Ultrasound Basics

Presented by: M. Sadir Khan

Msadirkhan3@gmail.com

© 2016 Conquest Imaging

 Agenda
Introduction and Welcome
Ultrasound Basics
Ultrasound Types
Building Blocks of a Diagnostic Ultrasound System
Introduction and Welcome
Welcome to Ultrasound Basics Training.
After completing this training, you will :
➢ Understand the basic principles of diagnostic ultrasound.
➢ Be able to identify transducer types and their use.
➢ Understand the trade-offs about image quality and
resolution.
➢ Understand the different imaging modes.
➢ Be familiar with the basic building blocks of any ultrasound
system.
➢ Be familiar with different systems and their intended use.
Introduction to Ultrasound
This module provides a basic review of ultrasound theory topics. After completing this module you will be
familiar with the basic concepts needed to understand how ultrasound works.

What is Ultrasound?

Sound Types by Frequency Range

What is the Piezoelectric Effect?

Ultrasound Transducers

Tissue Interactions

Image Quality
What is Ultrasound?
It ’s a sound wave with frequency higher
than 20,000 Hz.
Sound Types by Frequency Range
Frequency Range 20000 Hz
Designation Examples
(Hertz)
0-16 Hz Infrasound Seismic waves

16Hz-20KHz Audible Sound Speech, music

20KHz-10GHz Ultrasound Dolphins, medicine

1MHz-20MHz Medical Ultrasound Ultrasound Imaging

!0GHz-10TH Hyper sound Acoustic Microscopy

22000 Hz

500 Hz 1000 Hz
Ultrasound Applications

Clinical Application Imaging Modes Used For:

Radiology 2D Gall bladder, kidney, liver, spleen

breast and thyroid

Cardiology 2D, CW, AUX CW, PW Doppler and Noninvasive evaluation of heart function
Color Doppler

Vascular 2D, Color Doppler and PW Doppler Detection of blood flow and evaluation of any
abnormalities

OB/GYN 2D, M, PW Doppler, and Color Viewing fetal structures such as heart,
Doppler kidneys and maternal structures such as
ovaries, fallopian tubes and uterus
How Do We Generate an Ultrasound Wave?

➢ By using piezoelectric elements that generate an ultrasound wave in response to

an electrical pulse.

➢ The ultrasound wave then travels through a medium such as the human body.

➢ Some of its energy gets reflected back toward the source.

What is the Transducers
Ultrasound Piezoelectric Effect?
➢ Ultrasound transducers used in diagnostic imaging employ an array of piezoelectric elements.

The most
➢ Each important
element property
is wired to allowofthe
a piezoelectric material
application of short highisvoltage
how itpulses
can convert electric
during the energyoftoultrasound
transmission acoustic
energy
wavesand
andvice
the versa.
reception of the electronic signal generated during the receive phase.

➢ The average 2D transducer utilizes 128 piezoelectric elements.

➢ Diagnostic ultrasound imaging range of frequencies is between 1 to 20 MHz.

Standard Array Formats

Phased Linear Curved

Array Array Linear
Array
Linear Ultrasound Transducer

Linear Probe Piezoelectric Linear

Array
Phased Array Ultrasound Transducer

Phased Array Probe

Piezoelectric Phased Array

Ultrasound Beam Focusing

➢ An ultrasound beam requires

focusing during transmit to
improve the resolution of the
acquired image.

➢ Transmit focus is done

electronically in all modern
ultrasound systems.
Ultrasound Beam Focusing
The timing of the transmit pulses to each element is aligned so that the wave fronts from all the piezoelectric
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.

Electronic focus is the same as

using an acoustic lens; however,
using electronic instead of physical
focus allows the transmit focal
point to be changed simply by
changing the delay pattern.
Ultrasound Receive Focusing
➢ The wave fronts propagate once they leave the transducer, and there is no way to alter the transmit energy
pattern.

➢ During the receive mode, dramatic enhancement of the focal capabilities of the system can be achieved.

➢ As the ultrasound wave strikes various interfaces/tissues in the body, some of its energy is transmitted and
some is reflected toward the transducer.

Transducer

Reflected Energy

© 2016 Conquest Imaging

Receive Dynamic Focus

Dynamic focus is achieved by controlling the delay of each signal arriving at each element through each channel,
such that only signals from the computed sliding focal point arrive at a final summation point at the same time.

© 2016 Conquest Imaging

 Gray-scale Imaging / 2D Imaging Dynamic Focus

➢ The ultrasound system applies high voltage pulses to the

transducer elements. This produces ultrasound waves that
travel through the human body and interact with various
organs.

