to study the field of transducer. small eestor tcnlated perpendicular to the beam axis, andthe srength of an echo finn he el tori measured: This wally is dose be vaious axial diseaice, You might expect the echo from the reflector to be strongest when the reflector i directly on the axis of the ‘eam, Surprisingly this isnot aways the case, particularly in the near field! Figure 2-26 illasrates ths, Fach ofthe graphs results from one of the redecior passes through the beam ‘The point 0on each graph represents the center ofthe bean and the transducer axis. The fit plot within dhe near fd exhibits minima and masima for different postions of the refcctor.This isa manifesarion of the roughnes of the beam ‘within the near field. Ar distances approaching the NFL, the bboam becomes narrower and smoother Here the echo from the reflector is songest when it iin the center of dhe bear and gradually gets weaker ani weaker as the reflector is ‘moved further and further off axis. For an unfocused tans- ducer the best spatial deta, chat i, che narrowest bean fobrained in the region corresponding to the NFL. Beam profiles obtained in the tar field also exhibit smooth curves, as illustrated in Figure 2-26, However, the central peak gets weaker as you look further along the transducer beam axis. The beam aso civerges with inereas- ing distance from the trinsducer, shown by the profile widening ou le, shown by the angle # ‘sen the wavelength and rane ir) where Ais the wavelength and d tie diameter of the trans- ducer, Thus the divergence aagle is leas severe gt higher frequencies, where the wavelength is sinaller. Abo the divergence angi hex large diameter transducers are used rather than sina) diauieter probes Prapories of UlrasoundTransducers 31 Echo amplitude FUMIE, Series of bese plots aisied at sever! depuis using the method outhined sn Figure 2-25, Each graph depicts the ao ample fom the reletor vers thr ditance th reflec fom the beam ais The narrowest ple occur at the NFL. (The gray-shaded regions depict tae projection af ‘he ulratound beamn a the dep ofthe plor) hin’ Sing =12Wavelength @.) ‘Diameter Fique 227. Far Geld divergence of beam, The divergence angle, #, depends on exe wavelength. A and the diameter of the trance a wnocesct transducer Dependencies on transducer frequency end size We will illustrate important properties af the manséucer beam parameters with some examples Example: What is the near feld Jeng “or 9 275 MHz 13+ Solution: You are given the diameter a transducer radius. You need to know the before computing the NFL, Frost Chapter |, Equasion diamoter unfocused transduce hhene2 Essentials of Utratound 5 where ¢ is the speed of sound and f the frequency Firs, find 1540 m/s 225 x 1 ere 68x Wem 0.68 mam, ‘Then, fiom Equation 2-3, a 4a U3 mami? 4X06 NEL = = 62mm 62m The near feld for this transducer extends out to» dis tance of 6.2 om. Now consider a similar sitzation, in which the uleasoue freguency is greater Example: What is the near feld length for « 5-MH2 13mm ciameter uansducer? Solution: Fist, compute the wavelet, 1540 m/s 50 X 106 eA 3X 104m = 0.3 mm ‘Again, from Equation 2 np <3) 4x03 mm = 140mm = sem From these rw examples we sce dt for transducers, of the same size, the NEL increases with increasing fre~ quency Equation 2-4 dbove illustrates that the divergence angle also depends pr the transducer frequency. The sine of the divergence dugle is inversely preportional ro the frequency. Since the sine of an angle increases with increasing angle Gf the angle is beaween 0 and 90 degrees), as frequency increases, che divergence angle decreases. Phas for a gives 1, ‘The NFL intreases with increasing frequency. 2. Beam divergence is les for higher quencies The dependence of these two beam characteristics on transducer frequency i illustrated in Figure 2-28, Perhaps it is counterintuitive that the near feld length should extend further for higher freqnencies, luecause higher frequencies do not penetrate into tsste a: seulily a Tower frequencies. Is there an error somewhere in our chought process? Actually these discussions on ‘beam patterns only account for dependences ofthe beam fon the size of the transducer and on the wavelength, which depends on the frequency. They illustrate that one would like to use as high a frequency as posible in any examination because of the better beam definition at higher frequencies. They vividly point out why abdom:- nal ultrasound examinations are done using 3.5 Miz rather than, sy, 100 kHz, because beams from 130-LHz tramducers would be very divergent if these trarsducers were of the standant sizes with which we are acqnainied. Nevertheless, the basic discussions on single-element, nonfocused beams do not take attenuation into account, in the real world, attenuation ultimately limits the ire quency at which the design engineer—as well as the ultasonographer—can expect to conduct an ultrasound examination, The near field length also increases with increasing, transducer size, This is seen very readily upon inspecnon of Equation 2-3 above. Since NFL is proportional to the square of the diamerer, doubling the tansducer diameter ‘quadruples the NFL. The divergence angle in the far field, fon che other hand, decreases with increasing transducer diameter, as shown in Equation 2-4. The dependence on transducer diameter may be summarized ss follows |. Fora given frequency the NEL extends farther for anger diameter transcucers. 2. Fora given frequency, beam divergence in the far field decreases with increasing eransducer size. ‘This behavior is illestrated it Figure 2-29, The beam patterns shown in Figures 2-28 and 2.29 ive some hints about how the lateral resolution behaves ‘with frequency and transducer size, The smaller diver- gence angle with higher frequencies indicates chat eral ‘solution is generally improved if higher frequencies ste used. Also, at large distances from the transducer (Figite 2-29) a larger-diameter cransducer results int better lateal resolution than does a smallersdiameter «ransducer. Side lobes A side lobe is energy in the f field or focal region of a: ultrasound transducer that is not part of the main Sean lus the beam sketch in Figure 2-24 side lobes are shoxsn tm the far field. If they are strong, side lobes degrade Li etal resolution,| | | A standard simgle-clement transducer producing con- ‘inuous sound has side lobes that are about 14% of the nitin beam. Side lobes of this sength are nat good iit most ultrasound studies because hey significantly degrade revolution. Fortunately side lobes are suppressed signif. cantly below this level. One tesson they are suppressed is that we use pulsed transducers rather than continuous wave ones. When a transducer is pulsed rather than oper= ated continuously, side lobes for different frequencies sn the pak ram appesrat diferent angles: they literally smear one another our. nestly eliminating dem, Thus der normal eirewnstances they are probably iniconse~ qpential fo the image. In applications where additional side lobe reduction is desirable, the manufacurcr can choose to epply apodization. This is x ¢roaes whereby the strength of the signal applied to che mnsducer face 1s noe umifori over the whole surface of -he pieznelectric element, but is made to got progressively weaker ffom the center of che ounward. With single-elemene tansdacers special des) make this possible, Wat! transducer arrays, any neces sie lobe reduction through Low frequency High frequency NL length snd 2 uiven dia ejusncies have reat field lengths, bur soles divergence ang ins with longer wi figue 2. si henge and © Fora fixed trequems b slluscraty the dependence ofthe nese tel? x The tana oreliameer Juuneter wansducer exlbye bem that has 2 Tonge nes eid length an los dvengens Prapenies of Ultesound Transducers 33 apodization can be done quite readily daring the bean forming proces FOCUSED TRANSDUCERS Having established a basis for how an ulkrasound lbeem is affected by frequency and transducer diameter, we sow tur our attention to transducer ¢ asonographers. The sment, focused transducers. These are vsed in raphy applications: in addon, many mechanically scanned transducers contain o} moze single-clement. focused transduce. yent transducers are fozused by at lanar piezoelectric nent that is curved. Both ech ns wed Ore ist to be considered are sing Tens attached © a fo by using an are ilustrated in Figur ‘maze common approach, Focusing has the eifet of narowing the be sod increasing dhe amy over fins! axial range in comparison to an equ fone with the