Ultrasound Imaging

• • • • • • • • • • • Ultrasonic waves Interaction with tissue Tissue properties Production and detection of ultrasound Fields of ultrasound transducers Image formation Resolution in ultrasound images Electronic focusing Real time imaging Doppler ultrasound Demonstration of ultrasound technology, meet in IAHS lobby, Thursday 5:45 pm.

Download overheads at http://www.jccresearch.ca/people/personalpage.asp?person=Patterson Further reading (available electronically at McMaster) PNT Wells, Ultrasonic imaging of the human body, Reports on Progress in Physics 62 671-722 (1999).

The Ultrasound Spectrum

WAVELENGTH IN WATER 1.5 mm 0.015 mm

l f = 1500 ms -1 FREQUENCY In water Ultrasound microscopy

1 GHz

100 MHz Medical imaging

0.15 mm 1.5 mm

10 MHz

1.0 MHz

Therapeutic applications

15 mm

0.1 MHZ 0.02 MHz (20 kHz, hearing threshold)

Description of Ultrasonic Waves

• In general, both compressional and shear waves can propagate in a solid, but soft tissue will support only compressional waves. • While there are minor differences in the velocity of ultrasound in soft tissues, the value 1540 meters per second is assumed in image reconstruction. The variation of velocity with frequency ( i.e. dispersion) can also be ignored. A round trip of 1 cm takes 13 microseconds in tissue. • The product of wavelength and frequency is equal to the wave velocity, so in soft tissue the wavelength of 10 MHz ultrasound is 0.15 mm. The wavelength plays an important part in determining the ultimate resolution that can be achieved with an imaging system.

• The energy transported by the wave per unit time per unit area is referred to as the intensity. The usual units are Watts per square centimeter. The average intensity in diagnostic applications is below 100 mW cm -2, but the peak intensity can be much higher.

Note that the acoustic impedance of compact bone (e.48 X 106 kg m-2 s -1 and most soft tissues are within a ten per cent of this value. the fraction of incident energy scattered by the inhomogeneity will increase with both of these quantities.g. . “relaxation processes” in which acoustic energy is coupled to changes in molecular conformation are important. Both mechanisms are dependent on frequency .viscous losses vary as f2 and relaxation losses somewhere between linear and quadratic dependence. the skull) is about five times higher and that of air is lower by a factor of 3. For our purposes.700. the acoustic impedance is Z = ρc where ρ is the density and c is the speed of sound. such as tissue. The physical process of scattering depends in a complex way on the size of the inhomogeneity and its acoustic impedance relative to the surrounding medium. Scattering Scattering of the ultrasonic wave does not take place unless the wave encounters a change in acoustic impedance. the main mechanism is viscous loss. For complex media.Propagation of Ultrasonic Waves Absorption This occurs even when the wave propagates in a homogeneous medium such as a tank of water. For water Z is 1.In general. For simple fluids.

Z1)/(Z2 + Z1)]2 . #2 Large object with a “smooth” boundary In this case the incident wave is reflected and refracted at the surface analogous to the behavior of a light wave at a discontinuity in refractive index. In this regime the scattering is approximately the same in all directions. θ Z1 θ Specular reflection Z2 φ For the simple case of normal incidence the intensity reflection coefficient is R = [(Z2 . and the scattering cross-section is proportional to f4. This is analogous to Rayleigh scattering of light by small particles. of diameter about 10 microns.Two special cases for scattering #1 Object much smaller than the wavelength A classic example is scattering by a single red blood cell.

63)2 / (7. 100% SKIN This is one reason that ultrasound is not used 58% to image the adult brain.Implications of Specular Reflection Consider a soft tissue/bone interface. 33% but it is used in infants where the skull is not BRAIN yet calcified. In other words. The reflection coefficient at gas/tissue SKULL interfaces is even larger. TRANSDUCER SKIN COUPLING GEL . so ultrasound is not useful in imaging the lung.1. The gel fills the space between the transducer and the skin and prevents reflection by trapped air.63)2 = 0. and only 33% of the scattered intensity out of the brain. This means that if we were trying to use ultrasound to image the brain. we would only get 33% of the incident intensity into the brain. The intensity reflection coefficient is (7.42. the transmission is 58%. This also explains why a coupling gel is used during ultrasound exams.80 + 1.80 .