➢ The reflected energy travels back to the transducer where

each of its elements acts as a receiver. The reflected
ultrasound energy is converted into tiny electrical signals.

➢ The ultrasound system processes these signals to produce

an image that represents these reflections on the monitor.
Tissue Interactions
When an ultrasound wave travels through a medium, it causes expansion and compression of the medium.

Ultrasound waves interact with tissue in these five basic manners:

➢ Transmission
➢ Reflection
➢ Scattering
➢ Attenuation
➢ Refraction
 Ultrasound
Image QualityAttenuation Effects
Refraction
Ultrasound attenuation by tissue produces heat energy and this property is used for some non-diagnostic
The following
Refraction
Refraction: parameters an influence ultrasound aimage quality:
treatments.: takes
Ultrasound
place at
waves interface
are only due
refracted
to theat
different
different
velocities
medium of interface
the acoustic
of different
waves within
acoustic
the two
impedance.
materials . Occurs when the ultrasound signal is deflected from its straight path and the angle of deflection is
away fromprolonged
Extreme the transducer.
exposure without movement of the transducer could cause harm to tissues.
➢ Detail/Spatial Resolution: The ability to distinguish small structures (axial and lateral resolution).
➢ Refraction allows enhanced
➢ image quality by using
TheImage Uniformity:
American Institute ofComparable
Ultrasound indetail and (AIUM
Medicine contrast throughout
) guidelines the image.
for limits below which ultrasound clearly has
acoustic lenses.
been demonstrated to be safe:
➢ Contrast resolution: The ability to differentiate different tissue types without introducing noise.
➢ A diagnostic exposure that produces a 1°C or less temperature elevation above normal.
➢➢ Temporal
➢Refraction can
An exposure
Resolution/Frame
result in less than 1rate:
intensity
The rate to acquire frames and display them.
W/cm2 for focused ultrasound beams.
ultrasound double-image
➢artifacts.
Dynamic
Diagnostic range: Largest
ultrasound systemsand smallest
generally havesignals
outputsacquired and 10
ranging from displayed.
mW/cm2 for imaging to as high as 430
mW/cm2 for pulsed Doppler ultrasound. There has been no evidence to date to suggest adverse effects at these
➢ Spatialoutputs.
ultrasonic Discrimination: The ability to limit artifacts and reflections from other locations.

➢ Bandwidth: The system ability to reproduce signals appropriately.

Image Resolution
Ultrasound Modes
Transverse
Contrast
Lateral Resolution
Resolution
Resolution : The ability
: Transverse
: Lateral toResolution
Resolution differentiate
is thedifferent
is the minimum ability tissue
fromtypes
to differentiate
separation without
otherstructures introducing
tissue theside by side
ultrasound
This module
within the provides beam
ultrasound an overview
across of ultrasound
the image modes. After completing this module you will be familiar
plane.
noise.
beam The
can use of
distinguisha tissue
in a planemimicking phantom
perpendicular to the allows the beam
ultrasound user to. qualify the contrast
with the Contrast Resolution:
different modes of ultrasound and their appropriate uses.
resolution of the ultrasound system. The system should be able to resolve structures
with contrast level differences as low as 3 dB.
Doppler Ultrasound
Linear Would be seen as
Array one structure
Pulsed Wave Doppler (PW)
Lateral Would be seen as
AUX Continuous
WouldWave Doppler
be seen as (CW) two structures
Linear Resolution
two structures Array
Would be seen as
one structure
Would be seen as
one structure
Transverse Resolution
Doppler Ultrasound
What is the Doppler Effect?

A change in the observed frequency of a

wave, as of sound or light, occurring when
the source and observer are in motion
relative to each other, with the frequency
increasing when the source and observer
approach each other and decreasing
when they move apart. Also called
Doppler Shift.
Doppler Ultrasound
If the source is moving toward the receiver, the frequency goes up.

If the source is moving away from the receiver, the frequency goes down.
Doppler Use in Ultrasound

Doppler is used to evaluate blood

flow where the ultrasound transducer
is both the source and receiver of
ultrasound waves.

The blood flow is in motion relative to

the imaging transducer.
Pulsed Wave Doppler (PW)
The system produces short bursts of ultrasound waves (TX) and listens to the reflected waves (RX) in between.

TX RX TX RX TX RX TX

The same crystals are being used for transmit and receive of the ultrasound waves.

It uses the same pulse-echo technique in 2D imaging mode.