same fiequency and diaaecer) tt Figure 2-31).The foeal distance 10, The curved element isthe ide of echoes from re od teansdice . Backing \ “Lens material Piezoolecric clement Backing Piezoelectric material element fied 240 Focusing for sgle-cloment eraoscticns The f:agran illestates sft disk eleuseut wih an Unlocused NA. MUP. thaw potter fn sngle-ebecac docene iuver The be is mageowese a the foci cia. lace reoletion 8 oF reflectors that ate the tha. =e‘M4 Essentials of Ultrasound Physios sponds to the plane where che beam width is narrowest The focal zone correspon to tke region over which the width of the eam +s less thas wu times the width at the focal ditance. Obviously the lire resolution is best for reflectors that fall within che focal zone of the transducer if isthe diameter of che transducer and F the focal ice, the beam width ar the focal distance can be dist approximated as at) Game diameter, sate er frequency transdue~ ers have narrower Beams in the teal region than lower frequency probest (Fig » With a single-clement, focused transducer the focal tance is fixed during the minafacturing process. refore in a chinical situation a transducer’ frequency and dimensions should be chosen to optimize the resol tion over the region of interest. In the next section we will see dhat transducer arrays ca provide much more Aesibility in focusing characteristics of transducers ‘TRANSDUCER ARRAYS General properties of arrays iy most of today’s ultrasound imeruments, transducer arrays are used rather that single-element transducers. An array transducer assembly consias of 2 group of closely spaced piezoelectric elements, each with ity own electri cal connection to the wleasound irstrument. This enables elements to be excited individually of in groups to pro- duce ultrasound beams; echo signas detected by indivi tual elements are amplified separately before being com bined into one signal for cacts retlctor. Types of arrays Four types of arrays are chown in Figures 2-33 0 2-36 Linear and curvilinear (or cans airs consist af groups ow requency High roquency FMR BAL eece ot Requeney cna tocwedl beam pater Higher frenmency transducers prontice aanmver bean in the focal region than lower fiequeney pre of the sane dusnetor anal eu of rectangularly shaped piezoelectric elements arranged by side as show in the figures. An entive aay right consist of 120 10 250 or more separate clements Individual sound beams are produced by actvating aroups of 83, 20 or more of these elements to. produce a puke and collect echo signals ftom along the beam line. The puke travels along a beam line that is perpendicular co dhe face of the array. Consequently, the linear array produces 4 rectangular imaged field, while the curved array pro- duces a trapezond-shapesl image field. Modern phased array transducers typically have 128 separate elements. However, the phased ar sovaller than the linear and curved arrays, so thy ae marrower (am in those arrays. Individual sound pulses are produced by activating all elements in the art. The puke caves along a beam line that ean “ ferent directions using time-delay methods disrussed in Chapter 3, Annular arrays consist of a circular target and bulls e9¢ arrangement of elements, shown in Figure 2-36 Sound pulses travel along a beam line tha is persed Fame 23 Linear ary, with a atasourl pe smeraing along one beam kine HRUEZ. Cort reing long 1 ce, with aeeon plseFigue 28. Phased sexy, i ‘taveling off at an ana ltesourel pulse lar to the surface of the amay. The Beam line is swepe mechanically across the reginn to be imaged by manslat ing the array using an arrangement such as that shown in che Bgure. Advantages of arrays Arrays provide (wo advantage: 1. They enable electroric beam steering; beams are swept across the imaged field with no mechanical twotion of parts in the seanhead. (iis apples only to linear, curved, and phased arrays.) » They enable electronic focusing and beam form ing, providing very elective contol of the focal distance and the beam wideh throughout the imaged field (This applies to al four array types linear, curved, phased, and annular). Beam formation with an array [A sound beam is produced by a transducer array by apply ing electrical signals to eack element swed ro far beam With hnnear and eurvimear arrays 4 is involved for each beam: with secta ts usually cchoes far every beam, The the and anni are activated for teansnmittng sound beam is the sum of individual beams from each ot the el ens are quite small, often less than a half wavelemyeh, che eansmite pattern fiom a single element by ite ad anc not very useful (Figure 2-37), However, when 2 group of aneously, she cansmitced pat- nts, Since the individual ele: Propenios of Unesouré Wansiucors. 35 \ \ Four 236. Anular array one another along the common besm direction and cancel one another in other direct iding a well-defined, narrow ultrasound beans (Fig 7). Furthermore, this beam may be focused by maniy- uulaion of individual signals applied to different elesicuts Transmit focus When all clements is am array ¢ at the same time, the effec is analogous to the situatist in which a planar, unfocused transducer lenient is puises! The resticane beam is directional bu: untocused. Electronic focusing i achieved by introdicin im the applicarion af the excitation pulses wo the sepucace clements (Fagure 2-39). In this cave the wavetro ing tom: the transducer converge coward th are excited precisely delays tion, producing & narrow sound hea ever che cal region. With the time delays in action, the situssi0® + as though a focusing lens or 3 curved prese prodici Unlike the focal distance of 4 simgle-siement tans ducer, the focal distance of an array aay be ss ronicallysby changing the electronic delay arrays allows the selection of the transmit facal distence by the operator. When you vary the focus anstrument, you are actually changing the posi ‘ranamit oral cistance, moving it closer to or ft laces. Usally some wpe of focus indice placed on the cisplay to help the operator wo knose Wete the beam, fpr 44 Comparson of wpicl 2 Simensions, for a phase ar a With th ar attay, lection & 0 ae Leu thea thickness ditecion aswell sin the mage plane. Only the ane beara eth i afte by ne tort nla depth of 5 em consi factor that limite thei di th this eansducer: beyond a dope of 12cm suramatizes the analogy mentioned earlier. Table focusing and beam steering methods for variows ‘Two-dimensional (or 1'/2-SD) linear, curvilinear, and phased arrays Some transducer manufacturers are developin cher apy gach to fixing © slice chickn| ray. These consist of a two-dimensional matrix of e ments (Figure 2-50), rather thas: che single row of ele ments in standard (one-dintensanal) arcays. With a two-dimensional array, eleczronic focusing method > enhance resolution within the scanning plane 1 one-dimensional array > done li sy direction. There r c lly referred #9 as "1 1/2-1)” rather cha c onal array cechnelogy becius: the number of ch ments in the slevational d) say five oF seve meh less thes the sims ster! direction 100 to 200) include doing three-- and eflector depth. D. Ie inte prose-ccho imaging wnstriamens Thedlsance ffom the transducer t a redector is anferred from the echo rearn cine, esing knowledge of the speed of sound in soft tisue. Exeope or special instruments sed it ophthalmology? a speed of sound of 1540 m/s is always assumed PULSING CHARACTERISTICS AND DUTY FACTOR Ie is important co realize that when an ultrasound machine operates in a pulse-echo mode, the transducer transmits sound waves for only a stall fi ‘ume an examination is taking place. When the eransducer is applied to the patient, most of the time is spent “listen ing” for echoes that result fom reflections of the sound saves by the tise, ition oF the teal Echo ve Time = Retiector distance fig), The range equation in media wkraound The come delay Beewoen taney ple into the tasue and receiving sn echo signal fon reflector. indicts the reletorto-t Pulse-CeheUlvasound Instrumentation 47 The tsetion of time the tansducer actively transmits sounds called the duty factor. In uluasoued imaging and c-echo applications the duty factor is typically less ). Figure 3-? helps illustane ths mare clearly Shown are waveforms that correspond to (wo succesive ultrsound pulses emitted by a transducer. Pulsing parame tery illustrated are the puke duration, PD, and che pulse repetition pesiod, PP. Nove the puke duration isthe time fom nning of pulse to the end of ¢he snipe. The pulbe sepetition period, om the other