000. but with ultrasound it is conventional to express the attenuation coefficient in dB cm-1.000! This frequency-dependent attenuation imposes limits on the performance of imaging systems. . the coefficient is roughly proportional to frequency for a variety of tissues. we can express the ratio as dB ratio = 10 log10 (I1 / I2) so if the attenuation coefficient is. absorption and scattering result in attenuation of the ultrasound wave. Note the implications: at 1 MHz. but at 10 MHz. As shown on the next diagram. after transmission through 10 cm of tissue the intensity will be reduced by 10 dB. or a factor of 10. for example. In fact. We could express this as exp (-μx) using a linear attenuation coefficient μ. transmission through 10 cm of tissue reduces intensity by a factor of 10. transmission through 10 cm of tissue reduces intensity by a factor of 10. If the two intensities are I1 and I2. Frequency dependence The attenuation coefficient is a function of ultrasound frequency. 1 dB cm-1. After 20 cm it would be reduced by 20 dB or a factor of 100. a good rule-of-thumb is that the attenuation coefficient for soft tissue is 1 dB cm-1 MHz-1.000. Digression on the decibel The decibel scale is a way to represent the ratio of two intensities. The intensity falls off exponentially with distance.Attenuation Together.

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For PZT. or PZT. While resonance contributes to efficient energy conversion. first discovered in the late 1800’s. This pressure can result from an acoustic wave incident on the crystal. Certain natural crystals (e. a 1 mm thick transducer resonates at 2 MHz. The resulting voltage can be detected and amplified. it may be detrimental in other ways. Synthetic materials demonstrate a much more efficient conversion of electrical to acoustic energy.g. the same “transducer” is used to generate acoustic waves and to detect the waves scattered by tissue. quartz) undergo a change in physical size when an electric field is imposed on the crystal. In medical applications. . These materials also demonstrate a reciprocal piezoelectric effect: a voltage is generated across the crystal which is proportional to the applied pressure. A transducer has a natural resonant frequency corresponding to a wavelength (in the material) that is twice the transducer thickness.Generation and detection of ultrasound Both rely on the piezoelectric effect. Most medical transducers are fabricated from a ceramic material: lead zirconate titanate. so we have a means of detecting acoustic waves as well as generating them. + - This change can launch an acoustic wave in the surrounding medium.

PRESSURE POWER BANDWIDTH TIME FREQUENCY . the pulse is much shorter. we would expect that it is easier to figure out where a short pulse came from because longer pulses would lead to temporal overlap in the echoes and greater ambiguity about their source. This corresponds to a narrow frequency spectrum. but this is not what we get from a resonating transducer: PRESSURE TIME POWER FREQUENCY The emitted pulse lasts a long time and looks like a pure “tone”.Most ultrasound imaging is based on the localization of “echoes” or scattered waves from structures within the tissue. Intuitively. and the spectrum is correspondingly broad. Hence it is generally desirable for the source to emit a short pulse. If the transducer is “damped” so that it does not resonate.

. Similar results could be achieved with an acoustic lens As discussed later. Its thickness is one quarter wavelength. Multi-element arrays offer potential for electronic focussing and real-time imaging. that the PZT crystal is shaped like a spherical shell. This results in a focussed wave. Note also the matching layer. This is fabricated of material with an acoustic impedance between that of the PZT crystal (very high) and tissue. It can be shown that this maximizes power transfer from the PZT to the tissue in the same way anti-reflective coatings work on glasses and other optics. Note also. single element transducers are no longer used in medical imaging.This diagram shows a single element transducer with electrical connections and mechanical damping.

all vibrating in phase. In order to calculate the resulting field we must consider the possibility of interference and sum all of the waves taking into account their relative phase. nor would we be able to tell which direction echoes were coming from. and the same sort of integral appears in the acoustic problem. AXIS OF SYMMETRY P . Each emits a spherical wave.Acoustic fields of ultrasonic transducers A very small transducer (compared to the ultrasound wavelength) would act like a point source (and detector). This is exactly what you do to calculate the diffraction pattern from a single slit in optics. We can conceptually divide the transducer into many small elements. but at some arbitrary point in the tissue. Let’s consider a larger transducer as shown below. these waves do not arrive in phase because the distance to each element is different. This would be useless for imaging because we would not be able to direct the ultrasound pulse to a specific region.

Mathematically. we can show that the amplitude of the acoustic pressure wave is proportional to 2 J1 (k a sin θ) k a sin θ J1 is first order Bessel function where k = 2π/λ . In the “far field” we see a well-defined peak on the axis of the transducer. The peak broadens and decreases in size as we move farther from the transducer.This diagram shows the amplitude of the pressure field when the disk transducer vibrates at a single frequency. Close to the transducer in the “near field” there is a complex interference pattern.

