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BASICS OF ULTRASOUND

BASICS OF ULTRASOUND
BASICS OF ULTRASOUND
Introduction Introduction
Introduction
Introduction

In this section, a brief history and general overview of ultrasound diagnosis are described. Also the merits and demerits of medical ultrasound as well as a comparison with other techniques like CT and MR are outlined.

History

Ultrasound has been used as a navigational and detection aid by the bat for millions of years. It was not until the second world war, however, that man started extensive use of ultrasound for the same purpose. With the enormous potential of military research programs, ultrasound technology rapidly developed.

Although ultrasound had already been used in the therapy and was proposed by S.Y. Sokolov for diagnostic use in 1937, no successful attempt to apply the ultrasound echo-sounder principle to medical diagnosis was made until the early 1950’s.

Most of the equipment used at that time were industrial-type ultrasound devices for detecting flows in metal, but soon ultrasonic devices generally known as “ultrasonoscopes” specifically intended for medical diagnostics were developed. The major advantages of these devices are the non-invasive and non-ionizing nature of the examination and their relatively low cost when compared to X-Ray, Magnetic Resonance (MR), CT and Isotopic Scanning techniques.

Over the last decade, the diagnostic usefulness of the equipment has been vastly improved, as better instruments were developed and more clinical experience gained, and in several diagnostic fields, ultrasound technique has shown to be superior to other methods.

General Overview

In Medical Ultrasound, images representing human organs are formed by transmitting sound waves into the body and receiving back and processing the resultant echoes from the tissues. To accomplish this, medical ultrasound uses a process very similar to an ocean-going vessels “depth sounding” equipment or oceanic survey equipment. All of these systems make use of sound waves and their reflections.

Sea

Sea

Sea
Sea

Merits and Limitations

By comparison with CT, MR, X-Ray and other diagnostic methods, Ultrasound Diagnosis, especially for soft tissues and moving organ like heart and blood flow, has shown great advantages as following:

* Real Time Imaging (Except MR) * Non-invasive (Except MR) * Non-ionizing Radiation (Except MR) * Relatively Low Cost * Wide Applications * Mobility * Flexible Imaging * Biopsy

For the reason of physical and technological limitations, ultrasound method also suffers from restrictions in imaging and applications as does other technique. Apart from the geometric distortion of the image display, another important limitation

is the Resolution. Higher frequency ultrasound gives better resolution, but attenuation in the tissue also increases with increased frequency. Therefore, a compromise has to be made between resolution and penetration depth.

Frequency

Low

High

Resolution

Resolution Better

Better

Penetration Better

Frequency Low High Resolution Better Penetration Better

Due to the nature of ultrasound propagation, strong reflection of ultrasound beam from boundaries between tissue and air or boundaries between tissue and bone prohibit normal scanning of the lungs and the intracranial soft structure in adults as well as to some extent the intestines.

Generally, ultrasound diagnosis, being one of the diagnostic imaging, is playing a more and more important role in Medicine as technology is rapidly developing, and is selected for a screening diagnosis as a first and a finished Diagnostic Imaging in the world.

Physics Physics and and Principles Principles
Physics
Physics and
and Principles
Principles

In this section, some basic concepts are defined and explained as foundational knowledge to introduce and understand ultrasound system.

* Properties of Propagation

  • - Velocity and Frequency

  • - Reflection

  • - Refraction

  • - Diffraction

  • - Scattering

  • - Attenuation etc ..

* Transducer and Impedance Matching

* Doppler Effect * Pulse Ultrasound

The Nature of Ultrasound

  • - Mechanical vibration or wave

  • - With frequencies above the range of human ear which is greater than 20 kHz. For medical diagnosis, typically ranging from 1 to 30 MHz.