hand, isthe time fiom the fagonning ofa poke to the begining of the nest one pulse duration usually is less than | gs wo ascal resolution, as discussed in Chapter 2. Pulse repetition periods, however, are much greater than this, Thus the time berween pulses, when the tamsducer is is {br echoes. is much greater than che duration of an indivicual rans pulse, and so the ducy factor :s small nn two, gives approximate ‘alues for the pulse-repetiion frequency, that i pulses emitted per second, for various operating modes. Column for presents ballpark values fer the dury factor. Exact saltes for both parameters are guite variable, and sicpend on the instrument and operator setcings. but the table helps illustrate eypieal conditions the number of Title}. Pulse-ccho travel time for various relector distances in soft rssue (speed of sound = 1340 1 Palse- acho travel tin Distance to reflector Time ——— i Fiore 32 ‘the da actor ow son period hin charters fr an ultrasound eats wnt pales. The pals luration (PD) are shown. Boeause the pile dition, PT ta pulberceo spsien Th PP) and the ps samc shartse than the ube pecan pote“8 Cenontas of Utrasound Physics Tie}? typical pulke-repetition frequencies (PRLF), ple repetition periods (PP), and uty fictors in ulssourd Made of operation PRE PP uty Factor (assume 1 pos PO) INSTRUMENTATION Today’ ultewound iniager i» vory sophisticated medical device, often supporting a number of diferent transduce evices (Figure ).A simplified block diagram shenving principal cam. ponents of an ultrasound scanning instrument is pre- ented in Figure 3-4, Identified are a pue transmitter, a receiver, a scan converter, and various methods for playing and recording images. The sole of each of these components is discussed in the nex! few pages, Modern ces, operating modes, and image display systems that use array transducers also have a separate component called a beam former, ased to provide beam steering and electronic focus: Beam former The role of the beam former is best understood by con sidering the material on array transducers in. Chapter 2. ‘We mentioned that array transducers can be focused elec tronically at different depths. The beam former provides the pulse-delay sequences applied to individual elements to achieve ur focusing. It also controls dynamic focusing of the received echoes and controls the beam ircction for electronically scanned arrass The receive focus and the scanning part of 2 beam former traditionally have been an analog devive (see dis cussion later on analog vs. digital systems), operating om echo signal waveforms trom cach clement and combining these into a single signal for later stages of processing, In wut serves both at the ug tbe sigpialy from all clemients 0 Figure 3-5, 4, the analog delay source of time delays for focusin nals and ad ened echo sig- ndace a sing echo signal for each reflector. Technica) documents refer for exampl fanction.? The ¢ instrament, and eventually i vert the signal inco a digital formar for iige Chapter 4) There #5 a gro equipment manufac formers (igure 3-5. 1) in cccho signals converting each signal to sequences ot Suansningg dey Kins” so carry ome this 10 signal is sont om to laser stages of the tendency aniong ultusound digital beam. 5 Idividval firse digitized, Hite 34. A ssodera wlirasownd scanner (Coury of Siemens Digical electronic components chen introduce che éehys necessary for focusing and orher beamforming fanctons and fimally combine the digitized signah from al. elewients into one signal. This signal goes on tw form the im The advantages of digital beant foriers ineluds sheir sebiliry: their programmability a very wide range of signal frequencies; that is. the their acveptancs of a broadband The programmability feature espedi new trinsducer types and new beam-fortning functions as they ire developed. When a cl the seer probs. The juenicy range mean thar Sica sw broadband perey sand computer programs lape the digital beam: former to the ne peance of a wide th nded i beamn formers can take I advantage 0! transducers. with the short-pulse, wie width of which these ansducers are eapele Disadvantages of digital bea have included the complesiey of producing a bears for control hile formers in dhe pastPrlso-Foko Uivasound Isrumentation «9 Beomturmer] | ecdier nes ment ston |—] ant rocas Trani Ut. simples ioc digran hgilighing principal components ofan uleasound image Delay Pro- controler; Elemants amps rot ins aie Pree Digital de Flements amps Digitizers weighing” figie 35. A, Anaiog beam former. The echo signal remaiss in analo, ws Lo Lom kf) t Digits) ‘ mat when time delays for fcusng ae applied and somation of sigals from individual channel iy done. B, Digial beam former Time delay and surnmation are one om eho signals after they ae digitized accepting and procesing a sulficienr ringe of echo signal amplitudes, however, this disadvantsge is gradually ditiin— ishing as technical advancements continue and more experience is obtained with the digital varity. We likely scruments unlizine digital beam formers Pulse transmitter The function of the pulse « vide electrical signals for ducer. In response £0 eaclh signal iF pl he pero! rans vibrates, producing an ulcasound pule that revels through th sue. The pulsing signals are protides at 2 rate called ¢ pulse-repetition frequency (PRF). The PRE varies with operating made and other semogs on the machine; typical conditions are indicates! in Table 3-2 abowe second columa of Some instruments provide control of the output power to vary the semitivity of the scanner (Figure 3-6), Sensitivity refers to the weakest echo signals chat the inszrument is capable of detecting and di slaying. By increai y ultrasound pulses crav unto the tisuc, This rests in. larges-amnpl nals from all reflectors, and allows echoes irom weaker reilectors to be visualized on the ‘Thus when the transmit power is ner od (Figure 3.6) L. The amplitude of the eleesrical sign applied to the tramducer increases 2. The tainducer produc higher inceusiey sound 53. Echo signals om serucrures chroughaut the tied have higher Fin nplitudes rnd 3.8) appear brighter‘0 Essentials of Urasound Physice ~ | ania I> 0 ee | 2 =) b'0 a FUE. Fancsion ofthe oxtp power como Incoming he per power mrss the ampiide ofthe mans puke in the buer dggn), increasing the amplitudes of all sho signals. Tis results in weaker echoes being picked up, Tignt37, 2-1 uiersonnd image of the Her chesined usig a reliively low-outpur poser setting. (Oh tie sataner th anit level is inca by both the spatial peak sie average intensity [STA] and the psechanics inex [Ml] in the upper leticNand corner. Hete che MI is 2, Under it, the acoustical energy produced by the can in terns of a mechanical index (Ml) and thermal index (TH), These terms are discused in more decal iy Chapter 9. The instrumene used for oben 3-7 and 3-8 employs the MI label. sehich can b een on the top lett side of these image Receiver, Foho signals detected by the erinsduicer ase applied to th ae peocessed fo involves ech and compensation for at display The fist signal ampliiation Signal amplification is necessary since dhe amp of ecko signals ar the transéucer are generilly to0 bw to allow sisualization on a display: The degree of ampiitca the gain of the receiver, The gain is the cate Jn may be expresied as a sample FigreBE Sean of the same rion asin F higher mans porser, When the pews ff grexer miagimade and appear brighter throushot the imaged field. The transmut level is indicted by che SPTA value nd the MI sake inthe rp Tet of dhe i * Nf\p- Amplifier >> Goin = Aw Fine 34. tacit ofthe gain ofan amples Th “yratio Gay 100), More commonly itis expressed in deci bels For example,a gain of 40 dB is the same as an ampli fcxtion rio of | ‘The preamplifier. Most instruments carry cut the amplift cation in different stages. The frst eparately as a preamplifier the pre close to the transducer as practical, Ie hooss weak echo signals so they are laege enough t0 be amplified by ch lo has special circuit components tha high wansducer (Figure 3-10). One pr ‘main amplifies. I prowet the amplifier trom de applied tw vwith all ampliiers is chat besides amplifying the desired Js, they alse generate low-level, spucious electrical called noise: The preamplifier must generate a lic- wossible because later amplification stages in amplify the noite at well as the echo sigmals Gain adjustments, All instium: jectease the sensitivity of the instrument. Operator adjustable gain controls usually are in two parts: an over all gain control and