Wm Tod Drost er ny aed aeale eraction among the sonographer, patent, and machine. An understanding fof the physics of ultrasound is important because it helps explain some of the limitations of the modality and artifacts encountered, This isthe only disgnostic imaging modality that does not use electromagnetic radiation. In this chapter, the physical principles of ultrasound waves, the interactions of tultzasound waves with mater, transducers, Doppler techniques, and ultrasound artifacts are discussed, {YSICAL PRINCIPLES OF ULTRASOUND WAVES Sound travels in waves and caries information from one location to another. It transmits energy by alternating regions of low pressure (rarefaction) and high pressure (compression). ~ Unlike Tight and radio waves, sound waves require a medium through which to uavel.” Frequency, wavelength, and velocity are parameters used to describe sound waves; these terms are also used in reference to electromagnetic radiation (see Chapter nD Frequency is the number of times a wave is repeated per second, One wave of cycle occurs when pressure sarts at @ snort value, increases to 2 high value, decreases (passing the rormal value) to a low value, and then returns to normal (Fs, 4.1)-A gyde may also be defined as the combination of compres- sion and successive rarefaction." Frequency is expressed in hertz (Hz), where 1 Haz equals one cycle per second. In diagnostic ultrasound, the frequencies are typically between 2 megahertz, (MHz) and 1 MHz ( MHz = 1,000,000 Hz). ‘The audible ‘ange of sound for human beings is 20 Hz. to 20,000 Flz; sound, Jess than 20 His infrasound, and sound greater than 20,000 Hz (0.02 MH) is ultrasound.” ‘Wavelength is the distance traveled by a sound wave in one cydle In ultrasonography, wavelength is expressed in millimeters (iam). Wavelength is important for image resolution and is discussed later Velocity is the rate at which sound travels through an acoustic medium, it is determined by the physical density (mass per unit volume) and stiffness (hardness) of the trans- ‘isting medium.'” The velocity of sound in some commonly encountered tissues is listed in Table 4.1, IC physical density remains constant, velocity increases a5 stiffness increases. IF the stifness remains constant, velocity decreases as physical density increases. As a rule, velocity is highest in solids, lower in liquids, and the lowest in gases. In solids, molecules are closer togethes, so sound waves are transmitted faster; in gases, che molecules are far apart, and sound waves travel more slowly. Medically, sound waves travel the fastest in bone and the slowest in gas-filled lungs. Velocity is related to 58 frequency and wavelength of a sound wave in the following equation: Velocity (man/s) = Frequency (MHz) Wavelength (mm) (a) For a constant velocity, frequency and wavelength have an inverse relationship so that as frequency’ increases, wavelength decreases, and vice versa, Within soft tissue, the average velocity of sound is 1.54 mrv/us (1540 m/s). " The velocity of sound in soft tissue is important because ultrasound machines use this constant velocity for all calculations, ULTRASOUND WAVE INTERACTION WITH MATTER ‘The principle of echo formation is important because echoes contain the diagnostic information about the structures being smaged. The interface that causes the echo reflection and the angle at which the sound wave strikes the rellector, or the angle of incidence, should both be considered. “Acoustic impedance ofa tissue isthe product of the tissue’s physical density and sound velocity within the ussue,'* Acoustic impedance (Z) = Velocity (v)x Tissue density (p) (42) (Changes in acoustic impedance from one tissue to another ddeteemine how much of the sound wave is reflected and how ‘muuch is transmitted into the second tissue, The emphitude of the returning echo, which is what is used to make the image, 's proportional to the dillerence in acoustic impedance in two adiacent tissues or substances. If two tissues have no difference im acoustic impedance, then no echo is created, If a large difference in acoustic impedance exists between two tissues, {hen almost all the sound is reflected in an echo. "The following formulas are used to calculate the percentage of the sound, wave that is reflected and transmitted” reflected = (Z, ~Zi (Zo +Z)*100 43) 9% transmitted =100—% reflected 44) In Eq. 3, Zis the acoustic impedance of the second tissue, and Z, is the acoustic impedance of the fist tissue. The pproximate acoustic impedance of Ussues encountered com- ‘monly is listed in Table 4.2 and the percentage of sound reflected at various tise interfaces is listed in Table 4.3. By the valtes in Table 42, the largest difference in acoustic impedance occurs at interfaces with bone and gas. Almost all sound is reflected at soft tissue/gas end soft tissue/bone interfaces. Thus, little or xo sound passes these boundaries. Hence the speed of sound