Pulsed Wave Doppler (PW)
PW allows us to sample at a specific depth along the Doppler line. This is represented by the sample volume ( Gate )

The velocity that PW can represent is limited.

Spectral Data is a
representation of
the blood flow
Pulsed Wave Doppler (PW)

➢ The maximum depth for the sample volume

in PW is limited by the transducer frequency.

➢ The signal always alias at a certain point

depending on the frequency of the
transducer. Setting image parameters
correctly is crucial for getting a clean image.

➢ A good PW Doppler image has no noise in

the background and a clean window in
normal flow states.

➢ Also, it should display accurate velocity and

have clear audible signal. Spectral Data is a representation of the blood flow
Pulsed Wave Doppler (PW)
Spectral data in a PW image mode provides information about
the direction, velocity and quality of the flow.

Blood flow is towards the transducer

Velocity

Time
Direction of Flow in PW
Aliasing
Aliasing happens when Doppler sample rate is not adequate enough for high frequency shift.

When the velocity of the flow is too high to be displayed in the spectral window, the peaks are cut off and
displayed below the baseline.
Aliasing
Aliasing:

Mirroring:
AUX Continuous Wave Doppler (AUX CW)
Uses different piezoelectric elements to send and receive ultrasound waves.

One element constantly sends ultrasound waves of a single frequency while another constantly receives the
reflected waves.

No B-mode image is acquired or displayed.

AUX Continuous Wave Doppler (AUX CW)

➢ AUX CW Doppler can display flow at any velocity

without aliasing.

➢ AUX CW Doppler cannot position the sample to

listen at a specific depth.

➢ Samples everything along the Doppler line.

Steered CW Doppler (CW)

➢ This imaging mode is available on cardiac

systems.

➢ It utilizes an imaging transducer (phased array)

to generate a CW Doppler image.

© 2016 Conquest Imaging

Color Doppler Ultrasound

➢ Color Doppler provides a method to

visualize blood flow and differentiate it
from surrounding tissue.

➢ It provides information about the

presence of blood flow, its direction and
speed.

➢ Color Doppler utilizes pulse-echo Doppler

flow principles to generate a color image.
Color Doppler Ultrasound

This color image is superimposed on the 2D

grayscale image.

The red and blue colors provide an indication

of the flow velocity and direction.
Color Doppler Ultrasound
The upper part of the color bar represents flow toward the transducer.

The bottom part of the color bar represents flow away from the transducer.
Color Doppler Ultrasound

The color box in Color Doppler imaging

mode must approach the vessel or heart
chambers at an angle other than 90
degrees.

Otherwise, based on Doppler principles

there will be little or no color at
perpendicular incidence.

54
Velocity of Flow in Color Doppler Ultrasound
Color Doppler is different from PW or CW because it provides an estimation of the average velocity using a
technique called “Autocorrelation.”

Every reflected echo is correlated with the

corresponding echo from the previous pulse to
determine the motion that took place during
that pulse.

© 2016 Conquest Imaging

Velocity of Flow in Color Doppler Ultrasound

The shade of the color determines the velocity

of the flow.

For both red and blue colors, the darker the

shade, the slower the flow. And, the lighter the
shade, the faster the flow.
Aliasing in Color Doppler Ultrasound
When the velocity is faster than
the lightest possible shade that
can be displayed, aliasing occurs.
This forces these peaks to wrap to
the opposite color.

Adjusting the range of velocities

that can be represented on the
system eliminates this problem.
The frequency of the transducer
is a limiting factor.
What Defines a Good Color Doppler Image?

➢ The color fills the entire

blood vessel/chamber to its
walls.

➢ The walls are clear of any

color.

➢ The frame rate is adequate

to display the blood flow.

➢ Spatial resolution is good

(the size of the color dot)
Power Doppler Ultrasound

Power Doppler Imaging (PDI) visualizes the

integrated power of the Doppler signal
instead of its frequency shift used in Color
Doppler Imaging.

➢ PDI does not carry directional or velocity

information.

➢ Power Doppler Imaging is also called

Color Power Angio (CPA).
SonoCT Imaging
SonoCT Real-time Compound
Imaging technology is a unique
approach to overcome the inherent
artifacts of conventional ultrasound
that compromise image quality.

SonoCT imaging technology uses

transmit beam-steering techniques
to obtain co-planar, tomographic
images from different viewing
angles, then combines these micro-
angulated images into a single
compounded image at real-time
frame rates.

© 2016 Conquest Imaging

SonoCT Imaging

➢ Real-time spatial compound imaging (SonoCT) uses electronic beam steering of a transducer
array to acquire multiple (3 to 9) overlapping scans of an object from different viewing angles.