Ti Overall gain control. Tis is « single gain control ineseases amplification at all depths. [eis towne! on mos but not all, struments operating in pulse-echo mode all gain can have a similar eff ne transmit power: echo signals om through Id are increased in amplitude, and age appears brighter (Figure 3-11). However, it ix importane to keep in mind thar changing i simply changes the amount of amphtication of echo sig. nals det ns transmit pov cout the ro by the transducer and, therefore, fo the wansducer, Incteasing the teansmit power receiver amplification does not! ‘Overall gain she | Preamptitier Pulse-Eeho UtresoundIsoumentton 51 we confused with compression or dynamic range control which may appear to have a similar effzct. Compression is discussed later Swept gaia, or TGC. &: rurning co the trans tucer from steuctures situated at Large distances fom thy ransducer genetally are weaker thar. ecaoes retursing rures, This is # result of sound bea all utrenuuation in the medium. The situa © 3-12. Ifthe reflec th ame. al weakening of the echo signals with increasing reflector distance results (om ateauation Sound beant attenuation is compensated for using swept gain (also called TGC. for time gain compensa tion, and Di sai compensation) in th receiver (bottom 12). In chi rocess, che receiver amplification is increased with sin for dept signal trace in Figure following each transmit pulse, so that echo signals ort awe B11. A, Scan ofthe liver obtained with ew 7 f che sane te¢0 th ‘ Is from tho i -2 Essentials of Uteasound Physics Depth ae sient Twihoe Tae Echo sion Toe wit Tac Fine 312. ‘the TC function in the reser of pole-echo syaem. The top sigial ace represents echoes on ego refecion, where ateution decreases the amplitude x the disance tothe reflector increases, TGC: compersates for attenuation an asue by increasing the evier sun m4 ‘ating from distal nflecrors are amplitied more than echo signal originating close to the teansdacer. Proper applica tion of the swept gain finetion hs the effect of equaliz~ ing echo signals from similar reflectors, Sider bar TGC contol. The most common TGC con twols consist of a series of dider knabs, each providing adjusment of the receiver gain at a specific depth range (Figure 5-13). The slider knob arrangement traces a pat- tern sometimes called a gain cure. ‘The “slope” of the gain curve needed to effectively compemate for attenuation and produce a uniform image of tissue sructures depends on the tissue’ attenuation and on the ffequency. More ‘highly attenuating tissues require teeper-sloped gain ccurves than tissues that have low attenuation coefficients. When higher frequency transducers ire used, the higher attenuation also dictates steeper slopes to provide ade- ‘quate compensation. Knob TEC control. Another TGC method available in some instruments consists of a limited namber of gain controls, cach controlling a different aspect of curve. Controls for the “initial gain,” the “slope? “far gain” are common (Figure 3-14) controls on the gain curve ar illustrated in the figure: The initial setting regulates the receiver gain 3 the time of the ‘sansmit puke by the transducer. The slope adjusts the rate ‘of compensation with depth. The far gxin control adjusts the maximum receiver gain following each transit pulse. Internal time-varied gain. In adi adjusted gain controls, some i nal, automatically ser swept gain. This fearure can both correct for changes in sensitivity veesas depth for trans- ducers and can provide an average swept gxin compensi to operator uments provide an inter * 2 =. Gein ‘grades spe fiom }13. Stder bar TGC: comols. Exc bar adjuss the ein at ‘one depth ranze. The farther any one coma! is puted th the higher the gain a the corresponding depth - - apt as Fie. ERtece oF he msl gai» weve These are showin on figure knob TGC controls. One cancol adjsts the slope, and a cicd dhe far tion sate. The szstruimert ean be made to sense whatever tranlucer asembly is connected to the puker-receiver and make an sitial seting of the swept gain. Operator adjustments. though still necessary are mininnzest seme~ what by this fearure. Lateral gain. Some instruments have 1 imetion called literal gain, {eis found usetl, For example, in eche cardio side nosunifor _gtiphy 9 cor:pensae for side image brightn-w caused by different amounts of tema tion for diffe-ent pathways chrough which individual beams travel (Figure 3-15), In contrast to TGC, which increases receiver gain with inereasine echo arrival ime along each beam ineLateral pesition FinweH18 Laveral gain, used wo vary che amount of smplificaion som one side ofthe image 10 the oxen, lateral gain controls affect echo daa trom individal beam lines differently. Many applications where it is used requite higher amounts of amplification fiom lateral sar gins of the image than along the cenal part of the image. as in Figure 3-15. Dynamic frequency tuning. Most receivers are broadband, that is, they amplify and process echo signals for all fre~ quencies contained im the ultrasound pulse, For example, 2. 5-MHz center frequency pulbe may conta a range of lrequencies between 3 and 7 MHz, and all frequencies are processed equally by a broadbanchwideh amplifier. It is also possible wo tune the receiver un amply « more lined range of frequencies. Sometimes this can help reduce spurious electrical noise, Some instruments provide a dynamic frequency tracking feature. [ts use has to do with the face that no all ultrasound frequencies centained in the wound pulse emitted by a transducer are attenuated sn tissue, As mentioned in Chapter 1, higher frequency sound waves are attenuated snare supidly and penstrat less deeply than lower trequencies. Because a briet pulse of ultrasound contains a range of frequencies (see Chapter 2}, the preferential aenvation of high fre quencies results iu a change in die pulse sliape, and in the frequency content, as it interrogazes deeper and deeper structures. This is shown in Figure 3-16, where the pulse of soun: cransducer gradually loses more of the higher frequency components watl nncreasing distance traveled, the same fate nitced By th Polze-Echo Utasoenéstramentsion 53 tral -\- Fire 316 este shape changes resling fom avenution in sisues.Amenustion reduces the ample ofthe pube at iy into the tinue We ako anges dhe he eng higher froqacni Alen fique 17. Dynamic frequency tracking feature. The cemer frequency of the recever is varied with ame afer each tuausmi pulse giving empllass to high feqaences for shallow structures and low frequencies for greater depth The receiver can be set up 50 tha, for arriving from shallow regions, ic responds most effec- tively co the higher frequencies in the pale bandwicth Then the response can be shifted gradually to favor the deeper sera (Figure 3-17). This makes most effciens use of the ultra sound frequencies available from the transducer not all, wltasound tstrur lower Frequencies for signals frequency tricking is available on some, howglt Reject. Some instruments also provide a reject control. lar and cracor adjusted ar up" the radar The term ret stems fiom its wwe with older id inscumients,in which dhe op: clectionic noise rejction conteal «© “ek nines both low ois for sonar signal [a ultrasound, rejec level electronic noise and low-level echoes thom play Pogue 3-IN), Large amplitude echo sige atlecte fey late‘St Essentials of Utrasound Physioe Dynamic range and compression. Most clecrronic devices have 2 hinted input signal ampliuate range over which they will respond effectively. This is called the dynamic tauge ofthe device and is ofen is given in decibels. IF the ‘incoming signal is too low; the device wil not respond to the signal at all.An example heze might be a weak radio fr television signal from a distant ansmitting station, whet all that can be identitied is ise on the speaker of sow” on the television screen. fhe input is too large the ourput ofthe device “peaks out" and it can no longer respond to variations in the input; we say “asuration”™ kas occuszed, Input sigmis Berveen tlese two extremes— theshold and satuation—are withia the dynamic rang of the device Different components of an uleasound seanner have capabilities. This is stated Figure 3.19. The tramducer and the receiver must be ‘capable of responding to 2 tremendous range of echo sig- anal amplitudes, usually in exes: of 100 dB, This large amphirade range represents echoes from highly refleces interfaces positioned! close te the carsducer down co very sifferent dynamic range Echo signal mo reject