  • - Obeys the same physical laws as wave

Compressive Wave
Compressive Wave
Compressive Wave
Compressive Wave

Compressive Wave

Sound Spectra

0

20 Hz

 

20 kHz

1 MHz

30 MHz

0 20 Hz 20 kHz 1 MHz 30 MHz

Infrared

 

Audible

NDT

Diagnostic Imaging
Diagnostic
Imaging
 

Sound

Sound

Cleaning

0 20 Hz 20 kHz 1 MHz 30 MHz Infrared Audible NDT Diagnostic Imaging Sound Sound

Velocity

  • - Dependent on the medium and temperature

  • - Roughly be considered as a constant 1540 m/s in human body.

  • - The relation between velocity and frequency is following the equation below:

Velocity = Frequency * Wavelength ( )

Table 1. Approximate velocities of sound in human medium

Medium

Velocity (m/s)

Blood

1570

Brain

1540

Fat

1450

Kidney

1560

Muscle

1590

Distilled Water

1540

Specific Acoustic Impedance

  • - The specific acoustic impedance Z is defined as the product of the density of a medium and the velocity of the sound in that medium ( c).

  • - Basic concept to understand ultrasound wave reflection.

Reflection

Transmitted wave

Incident wave

Reflected wave

Reflected wave

Medium 1

Medium 2

Reflection

  • - One of the basic principles of medical ultrasound diagnosis.

  • - Occurs at areas of acoustic impedance mismatch.

  • - Divided into several different types including:

Specular Reflections, which occur at large change in impedance producing a large reflection, and also reducing the continuing wave amplitude.

Medium Reflections, which occur with dense tissues such as muscle.

Diffuse Reflections, which occur with soft tissues such as liver.

Refraction

When a propagating ultrasound wave encounters a Specular interface at an oblique angle, it is Refracted in the same way that light is refracted through a lens. The portion of the wave that is not reflected continues into the second medium. It is dependent on the velocities of the two medium. If the velocities are equal, There would be no refraction occurred and the beam goes straight into the second medium. For the velocities of the different tissues in the human body are quite close, refraction's can be ignored.

incident wave Transmitted wave Reflected wave Medium 1 Medium 2
incident wave
Transmitted wave
Reflected wave
Medium 1
Medium 2

Diffraction

If an ultrasound beam passes an obstacle within a distance of 1 or 2 wavelengths, its direction of propagation is deflected by diffraction as shown in the figure. The closer the beam is to the diffracting object, the greater the deflection is.

1 or 2 wavelengths Deflecting beam Diffracting Object
1 or 2 wavelengths
Deflecting beam
Diffracting
Object

Scattering

- Occurs when small particles absorb part of the ultrasound energy and re-radiate it in all directions as a spherical field. This means that the transducer can be positioned at any angle to the ultrasound beam and still receive echoes back. Scattering allows reflections from objects even smaller than the wavelength. Many biological interfaces have irregular surfaces, tending to give scatter-like reflection, which is quite useful, as it will give at least some echoes even though the beam is not directly perpendicular to the reflecting interface.

Spherical Scatter-wave

Spherical Scatter-wave

Backscatter

Backscatter or Rayleigh scattering occurs with structures smaller than the transmitted wavelength. Reflected energy is very low, but contributes to the texture of the image.

Backscatter Backscatter or Rayleigh scattering occurs with structures smaller than the transmitted wavelength. Reflected energy is

Attenuation

Attenuation of ultrasound wave occurs when it is propagating through the medium. Loss of propagating energy will be in the form of heat absorbed by the tissue, approximately 1 dB/cm/MHz, or caused by wavefront dispersion or wave scattering.

Attenuation Attenuation of ultrasound wave occurs when it is propagating through the medium. Loss of propagating
Attenuation Attenuation of ultrasound wave occurs when it is propagating through the medium. Loss of propagating

Transducer

The transducer is the component which, when connected to the ultrasound equipment, transmits the ultrasound and receives its reflections or echoes from tissues.

Transducer is one of the most important component of the ultrasound system. For more detail information, please refer to System Components.

Impedance Matching

-To transmit as much power as possible from transducer to the tissue.