➢ The single-angle scans are averaged to form a multi-angle compound image that is updated in
real time with each subsequent scan.

➢ Compound imaging shows improved image quality compared with conventional ultrasound,
primarily because of reduction of speckle, clutter and other acoustic artifacts.

➢ Early clinical experience suggests that real-time spatial compound imaging can provide
improved contrast resolution and tissue differentiation that is beneficial for imaging the breast,
peripheral blood vessels and musculoskeletal injuries.
SonoCT Imaging

➢ SonoCT imaging enables clinicians to acquire up to nine times more tissue information than the orthogonal
beams used in conventional ultrasound, without any unusual manipulation of the transducer and without
sacrificing frame rates.

➢ SonoCT reduces angle-generated and speckle noise artifacts.

➢ Structures with curved and irregular borders are more readily visualized.

➢ Contrast resolution is improved and tissue margins are more discernable.

➢ This powerful imaging technology is available on linear, curved and volumetric array transducers.

➢ SonoCT produces images superior to conventional imaging in up to 94% of patients.

© 2016 Conquest Imaging

Harmonic Imaging
It ’s an ultrasound imaging method in which the higher harmonic echoes (usually the second
harmonic) of the fundamental (first harmonic) transmitted frequency are selectively detected and
used for imaging.

Simulated beam profiles from

the fundamental up to the
fifth harmonic for a focused
single element transducer.
Harmonic Imaging

Ignoring original The higher harmonics may have been created by non-
transmitted signal linear scattering, e.g. from gas micro-bubbles or by non-
and receiving 4 MHz linear propagation of the ultrasound pulse.
signal

A large transducer bandwidth is needed for harmonic

imaging since the receiver center frequency must be set
to twice the center frequency of the transmitted pulse.
Harmonic Imaging
When harmonic B-mode imaging is used to
improve image quality and contrast resolution of
tissues, the technique is called Tissue Harmonic
Imaging (THI).

When harmonic Doppler ultrasound is used with

micro-bubble contrast media (ultrasound
contrast medium), the purpose is to improve
detection of flow in small vessels by selectively
enhancing the Doppler signal from blood and at
the same time suppressing the echoes from
surrounding tissue.
Panoramic Imaging
Panoramic Imaging is a feature of most
contemporary ultrasound systems.

It is an imaging process that produces a

panoramic image using conventional
transducers and provides both qualitative and
quantitative information.

Panoramic imaging broadens the scope of

spatial relationships, thereby sequentially
aligning individual images in their anatomical
context.

Panoramic imaging has the ability to display an

entire abnormality and show its relationship to
adjacent structures on a single static image.
Panoramic Imaging
When producing a panoramic image, the
transducer needs to be moved smoothly
and in a precise direction.

If the object scanned is off plane or off the

desired path, forward motion is
discontinued and orientation can be
corrected.

Image registration stops if the transducer is

stationary.

Once the region of interest has been

scanned, the panoramic image is saved and
can be viewed on the monitor.
3D Ultrasound Imaging
In 3D mode the ultrasound waves are sent at different angles. The returning echoes are processed by the
ultrasound system to reconstruct a three dimensional volume image of the internal organs. 3D ultrasound
images allow us to see width, height and depth but no real time movement.
3D Ultrasound Imaging

3D ultrasound is a series of 2D images,

rendered by the ultrasound system. The
transducer sweeps left and right, collecting
a series of 2D images.

“Surface rendering ” allows for this series of

images to be digitally interpreted by the
system and displayed on the monitor.
Real Time 3D or 4D Ultrasound Imaging
Real-Time 3D or 4D imaging provides instant three dimensional images live. These images allow us to see width, height,
depth and real-time movement.

This image can be captured using 3D matrix array transducers. Also, they can be generated using 3D mechanical array
transducers.
Images shown are generated using 3D mechanical array transducers
Real Time 3D Ultrasound Imaging
Real-time 3D imaging is sometime called 4D imaging.