t Noise ant low amplitude echoes Echo signal wit ject Time Figre3k. reject function in the receiver of s pue-echo. insrument. Rejecevlminates low-level sgaah an! low-level sleetmnic noise fo the display ‘weak signals fiom scatterers, which may have low adei- onal strength because of ultrasound attenuation. Image rmcmories are generally more limited typieal ove has a dynamic range capability of 40 t0 45 dB. Display d tend to have evett more limited dynamic range cepabili~ tics, usally only about 20 10.30 The “gray Scale,” or dot brightaess, of an ulinsound image is related to the echo signal amplitude (sce Figure 3-26). Clinically it is usefal to display dot brightness Ganges for echo signal amplitude variations of a: last 60 dB, However, this echo range significantly exceeds the dynamic range of the disphy device. To overcome this Problem the echo signals are “compressed” within the receiver (Figure 3-20). Compression takes a lage denamie range, say 60 GB, and squeezes the amplitudes of these echo signals into a range to which the displey can respond. A special form of compression, known 2 Joga rithmic amplifcation, conpreses the larger amplicude sig nals while actually boosting the lower amplitudes. This xzives emphasis on the display to echo signal changes ainong the lower amplitude signals. Ie makes sense to de this because this emphasizes variations in sigatal ampli among scattered echoes, the source of the majority of the echoes seen on currenc uleasound imagers. Most ultrasound scanners allow the operator t9 vary the dyaamic range of the echo signals compressed into the display: This contr! afects the range of echo signals appearing as shades of gray on the image monitor. On dh ferent scanners, the control for this comes tinder dive fnamnes such as compression, fog compression, ot dynamic rage. Figure 3-21, 4 is an isage of the liver in an adult taken with 2 60-di8 dynamic range. Figure 3-21, Bis witha 40- UB dynamic range The 40-dB dynamic range image clearly bas a higher contrast than the 60-dB dynainie range image. The reason is that for the lower dymamic range a smaller change in echo sigmal amplinide is needed Td _ Memory | copy wae Sl we a FigWeH18 oynamic ange of various com spb a nie range more Ta joaznes oF an ultsonnd tranaducer are nach ere to the echo signal, the mara 1 tange, tay 3 of 60 dB, on the ince display even though the je. Notice the dynamic slsp’ devices. By ean diay echo. than those ofto cover the black‘to-white tarsition on the image itor than for a high dynamic range, Consequentl image appears to be of higher contrast atthe low an at the h rauige seu ting. Table 3 . 2 rizes this feature of compresio ‘On some scariners, reducing the dynamic range pre cerentally cuts out the Iow-lvel echo siguas, producing sumilar effects as reducing the everall gain. This isthe case for the 40-dB dynamic range sewing in an image of objects in a gray scale phantom in Figure 3-22. However pin mind the different roles played by the ro fune- ions, overall gain and dynamic range Over jons reduce all echo signals equally: the dynamic range sl gain rehse eduction on these machines cuts out the lower echo sig nals, but has only small effect on the high signals, as shown in Figure 3. level echo Demodulation. Demodulation is done in the receiver to convert the amplified echo signal burst into a single puls cr "spike," for each reflector. Steps in a simple demodu- Orgia 6008 ” Comprossod signal Anan Depth = GAL cho signal compresson. The echo si al amphiudes for « given dynanic range, sy €0 dB, ace reduced or s0 they ean be accen Logarithmic compresion boosts the ke spl variations among diem to be sen, whi Fist A, Image of an adult nec sing a 60-4 dynamic range. B, Saae image as Pelee cho Utrasound nsrumentation 55 lation process are ustrated in Figure 3-24 The osillat= ing type of echo signal waveforms in the top ace of Figure 3-24 are gefecuedi to as radi frequen of signaie The # signal is rectified {inversion of negative component shown in the middle crace) and then staoothed. Thus waveform to 2 sign thar Bs 8 demodulation changes the form of converting the principal ones ate summarized in F 3-25. Amplification is necessary because echo signal detected by che transducer are ak for dis play. TGC compensates for echo signs) reduction with depth caused by atcenuatio: signal 3) ot, Demiodulatioa aad rejection farther processes involved in conditio ting echo signah before they are displayed, tially x0 and log compression enables a large ech amic riage to he viewed Principal echo display modes A-mode (amplitude mode). Two well-keows echo signal display modes in pul trated in Figure 3-26 The mode display, is a trace that shows the instartaneous echo sigaal amplitude versus time afte scho ulerasonagraphy are illus frst, the A-mode or amplitude temumission of the time is proportional to the selector depch, so the A-mod! display shows echo amplitude spike height) versus reflec tor distance. Recall, a pube propagat summed in the instrument’ caliseaio mining reflector distance from the transit cit. acoustic pulse. In pulse-echo ultrasound, Tile Displayed dynamic range and image contrast Low dynamic ringe uc aken using a 4d‘6 Essamiate of Utrosound Phy echogenicity of masses tated frons the distri- bution of spikes on the display. However, the A-nade by The A-mode enables pr transducer stirements; therefore itis used in som: thalmological applications, where accu itvelf is very limited be ats echo data ments of ocular dimensions are nceded* (Figure 3. fou a single beam fine, In most ultrasound imaging {alone A-mode instruments are corimonly found instruments ifan A-moce trace s present iehouy oe ophthalmology laboratories. The A-mode also allow ancillary display used by the operator to assis the settings studies of the relative cchogeniciy of srucestes witht Of the gain conteok and other operatin the transducer beam, as shown in Figure 3 ic, many sonographers never encoun: height indicates echo amplitude, so th any of their instruments, fie 3ZL_ A, Image ofa gray sale phamon wing 2 60-20 dynam range. Nosce, besides the fnage hi higher cont Wie: Satwation fete vot Bop a § nie c ok = A tein A ene anna LA Sse Relative echo ample (8) a Figue 324. Brightness vs. relative echo ‘signal level tow the two ‘igure 3 ‘emsodulation. This signal processing, a | 1 4s AML! pe | | | ET ‘oa tose wiePule-Eeho UtrasoundIntrumontation $7 AModo N f\ amplitude B-Mode bnighioss y Distance (MENT. Schematic Busration of te A-wode dip for B-mode (brightness mode). In 2 15 rode, or brightness mode, display echo signals are electronically converted to intensity-modulated dots on dhe screens The bri ronal to the echo signal amplitude (see The Bemode display is wed M-mode sraces and in uray scale. worcimensional M-mode (motion mode). A bssic M-mode display & shown tm Figure 3-29, The M in M-mod this ccho display fr walls of the heart seauads for mtn, as nly is used so display the sieving heart valves (tis abo known, as EM made for time niotton mode. The Meme display, very rich in information, sssimple t9 produce: i i ge tation of the Acmiode and Beano di Derth > sewer {flla(l FiNe 2 Use of te A-mode co determine the echorg of objects An echogenic mass tops has A-mode stunal spskes corresponding w de reflection atid satteeis within the reas. An echorffee mass, uch a 3 cyst lower, paodses no Ano spies wih ated by dowly sweeping a IS-mede trace across @ screen. as shown, The resultant display lusrates reilectx ind time on an oFthoscal axis. Nos ime” in this contex’ ler 0: ‘nds: it should not be confised with echo return time‘SH Essamials of Uteasound Physics Tine > sde display, obtained by sweeping the D. ‘mode trace across the display while the wltraownd bean is stionaty The M-mode disphy presents reflector dance from the transducer vers time already discussed ) Stationary reflectors crace out a straight line on an M-mode display, whereas moving rellecto curved lines, ‘The M-mode is applied most frequently in echo car~ diography, where the movement patterns of walls and valves of the heart may be recorded and studied, Reflector displacement patterns, vessel linear dimensions, and ‘echogenicity of objects are part ofthe basic information content of this modabity. For 2 very long time in the his- tory of echo cardiography, M-inode was the primary phy technique. M-mode can provide excellent temporal resolution of motion patterns. The M-made trace in Figure 3-30 is of normal mitral vake and displays excel lent detail of the mitral valve postion over time, Even rapid movements of heart structurs, such a5 the flurcer pattern of the mitral valve accompanying aortic valve regurgitation, are easily recorded with thie technology.