Impedance Matching -To transmit as much power as possible from transducer to the tissue. Transducer Case
Impedance Matching -To transmit as much power as possible from transducer to the tissue. Transducer Case

Transducer

Case

Impedance Matching -To transmit as much power as possible from transducer to the tissue. Transducer Case

Transducer

Crystal

Matching Layer

Tissue

Doppler Effect

In ultrasound Imaging, echoes received from most tissues will be at the same frequency as the transmitted beam. However, if echoes received are from tissues or blood cells that are moving, the transmitted and received frequencies will not be the same. This “shifted” frequency can be used to determine the relative velocity and the direction of this moving tissues. This effect is known as the Doppler Principle. Essentially, the greater the frequency shift, the higher the velocity of the moving object. Additionally, movement toward the transducer results in a higher received frequency, and movement away in a lower received frequency.

Doppler Effect

TXM RCV
TXM
RCV

If the reflector is moving toward the transmitter, the received frequency will be higher than the transmit frequency.

  • TXM

  • RCV

TXM RCV If the reflector is traveling away from the transmitter, the received frequency will
TXM RCV If the reflector is traveling away from the transmitter, the received frequency will

If the reflector is traveling away from the transmitter, the received frequency will be lower than the transmit frequency.

Pulse Ultrasound

For practical use, most modern ultrasound systems are designed based on the principle of pulse-echo technique, which means that transducer emits only a few cycles of pulses at a time into the human body. When encountering tissues interfaces, reflection and scattering will occur and produce pulse echoes, By detecting these echoes, tissue positioning and identification as well as diagnosis can be made.

Spectral Doppler

Spectral Doppler, of high value in ultrasound diagnosis, can be used for evaluation of blood flow, includes three kinds:

  • - Pulse Doppler(PW)

  • - High Pulse Repetition Frequency Pulse Doppler (HPRF)

  • - Continuous Wave Doppler (CW).

Pulse Doppler

In Pulse Doppler, a single ultrasound line is repeatedly fired. Echoes reflected from moving structure, including blood cells, experience a Doppler shift in frequency. Using the Doppler equation, the echo information obtained within the Sample Volume is analyzed for shifted frequency content and amplitude, rather than transmit frequency amplitude. From this, the blood velocity can be determined.

Transducer Sample Volume
Transducer
Sample
Volume

Pulsed Doppler Line

Pulse Doppler

In order to obtain enough data to calculate the frequency components of the sampled volume, many ultrasound lines must be fired.

The frequency data is converted to velocity, and displayed in a scrolling strip format on the monitor.

The highest detectable velocity is limited by one half of the rate at which the ultrasound lines are fired, known as *Nyquist Limit “.

Time Velocity
Time
Velocity

Pulse Repetition Frequency

T T T T R R R R
T
T
T
T
R
R
R
R

Pulse Repetition Period

* Pulse Repetition Frequency (PRF) is the number of times per second that transducer transmits a pulse.

* Pulse Repetition Frequency is dependent on transmit depth and propagation velocity. ( 1540 m/s )

Nyquist Limit

The maximum Doppler shift velocity measurable in Pulse Doppler is limited to one half the sampling rate defined by the PRF, which is mainly determined by the sampling depth. For a given transducer and depth, this maximum measurable velocity, which is known as the Nyquist Limit, can be calculated using the following equation:

Nyquist Limit =

PRF

2

Aliasing

If the maximum velocity for that transducer and depth exceeds the Nyquist limit, a phenomenon known as Aliasing occurs. Aliasing results in the display of erroneous velocity information.(Showing a “wraparound” effect.)

Velocity

-2 2 0
-2
2
0

Spectral Display Showing Aliasing

HPRF Doppler

Transducer

HPRF Doppler Transducer The Nyquist limit will decrease with depth of the sample volume. As this

The Nyquist limit will decrease with

depth of the sample volume. As this limit reaches 1/2 PRF, the system automatically increases the sample

rate by increasing the PRF and the

number of samples. This results in

more than one wavefront propagating

through the body simultaneously.

Therefore, information obtained may be from more than one location.