Recent advancements in computer technology and software engineering make 4D ultrasound

imaging possible. Images shown below were generated using 3D matrix array transducers
Ultrasound System Blocks
This module covers the basic building blocks of any ultrasound system followed by some examples of various
systems.
Building Blocks of a Diagnostic Ultrasound System
 Building Blocks of a Diagnostic Ultrasound System

➢ Front End, Scanner, Coherent Image Former, or Acquisition Subsystem

➢ Back End, Scan Converter, DIMAQ Workstation, or Platform Subsystem

➢ Power Supply Subsystems – Low voltage and High Voltage Power Supplies

➢ Operating System (OS) and Ultrasound Application Software

➢ Ultrasound Transducers

➢ User Interface or Control Panel

➢ Display Monitor – LCD or CRT based

Generic Ultrasound System

Harmonics 3D Real Time 3D

2D / M Color Doppler Power Doppler PW Doppler CW Doppler AUX CW

Ultrasound Application Software

Operating System Software (OS)

Probe 1 Display
Front End, Back End,
Probe 2 Scanner, Scan Converter,
Front End Processor, Back End Processor, User Interface
: Image Former, DIMAQ Workstation,
or Acquisition Subsystem or Platform Subsystem
Probe n DICOM

High Voltage Power Supply Low Voltage Power Supply

AC Input Box and Isolation Transformer

© 2016 Conquest Imaging

Front End subsystem
A generic front end contains the following components:

➢ Probe Interface
➢ Transmitter Front End
Controller
➢ Receiver
➢ Beam former
➢ Front End Controller
Receiver

Beam
Former

Probe
Transmitter
Interface
Back End Subsystem

A generic back end contains the following components:

➢ System Master Controller

➢ 2D/M Signal Processor System Master
Controller
➢ PW/CW/Color Doppler Signal Processor
➢ Image Memory & Video Layout
➢ Video Processor 2D/M Video
Processor Processor
➢ Peripheral Interface
Image
Memory

PW/CW/Color
Peripheral
Doppler
Interface
Processor
Back
Front
FourEnd
EndInterconnections
Interconnections
Channel Front End Image System
Frame N
Frame 1

RX Dynamic
Power Focus
Subsystems Memory Display
4 Channel Ultrasound Front End
Ultrasound Frame N-1
Ultrasound Signal
Interfaced
Signal with
Multi a Linear
Channels Array Probe
(2D/M/Color/PW/CW
Ultrasound Modes) Line

Linear HV Color/PW/ Signal (2D/M/Color/PW Image

PW/CW/ Image
Modes)
Array Switchers
Color
CW ModeFrame 3Memory Ultrasound
Video
High Voltage Power Supply:
Ultrasound Active RX Channels Beam Signal
Frame 1
Processor
Probe Signal Doppler Frame 2
Receiver RX Focus Pattern Former
Data for 1st
➢ Processor RX Amp
Frame N Line
Provides voltages toTX drive
Amp the probe’s elements (array) in
Image Line 1
Ch1 to 4 Vertical Line
Control System
the range of +150V/RXTX-150
Amp V.
Amp
Receiver MasterA/D Converter
1

TX/RX Interface with Front End Image Line 2 Signals Video Signal
Probe Control
RX Amp Signals Front End Controller Digital
Signals Interface with the Back Video
Interface
TX Amp Controller ScanEnd
RX Amp
Processor
Converter Video
TX Amp Front End Control
Low Voltage Power2D/M Supply: Front End
Signal
Mode Frame 1
ControlFrame Power from
Signals1 from Back End
2D/M Mode Peripheral
➢ Provides +3.3
HV TX /+5/-Transmitter
5/+Active
Processor
Pulses
HV Power
12/TX-12/+15/-15 VDCControl
to the Supply
Back End Supply Interface
Signals
Main Power
Image Line (X) Transmitter HV Pulses
& Front(-100
End subsystems.
/+100 V) Channels
Line
TX Focus Pattern System Master
Power to all Front End modules High Voltage 13
PowerLow Voltage
Supply Ch1 to 4 HV Power Supply Input Controller
Image Line N
Programmable Power Supply Voltages Power to all
Power to HV Power Supply
HV Output
Back End modules
Basic Back End Processor
Ultrasound System Block Diagrams

Acuson Sequoia

GE Voluson 730

GE VIVID7

Philips iU22
Acuson Sequoia 512 Ultrasound System
GE Voluson 730 Expert/Pro Ultrasound System SPECTRAL

Acuson Sequoia 512 CSD

AUDIO
SYSTEM
Ultrasound System COLOR
DATA
MEMORY
F DATA
FILTERING B/M
COLOR
SUMMING
DOPPLER
B / M DATA
DATA
B/M ACQ. &
PRE-
FOCUS PROCESSING
DIMAQ
CONTROL Integrated
Workstation

DMA
SYSTEM
ACQUISITION CONTROL BUS DATA
ACQUISITION
MANAGER
CONTROL BDM
CN
SYSTEM CENTRAL BUS

SEQUOIA 512
GE Vivid 7 Ultrasound System
Philips iU22 Ultrasound System