® Most M-mode instruments hive a variable sweep speed, allowing the rime representation to be magnified oF compressed. The time calibration is usually achieved by internal markers multiplexed on the echo display line at prescribed intervals such as every '/2 second. The mark~ cs also provide echo depth information by being pro= duced to correspond to, sy, L-cm distance intervals, Since the velocity 18 the displacement per unit tie. the veloc ity of a reflector is estimuaced from the slope of the M- node trace. The slope is given by At/Ar, witere Ad Af are as shown in Figure 3-31, (Do no: confuse method of computing 2 reflector velocity with the Doppler effect discussed in Chapter 5.) The main disadvantage of M-mode i that only one anatomne sion (distance fiom the “inschce di represented. M-mode displays ate someti srefeered to as fr pick views of the internal anawom: The view an 2 standard M-mode is along a single axis, ewatlished by the fMe3, M-mode dspiy ofthe heart emphasving the race fiom the mitral vale The M-mode tace usualy roles excellent temporal deal of rapidly moving sawerres, . . §] : L . \ . . ° } OSsec | o<—__ i, Figse341. Use of the slope, 8d/At, of an M-mode trace to ‘estimate relector velocity. Depeh marker dots on the display are generate at fined time intervals, sch » every "= s shown here. so they provide both depth fos) atid aie © calibmtior w500 for the Meme nace location of a stationary ultrasound beam, Most current echo candiography examinations are done using real-time 2-D imaging, Doppler, and color flow, eradually retegat— ing M-mode to a display of lesser importance in cancion. raphy chan i wae just afew years ago, |ULTRASOUND B-MODE SCANNING Image build-up Doc real-time and wati ultnsound B-mode scanning ate done by sweeping pulsed ultrawund beam aver the vol- tume oF interest and dsplying echo signals using the Be rode ay shown in Figure 332, With modera teal-tine smagers, beam sweep is rapid and 2 continuous iamaye appears, «0 the operator fs litle appreciation of sweep even taking place. Nevertheles. che image i pro~ aressively built up or updated as the beat is swept, a8 indicated in this figure ho signals are positioned on the display in a loca tion that corresponds tothe reflector positon inthe body: ‘The location of each redlector i obssined from: 1. The position and orientation of the sound beam ‘say the ulkrasound beam is swept over the region being scanned, detected echo signals are placed along a line on the display that corresponds to the axis of the sound beam, ‘The delay time beoween launching of the acoustic pule by the transducer and rece signal; ftom the delay time and the assumed sound propagation speed (1540 m/s) the distance from the reflector to the transducer is known by apply- ing the range equation, jon of an echo Scanning technology: the first generation Ultrasound B-mode imaging was once done in most clin- ies using manual scanners. With these instruments, a sin= ale clement transducer wos attached to 4 mechanical arm (Figure 3-33). Sound pulses were traumimitted along the axis of the ransciucer-To produce an image, the sonogea- pher swept the beam manually by moving the transducer zeros the skin of the patient and tilting itn various dec tons The mechanical arm consteained che motion of the ansducer to a plane, so tie resultanc image depicted an anatomical slice. The arm alse contained sensors at each of its piver poi 2 position and ori- entation of the transducer face, and hence the ultrasound Dean axis. This information wis, of course, necessary for placing echo signals in their proper location on the dis- plas. as illustrated in Figure 3-32. ‘One advantage of manual seoscts lds of view obtained. The images produced views we ath CT and MIU insaging (Figure 3-34), Significant diadvantages of manual scauners, lowes resulted in their virtual elimination om sont depart these sensors tracked was the large ments, For example LL Te taak several seconds t0 5 These devices becas ‘static” imagers suse they worked aest on satiomary stractues know Pulse-Echo Ultascund Instrumentation 59 5 ) Log HME B-mode image (ako eilled 2-0 rage bukd-up. Uieraund poles ae sent int the body along diferent bean ps ere of which are shown. Echo sig ae displayed ‘sing the B-mode display. cies are poston along 2 Tine the display tha coresponds to she boars ak when thes are detected: the echo arrival time indicat the elector dep figne342 Manual (eae) seamner formerly wsed so rods ultrasound B-mode images, 27 ssallable anatomical views on the skill ofthe so er than with moder Another type of large anatomical scanner abo. appeared at various times in che hbistery of ulzrasonnd0 Essanials of Utrasound Physics Fiqwe 5. Water path scanner this arn Ps commonly for ultrssound breast imagicg ng So-called water path scanners exist in some departments In these instrament the ca ducer is offiet from the patient's skin surtice by 2 water path. The structure co be imaged can be imniersed in et or coupled a water-filled bag. The sean is done by mechanically translating the transduce gion to be imaged, thus through the tissue, Wat “a tion provides more uniform imaging: berween the tsansduce ter detail of superficial structu sweeping the path sca es mated scanning oper nd the skin surtice cesults in bet- Manual and water path scanners have for the most ps been replaced by automated real-time seanmers. Their use provides performance capabilities not attcinable with manual seanners—including the ability to visualize rapidly moving structures such as heart valves and the ease in locating and following internal anatomiea) landmarks and organs. The common types of automated seal-tim scanners are finear arrays, convex (or curvilinear) arrays phased arrays, and mechanical scanners ime scanners Linear array transducers. Lincar aay trontdacers consist of small rectangular elements lined up side by sid shown in Figure 3-36, Imaging is done by sequentialiy sniting and seceiving along parallel beara hi ing at one end of the ars 38 shown in Fig hho signals ariving at individual clemen are applied to the beam former, where they ere electro ically foevsed and dhea a signal for each beam live. After echoes arrive atthe trans ducer ffom the mascmum depth for the Est beam line, 2 second beam is transmitted along asighdly different, but parallel, line (Figure 3-36, B) and e di ‘Then a shitd beam is tarsmitted, and so forch, continu ing to the end of the array A single scan takes npicilly a9 5, more o: less depending on the numer of bearn lines and the image depth. Then the process is peated Scanning is continuous repeated and the image updated ani the operator “fteezes” the image. Individal acoustic lines forming the B-mode image are separated by one iment width. (Even closer posivoning of beam fines pos- sible if different element groupings are adopted.) ti. Chapter 2 we mentioned that tudividual beams are produced using a group of ¢ rather than a single element The reatous for this ae (1) a im the group a single ech from linear ments beam from an individual clement quickly divergss, «o an individual element’ beam 8 broad and lateral realution is poor; (2) the sensitivity is aso very poor if just one ele ‘ment is used: and (3) muluple elements enable electronic focusing. Electronic transnuit focusing as well as focusing di al © the image quality achieved with these systems, Other ing reception, abo discussed in Chapter 2, are cru features mentioned in Chapter 2, including dynamit aperture size and dynamic apodization. are ale apse Curvitinear arrays. A curvilinear, or convex, actus oper- ates on the suune principles a6 a linear atrav Figure 3.37) The array i made up of small rectargulir cle- ments arranged side by side. However. because the cle erge at like spokes of a wheel (F our a seution of 4 sector: the exact sha varies with dhe radius of the array an: which elements are placePole-Ecko Ukrsourd iarumentation 1 Thue 12, 4, Linear any cradocer with a bea emerging rn group of clement loca array the center axis of his beam shied br oe element compare tothe sation mA This wa done doppng the she te desc pn fa pelo gerald stay lire eeense ele Fite 57. Convex The region of a transducer asembly through which sound is coupled to the patients somerimes referred to 28 he entrance window. For many regions the conves shape of fis array provides better transccer-to-patient