a SECTION! ‘without moving the transducer depending on the sequence by which each array in a transducer is red. The multiple angles increase the probability of the sound wave encountering @ rellctr ata 90-degree ange This improves spatial resolution by improving contrast and margin definition” More time is required for data acquisition, thereby decreasing image and temporal resolution, Acoustic enkencemeat and shadowing artifacts (discussed later) may be reduced, and this i a potential drawback.” Using spatial compounding in canine and feline ultrasound imaging, compound images were perceived to have improved contrast resolution, border definition, and/or increased signal-to-noise ratio compared with noncompounded images.” DISPLAY, Image formation is based on the pulse echo principle.””* A small burse of sound waves is sent into a structure by a trans- ducer, and the transducer becomes an echo receiver In between, the transducer is dampened to stop the piezoelectric crystal from vibrating ‘When the intial bburst of sound is sent into the tissue, a timer is started to determine the amount of time it takes ‘0 receive echoes. The lapsed time from sending to receiving is directly related to the distance traveled by the sound wave, © Rate (mm/s) x Time (is) Distance mm) (Eq 5) ‘he ultrasound machine assumes a constant rate for the velocity of sound (1.54 mnv/ts), and because time is re distance can easy be calculated, Remember that the ie transducer to the reflector and back is twice the actual Gistance from the rellector to the transducer ‘This assumes that the sound wave travels ina straight line with no side trips along the way “Two modes of echo display are used commonly in ultraso- nography: brightness mode (B-mode, B scan, or gray scale) and ‘motion mode (M-mode). B-mode is used commonly in both abdominal and cardiac imaging M-mode is used only for echocardiography.” Bemode images are composed of a collection of dots that correspond to the amplitude or strength of the returning echo (see Fis. 13). These dots are displayed on a black background, and the brightness or gray scale of the dot is highest (ohitest) for the strongest returning echoes. The depth of the structure returning the echoes determines the position of the dots relative to the position of the transducer. Muluiple thin scan lines make ap a complete image so that B-mode images look like slice of tissue. ‘Memode records a thin section of an wltrasound image over time (Fig 4.6). The region for M-mode imaging is chosen using a Bemode image; the selected M-mode region is usually rep- resented on the screen as a line, Once the Memode cursor is in the desired location, M-mode is activated. On an M-mode image, the depth of the image is displayed on the vertical axis and time is displayed on the horizontal axis. The brightness of the dots is proportional to the strength of the returning echoes, as in B-mode. When holding the transducer stationary, the examiner can evaluate how structures move over time ‘Memode imaging is used most commonly in echocardiography. to evaluate the finction of the ventricles and heart valves, (Orientation of the B-mode image varies with the structare being imaged. The left side of the screen is cranial, and the top of the screen is dorsal (toward the patients spine) for longitudinal images, For transverse images, the lel side of the screen is dorsal. For cardiac imaging, the right side ofthe screen 1s cranial (toward the patient's head) wath long-axis images. + Physics and Principles of Interpretation Fig. 4.6 Mmode image depicting movement of the mie vlve At the top ofthe image is «B-mode short-axis image ofthe let venuce atthe level of Ue mal valve. The dete lini the mil ofthe B-mode age marks the loeaton ofthe Mmode tracing onthe bottom ofthe image re Memode xing dep the moverent ofthe mil vale ad Ie veuscle over time An elecrocardiogtash tracing superimposed in the Beton ofthe image The portion ofthe image closest to the transducer, usually the ‘op ofthe sereen, is called the near field and the opposite side 's called the far feld BASIC SCANNER CONTROLS “The power control modifies the intensity of sound ouput by he transdacer This is accomplished by adjusting the voltage applied to the piezoelectric crystal, Increasing the power leads to 2 uniform increase in the amplitude of returning echoes and thereby increases overall mage echogenicity (brightness). Keeping the power level low helps improve image resolution and helps prevent artifacts Gain affects the amplification of the retuming echoes wit the receiver. Increasing or decreasing the gsin increases ot decreases the brightness ofthe image displayed on the screen, is too low, the subtle parenchymal detail of tissue the guin is too high, the image is too bright, and contrast resolution is lost." A common analogy is to compare the gain knob on the ultrasound machine with the volume control on an audio device. At low settings subse music cannot be heard, and at high settings, the music is too offensive to be enjoyed. ‘Because sound waves lose intensity (attenuation) as they tavel in tissu, echoes retuming from deeper tissues are weaker 1an echoes returning from tissues closer to the transducer. To make an image uniform in brightness, amplification of the echoes from deeper tissues to a greater degree than echoes from shallow tissues is helpful. Time gain compensation controls allow the user to adjust the gain in selected regions of the image based on the arrival time of echoes to the transducer” Echoes from deeper structures take longer to reach the trans ducer Typically, an ultrasound machine has a series of sider-bars ‘hat contzol gain to echoes thet emanste from various depths, The top sliders control gain for structures in the near field snd bottom sliders for gain in the far Feld, Overall gain should be adjusted fist, then speciic regions of the image using the time gain compensation.” The reject function of an ultrasound machine is a method of reducing unwanted, low-amplitude noise. This noise, elec- ronic oF acoustic, is not useful and can subtly degrade the image. Many machines allow the user to select how much of,