Angle of Incidence

When the motion of the object and the transmitted beam are not parallel, it is necessary to correct for the angular difference. Motion that occurs at an angle to the beam axis will result in a decrease in the magnitude of the frequency shift and a lower calculated velocity. Therefore, the transmitted beam needs to be parallel to the flow for the most accurate velocity. An equation is used to correct for the angle offset. The transducer receives only the component parallel to the beam Vcos .

Ultrasound Beam Blood Flow V

Ultrasound Beam

Ultrasound Beam Blood Flow V

Blood Flow

V

Continuous Wave Doppler

Continuous Wave Doppler, or CW Doppler, is a similar modality to Pulse Doppler in that frequency data is gathered to determine blood velocity along the ultrasound line. With CW Doppler, the transmit and receive functions happen simultaneously. This overcomes the maximum velocity limit, but the exact point along the ultrasound line from which the velocity data originated can not be determined. (No range resolution).

CW Doppler is used primarily in diagnosing abnormalities in which range resolution is not important or when the sonographer is interested in the quantification of high velocity jets.

 

CW

PW

Range Resolution

None

Determined by Sample Volume

Maximum Velocity

Virtually Unlimited

Limited by 1/2 PRF

Continuous Wave Doppler

Transducer

Continuous Wave Doppler Transducer Monitor Velocity Time
Monitor Velocity Time
Monitor
Velocity
Time

Color Flow Mapping

Color Flow Mapping (CFM) combines B-mode image format and Pulsed Doppler to provide a two dimensional representation of blood flow in Real Time.

The Doppler ultrasound lines, like B-mode lines, are sequentially scanned through the frame. Multiple range gates are taken along the Doppler lines. The calculated velocity data is assigned a color to represent a certain velocity and direction, and then displayed combining with the B-mode image at the original location.

Blood Flow
Blood
Flow

+

2 - D
2 - D

=

CFM
CFM

MTI (Moving Target Indicator)

First

Blood Cell
Blood Cell

Ultrasound Line

Second

Blood Cell
Blood Cell

Ultrasound Line

Subduction

  • Blood Cell Signal

CFM Display

Monitor

Transducer
Transducer

Doppler Ultrasound Line

Color Box
Color Box

Limitations of CFM

  • - Only give the average of the velocity across the beam, can not get the maximum velocity.

  • - Sensitivity, a compromise to be made among the depth, velocity range, and PRF

  • - Frame Rate, influenced by FOV , scan angle and control system of transmit and receive.

System Overview
System Overview

In General, a ultrasound imaging system consists of several components listed below:

* Transducer - Transmitting and receiving ultrasound * Beamfomer - Transmit and receive control including phase delay, focus, aperture, signal conversion, etc ..

Transducer
Transducer

Phased Array

In a phased array system, a series of elements are arranged into a array. The timing of the transmit drive pulses to each element and are arranged so that the wavefronts from all the transmitting elements arrive at a selected spatial point at the same time. This is accomplished by introducing a curve into the timing delays whose center is the desired focal point. This in effect is the same as using an acoustic lens, as a lens implements focus by delaying waves to a specific degree so that the same result is achieved. Using electronic instead of physical delay allows the transmit focal point to be changed simply by changing the delay relationships.

Phased Array

Wavefront from Elements

Focal Point Time Delay Summation Wavefront
Focal Point
Time Delay
Summation
Wavefront

Linear Array

  • - Rectangular Scan Format

  • - Large Aperture

  • - Wide View at Near Field

  • - Smaller Effect of Side Lobe

Linear Array - Rectangular Scan Format - Large Aperture - Wide View at Near Field -
Linear Array - Rectangular Scan Format - Large Aperture - Wide View at Near Field -

Convex Format

Convex Format - Wide View at Near and Far Field

- Wide View at Near and Far Field

Sector Format - Radial “Pie-shaped” Scan Format - Narrow Aperture - Wide View at Far Field

Sector Format

  • - Radial “Pie-shaped” Scan Format

  • - Narrow Aperture

  • - Wide View at Far Field

Sector Format - Radial “Pie-shaped” Scan Format - Narrow Aperture - Wide View at Far Field