coupling, slong the entra ple linea figue 8. Typical beam tine arrangement. fo te curvines ¢ window than is provided by the sim. array. Echo data are obtained first from beam 1. then beatr The eles range fons very tghtiy curved 3. arrays to larger arrays with a gradual curvature. The sector scan format enables larger imaged fields from a smaller entrance beam area than the linear array: Multiple tans anit focusing and dynamic focus of received echo signal’ echoes om straetures near the ede of the imaged field ue important design features in dese arrays as well and in so doing there offen is some fall offs the senst In comparison to a phased array, which aso produces tivity of the clements and some degradanon of lateral re: & sector inn curvilinear array requires a olurian near the edges of the Feld larger entrance windows: However, 2 posible advantage lover the phased array is thar the beans emerge perpen-_Phased-array scanners, The tiatslucs dicular to the surface of the acaive elements uurvi- phased army sector scanner consists of «tightly group linear array. In other words, the convex array elements array of elements, Unlike the previous nwo types abv their sound beams forward; in contract, arrays, oll clements are involved tn proc mcr phased array must steer beans off to the side t9 pick up beam ard reeetving echoes for each acratst(© Essoutials of Ultrasound Physics beams produced by a phased artay are electronically steered at various angles with respect to the array surfice (Figure 3-39). Steering for each beam is achieved by intioducing appropriate time dehys sxcitation pulses applied to individual clements in the array. The sivection in which the sound beam is steered is depen det exact rime delay settings and te vacied fom cone transmic pulse to the next, stering the bear in cif ferent directions, Beam steering is also applied daring echo reception by varying the “ditctvity” of the arcay Echo signals from a reflector received by the different ele- ‘ments are delayed in an appropriate sequence, depending om the beam direction, then added together forming one signal for that reflector. This is carried aut within the beam former circuitry ofthe scanner Besides beam steering, electronic focusing abo is done. Delay settings for focusing, similar so those described in Chapeer 2, ace programmed along ‘ith the bean-steering delays. Borh single snd! multiple transmit focal zones und dynamic receive focusing are used in phased arrays, ‘An advantage of phased aetays over lncar and curv linear arrays is chet telatvely small entrance window, per- imitting coupling through the intercostal space. Phased arrays may have 120 or more indivicial piezoclecric ele ‘enss packed into a 1~ t0 2-cm row: Thus they may be sed effectively in pediatric and adult cardiac imaging Beam Figg 128 Phased array transcer Six in diferent dreesions by varying time the temsmie pulses Three different beam diveetions are shown, but rypically 100 to 200 separate be nections are used for each nage ive beans are svered sliferent ‘Au advantage of phased arrays over mechanical sean ners (see below) is the fexibility introduced in the scan ‘hing focmat. I is easy to share a scanning beam with on cr tnore static M-mode lines for example, enabling mul tiple-trace M-mode displays to be produced along with ewo-dimensional image. Also, since there are no mechan seal movements involved in producing the san. its easy ve synchronize scanning movements to exteraal triggers such as derived ffom ECG siguals, Both these ‘eatures luuve been employed in some electronic sector scanning instruments, Finally. Doppler and color ow imsagims, dis cussed later in this book, are easier to dowsing phased arrays than using mechanically scanned transducess Mechanically scanned real-time instruments. Conceptually the simplest rype of rapid autoscanners are mechanical systems, These usually employ one or more focused, single-element transducers to transmit andl receive ultrasound signals, A common arraagerient iy showu in Figure 3-40. This system employs from ewo to four separate transducers positioned in different loca tions on the rim of a rotating wheel. Transeicers pubed only during the time they swecp past the scan ‘ning window, as shown. The transducer astembly hous- ing must be filled with a uid wo ensure acousn: cou- pling berween the transducer element aut the window. (The type of fluid used and whether i is user rep enish- able if, for example, air bubbles are formed should be explained in the accompanying operator's mawal Piezoelectric ‘loment Fig ML Meckanical scanning tansducer Focuse flemene trnhicers ane mechan er the me be scanned.-This method of sani fone sith ares trandcereSome mechanical scanness incorponce annular arr ranaducers. Wh transducers rather than single-element this is the case, multiple transmit focusing, dye receiving focusing, and dynamic aperture contol ate pos sible with these units as wel. OF coune, beam sweeping for scanning still is done mechanically by eranslasing lem hin the transducer asiembly Unlike sequential linear arrys and electro rored arrays, mechanical scanners contain moving genecate the scan. The parts may comsist of gears, pulleys wheels, or oscillating shafts, d lesiyn Norcal wear and war on the drive se placing the tran not in use Again, con: ning mode whe manual for ch standby mode be operator's recommended transducer assembly nveen patient scans Special purpose automatic scanners Most of the real-time scanning arrangements described have also beva used in various spec: scanners. Special purpose tr ning instr fesigned main imaging application, For example are used effectively for imaging the Linear, curvilinear, and phased arrays, 2s ally seante! ate and some Il as me application. Some ¢ probes, are used guntions provide simultaneous ach other. This wo planes perpendicular to 10 as biplane imaging and has been found advantageous fe is referred determining the extent of disease in the prostate Pulse-echo instrument — — Provetive sheath Echo Ueacound icramrttion 63 Transvaginal scanners cornmonly are of che curvil cear design, although mechanical and phased acray probes 10 used in this application. Ju transrectal probes, distinct advantages provided with use off such transducer asetnblies include use of higher feequ cies for better spatial resolution, since the atensating pat to the scanned reg om is reduced significa ance of any beam distorting artenmaning risate avers mak ninal wal ¢ and laparoscopic wratisducer assemblies are ako becoming aval ‘enable the sonogra to place che probe in direct contact with che organ imaged, so higher frequencies, wich their inherently bet- ter spatial resolution, than are used for tanseuraneons imaging are common, The higher frequenc’ also is advay tageons in enabling ministurzation of the probe, nec sary we available wil dows. Many laparos wide accessibility through pic and intraoperative at, curvilinear, and pha Finally, various designs tor intrawseu ar ko available, A common configuration is a me cal probe, shown in Figure 3. The transducer typi- cally is 12 to 20 MHz, although 30 MHz or higher a being used for coronary artery imaging. The transducer mounted on the end of a cathe In the schematic in Figare 3-41, 2 sin clement piezoelectric element ism: har can be inserted. ited radially on 2 shat within the flexible protective sheath of ti catheter. The shaft is rotated by an external nism. The high-frequency miniature cleme excellent spatial decail (Figure 3-41, 19), buc done only over short distances. fine. A, neravscalar tannic song ster By Bemode image showing the nen ars wal of aL anterior descending) artery iat aul bear: he ioeze sbeaine using 2 30- MEL i sine ray of Howie Packard Compan(6 Essentials of Utrasound Physics FRAME RATE AND SCANNING SPEED LIMITATIONS Scanning speed, expressed asthe image fame ne, ot the number of times per second a sacep of the ultratourdd beam is done by the transducer. an important perfor mance characteristic of real-time sconnecs. This aspect of imaging performance 1s closely rated to tempor reso lution characteristics. The highce she faze rate, the bet- fer is tie ability ro image rapidly moving structutes, to ‘overcomte patient mocion arnficts, and to de rapid survey scans ofa region. As is curns ou, the maximum speed with which a real-ome inscrument can build up images it im ited by the finite travel time of sound pues in neue (Figure 3-42) ‘The principle behind this limitation is staightor wand: the separate transducer beam lies used fora an image (ee, for example, Figure 3-38) each require « small ‘ime interval to collet all echoes emerging frm thit line After each transmit pulse, che instrument waits to collect all echo signals down to the maximum depth setiny. before 9 subsequent transmit puke is hunched long an adjacent beam line. The time dey required benscen pales depends on the speed of sound in the medium and the maximum visualization depth (Figure 3-12) Consider the sector scan arrangement in Figure 3-43 ‘An image is produced by separa ulssound bean di tributed evenly over the sector ang. For simple scanning arrangements such as shown here, it aight he wseful employ 120 or more individual lines co form the image Fewer lines could be used, but only at the cost of lager aps betwcen individual lines, which might be undesnble, Ifthe Geld of view (i.e. the depeh sting) in Figure 3-43 rests in a viulization depth of D, the delay time Tig, needed to collect al echoes from anysigle line is given by Thane = 13s X D fem) a \where D (cm) is the distance D expressed in em, We wsed the information in Table 3-1 that the pulse-echo travel time is 13 1s for each em when the speed of sound is 1340 m/s, 7 . cia) 7 a pulse D- Tins A otped ie) Five The wan ulsuatey peed n ultrasound inn fy the ypc of sours in este, 154 as, 1 154 ern/ ps The time required so produce a complete image or frame” consisting of N such lines is simply N times Th, = Nine = N X13 us Diem — (4) The masximwan allowable fame rite, FR gy. i the ree iprocal of the time needed for a single cou:plete image. For cxample, if takes 0.1 s to do 1 scan, the maximum rite is 10/5: if takes 0.5 », the maxinuutn race 182/s, and so forth, Taking the reciprocal of Tames 8 get Mo, aa ee Ge 1 Tus & NX Demy 77.000 fs FR * Dem) a) This equation tells us that the maxinmum frame rate in units of frames per second) equals a constant (77,000) sivided by the number of lines used to form the image ‘ame, and divided by the depel setting (in units af em) The constant, 77,0001, is approsimately what you gee wht you take the ratio 1/13 jus;this may be verified eas- ily wich a calculator. Scan ortrame FiQMES3, ‘The spced of sound dictates chat cach best in requires 13 42s % D tw acquire echo data. here Dis the th setting in em Theretore re eta tine rested for one fame is 13 us X D2 N, schere as the number of bean lines used to foray theExample: Suppose the field of view af a sector san. nner is set for 3 maximum depth of 201 cm, and Nis 120 lines, Caleulate the maxisnan frame rate Solution: Using Equation 3-5, 77,0000/s NX D (em) FR = 7.000 /s 120 X20 Equation 3-5 tells us has the maximuas possible fiame tate is dictated by the depth setting. D, and X, the toumnber of bean lines used co form the image. Higher fame tates are possible if the depth setting is lower (Figure 3-44), which 2 sonographer can quickly verify with any scanner. Higher frame rates also are possible if the number of heam lines ssed to form the image is smaller. The number of beat lines can be redhiced using greater spacing berween beam lines (Figure 3-45). This, however, could compromise image quali, as che ultra sound image may look coarser and grainier when the line density is low. Another way to reduce Nis to reduce the imaged field size (Figure 3-46). This is done quite fi quently in color Dow imaging, where image acquisition times are quite long. Field sizes someximes are reduced in B-mode imaging as well when higher frame rates ate required. Results calculated using Equation 3-3 are for imag~ ing with 2 single transmit focal zone. Instruments that allow simultaneous muleple warsmit focal zones must decrease the image frame tate when these conditions are present; this is because of the longer time required co form each acoustic line with inultiple transinit focal 4am HMREH. Dependcnce of tram on the depeh set Pale-Eeha Urascand Instrumentation 65 zones, (Note, multiple receive focal zones do not decrease the fame rate since recsive focusing happens dynamically as the echo signals arrive from deeper ancl deeper structures) Manulacrorers jously artempting, to push scanmecs beyond the limits implied by Equation 3 5. For example, confocal imaging? uses optimizad p receiving parameters to attempt to obtain h gh fear rates when large numbers of multiple mansrsit teal zones are applied. Parallel processing, in which imige data from more than one beam line ate acquited simultaneously is anotier of dhese methods. As these techn we can expect insiruments with higher spaial resolution, superior image quality, and better temporal resolution than currene scanners to be avalible ling anc fine 48. Dependence of fase ave on N; de aumber of beat Lines used to form the image, Here Ni saried by ‘arying the spacing berween beam lines Higher FR Nissmaller Fit HE Dependes.+ of fame race ot N.the aumber oF beam Ines used rotor the mage In this sample banged by varying the size of the muaged sto5. 6 1 Essentials of Utrasound Physice Aeferences Sk) aT remy F: Dire uloacound pnpesssimmestation and exes, ed, Orland, 199, Grane & Staton. Dissonies VST Master Series Prodactkecanet, Milpes, CA, 1994, Diasonics McKnight RNA mixing chet o foes a eanducer array dymamicly, Hooter Pai! aul p16, December 1983, AnsericanInstie of Ulraound in Mein: Steud ‘ea ime play of ther and acon indes of nec sasundepupment, Late, MD. 12 Kendall (J: Ophthain ecrph Thortas, NJ, 1990, Shek HagenAnsert L: Ted of dant wiracnagpl St. Lowi, 1995, Mosby (Questions or Review A. Reflector distance to speed of sound The eange equation relates D. Reflector distance to echo arrsal ime C. Reflector distance 10 ecko amplitude D. Echo frequency eo speed of sound Rellector B & three tines che dance sean: the tense ducer a¢ reflector A. It takes esas Jong foe an, cho wo arrive from reflector Bas fiom selector A. ALS BS 4s D6 Wthe distance to a reflector is 10 en, the time beewoen ‘ransmitting 2 pulse and receiving an echo fom that reflector iy about A. 55 ps B30 ws €. 650 ps D, 1000 ps ‘The speed of sound asuned sn tie versus distance brations of most seasners is: A134 ous B. 1540 mom/s 2630 av/e D154 mis Duy factor is AA The fiacion of me the eraser emits sound 1B. The fraction of ine the transducry receives echoes ©. The faction of eine trxsmitting and receiv D. The amoune of energy coasted br the pulser E. The amount of enerey consined by the paler an: et, Palse repetition period is the mene A. Ultssound frequen 1B, Pulse mpertion frequency © Pulse diration D. Doppler treguency W uy 13, ‘The pulbe duration is the time from ¢he hey puss to: A. The beginning ofthe next poke B. The end ofthe same puke The end ofthe fist eyele an the pulse The end ofthe nest pulse ing ofa + Typicl duty factors ia polse-echo ultrasound sve A Between 0.1% and 1% BB, Between 1% and 108% C. Bersiven 20% and 50% 1D. Mecvesen 5056 and 100% ‘Which of the following will ineteste the duty factor? A. Increasing che pulse repetition frequency . tncteasing the trans ampliade Increasing the receiver gain 1. Decteasing the reject contr E, Increasing the examination time If the original acoustie power js 50 mW and the power centro] is changed to inceease it by 3-dB. che new poiver i A533 mW. B60 mw. C100 mw D150 mw E200 mW Whick one ofthe following drs nor increase when the ‘ouput (transmit) power contro! i increased? A. Amplitude of acoustic pulses mansmtted into tissue B, Number of transmit pulses per second G. Amplitude of echoes returning to the tansacer D. Patient expowire E, Dot brightness ow a gray sale cl display . In ultrasound, receiver pain isthe ratio of ‘A. Input signal amplitude to output smal ampiitade 1. Input fequency to output frequency (C. Output bandwidth co anput bandwidth 1D. Output dynamic range to input dynamic singe E. Oupur signal anyplaude to anput signal ample From the sandpont of minimizing expouure co pati, A. Low poster: igh gain B. High power low gain . Intermedkice posse, inte D. Fhigh power, high gain TGC or swept gain compensates or sound AA. Propagation speed. 1 Attention ©. Reflection D Refiastion !h component of an ultasotnd saraer iT ©. The scan converte D. The fmage mositor16. Reject eliminates: A. Electronic noise only 1B. Elecsronic noise and Ja-leveleclio signals CC. Electronic nose and high-irequency ccho signals D_ Artifacts echo sigs /. A measure of the echo sig! amplitude range over whieh ' nariceable change in ssp dot brighenes oceurs is the A. TGC slop B Gan 20, C. Echo range D, Dynamic rang Which of the following exmponents of a ulrasound inumaent bis the

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