Expand or Vector Format

Expand or Vector Format - Wide View at Near and Far Field

- Wide View at Near and Far Field

Beamformer
Beamformer

Conventional Beamformer

Transmit/Receive

Array Pre- Amplifier Delay or Digital Control Analog
Array
Pre- Amplifier
Delay
or Digital
Control
Analog
Summation Analog
Summation
Analog
Transmit/Receive Array Pre- Amplifier Delay or Digital Control Analog Summation Analog A-D
A-D
A-D
Transmit/Receive Array Pre- Amplifier Delay or Digital Control Analog Summation Analog A-D

Digital Beamformer

A-D Converter

Array Pre- Amplifier Digital Control
Array
Pre- Amplifier
Digital
Control
Summation Digital
Summation
Digital
A-D Converter Array Pre- Amplifier Digital Control Summation Digital Detector
Detector
Detector
A-D Converter Array Pre- Amplifier Digital Control Summation Digital Detector

Digital Beamformer

Digital Transmit Software Control - Dynamic Focus Digital Tracking Lens Memory - Dynamic Focus Sum Detector
Digital Transmit
Software Control
- Dynamic
Focus
Digital Tracking Lens
Memory
- Dynamic Focus
Sum
Detector
Cine
- Dynamic Aperture

Advantages of the Digital Beamformer

  • - Optimize Frequency and Band Control

  • - Multi Focal Zone at Any Depth

  • - Dynamic Receiving Focusing

  • - Dynamic Tracking Lens

  • - Sidelobe Compression

  • - Dynamic Aperture

  • - Higher Doppler Sensitivity

Clinical Merits

* Better Image Quality

  • - Assure Accurate Spatial Resolution

  • - Improve Contrast Resolution

  • - High Frame Rate

  • - Decrease Artifacts

* More Reliable Diagnosis

  • - More Accurate Detection and Analysis in CFM and Pulse Doppler

  • - More Sensitivity

Image Image Quality Quality
Image
Image Quality
Quality

Introduction

In this section, several parameters listed below, which are usually used to judge the image quality of ultrasound system are introduced and, for general purpose, some examples about the effects on the image quality are given.

* Resolution - Spatial Resolution (Lateral and Axial Resolution) - Contrast Resolution * Uniformity * Effects on Image Quality * Phantoms

Spatial Resolution

Spatial Resolution is defined as the ability to distinguish small structures with clarity. Generally speaking, it can be divided into Lateral and Axial Resolution, and it is dependent on the numbers of the channels of the system and the frequency used. The more channels , the better lateral resolution is. The higher frequency used, the better axial resolution is.

Lateral Resolution

Lateral Resolution is the ability of the system to resolve structures that are very close to one another at the same depth.

Lateral Resolution is dependent on the beam width as determined by crystal geometry, depth and focusing.

Lateral
Lateral

Lateral Resolution

Lateral Resolution Beam width is narrow enough to be able to resolve these two structures separately.

Beam width is narrow enough to be able to resolve these two structures separately.

Lateral Resolution Beam width is narrow enough to be able to resolve these two structures separately.

Beam width is too wide to be able to resolve these two structures separately.

Axial Resolution

Axial Resolution is the ability of the system to resolve structure that are very close to one another at different depth.

Axial Resolution is dependent on frequency and transmit pulse width.

  • 3.5 0.4 mm

MHz

  • 5.0 0.3 mm

MHz

  • 7.5 0.2 mm

MHz

10

MHz

0.1 mm

Axial
Axial

Axial Resolution

Beam Good Axial Resolution Poor Axial Resolution

Beam

Beam
Beam Good Axial Resolution Poor Axial Resolution

Good Axial Resolution

Beam Good Axial Resolution Poor Axial Resolution

Poor Axial Resolution

Contrast Resolution

Contrast Resolution, or gray scale resolution, is the ability to differentiate tissue types and to see subtle structures in the presence of very bright reflectors. It is one of the most important parameters to judge ultrasound image quality, and also this tissue-differentiating capability provides critical diagnostic information.