number. The sharp maxima and minima of the interference pattern are not so evident for pulsed excitation.number or f# Note that the amplitude peak becomes narrower as we decrease λ (i. . If the transducer emits a pulse (as it usually does) rather than a continuous wave. increase frequency) or as we decrease the f . the calculation is more complex because the pulse contains energy at many frequencies. The general features of the field are the same if we consider the frequency to correspond to the average of the power spectrum.e. Note that a focused transducer can be used as a detector and that it will have the same directional sensitivity.We can do the same calculation for a focused transducer with the geometry shown below: Focal plane a z P r In the focal plane the pressure amplitude is proportional to 2 J1 (kr / 2f) where f = z / 2a is called (kr / 2f) the f .

it is instructive to examine the resolution attainable with the older method.so enough physics. Before considering modern methods. In the early days of ultrasound imaging this was accomplished by moving a single element transducer over the surface of the patient. how do you make images? To obtain a complete image it is necessary to a “fill in the box” by getting sufficient A scans.…. ..

the “speckle” in the image. and the characteristic appearance of the cyst in the thyroid gland. Image courtesy of GE Healthcare .Typical ultrasound image – note the high resolution at 12 MHz.

Typical values of axial resolution are 1 mm or less. Axial direction Lateral direction .Resolution in Ultrasound Images Consider the case of a rectilinear scan where parallel A scans are obtained by translation of the transducer. This is why it is important to have well-designed wide-band transducers that emit a short pulse. The axial resolution is determined by the pulse length.

The first option is limited by the clinical requirements for penetration. In general.The lateral resolution depends on the focusing properties of the transducer.e. a higher frequency can be used than is possible with a large organ like the liver. For a small organ like the thyroid. It can be improved by increasing the frequency or by decreasing the f#. . The second option is limited by the fact that stronger focusing (i. lower f#) will result in a reduced “depth-of-field”. systems use the highest frequency possible. This means that lateral resolution is rapidly degraded at depths out of the focal plane.

Schematic illustration of the depth-of-field problem Low f-number transducer High f-number transducer Focal plane .

Electronic focusing The depth-of-field problem can be overcome to some extent by focusing the transducer at different depths for different parts of the image. The concept is illustrated below: .

A lens can be used with a linear array to provide some (fixed) focusing in the plane perpendicular to the array.Electronic focusing can be achieved with annular arrays or with linear arrays of transducer elements. .

there is a relationship between the number of A scans in the image. Because of its shape.Real time ultrasound imaging A major advantage of modern systems is the ability to acquire images in “real time”. this is sometimes called a sector scan. This requires about 30 images (or frames) per second. d. and the maximum depth to be imaged. Early scanners overcame this problem by using a rotating or rocking scanner: Surface Shaded area is the imaged region. Practically. L. For a frame rate F. In order to avoid ambiguity in echo location we require 1/F = 2 L d/c where c is sound velocity Clearly it is not possible to translate a transducer quickly enough to get real time images. this means that an image must be obtained in a time comparable to persistence of human vision. .

Another way to do this would be to have an array of transducer excited sequentially. The problem with this approach is that a single element has very poor lateral resolution. so that each is used to get an A scan. This can be overcome by using groups of array elements to steer and focus the beam as shown below: .

portable.The implementation of these ideas requires sophisticated electronics and fabrication techniques. and cheap compared to other imaging methods. Advances in these technologies have allowed real time systems to become small. .

. For typical blood velocities and ultrasound frequencies.Doppler ultrasound The Doppler shift is a familiar phenomenon at audible frequencies. In simple systems. Note: the factor of two appears in the equation because the moving object “hears” a Doppler shift. this can be presented to the operator as an audible signal. The same thing happens when ultrasound is scattered by a moving object such as a red blood cell. as does the observer of the scattered ultrasound. the Doppler shift is in the kHz regime.

. One problem with such a system is that it provides no depth resolution so it may be difficult to localize the blood flow information. This is overcome in pulsed Doppler systems that determine the Doppler shift as a function of depth. This is one case where a narrow-band or cw system is advantageous.Large signal from stationary objects POWER Blood moving away from the transducer Weak Doppler signals due to blood moving towards the transducer FREQUENCY The Doppler signal must be found in the “clutter” of signals from stationary objects.

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acquired a short time apart without moving the transducer. This information can be obtained everywhere in the image and overlaid as a color on the normal gray scale image. . and there is a relationship between this and the blood flow velocity. but the signal from the blood vessel has changed because a different arrangement of scatterers fills the volume that contributes to the signal. Red and blue are used to code for direction of flow and the brightness of the color is used to indicate velocity.Color flow imaging Blood vessel Consider the two signals above. The faster blood is flowing. The “difference” can be mathematically quantified as a correlation. As expected. the signal from stationary tissue is unchanged. the greater the difference in the signals.

Instead of imaging flow velocity. another mode is “power Doppler” where the integral of the power spectrum is displayed.Example (from GE’s clinical image library) of color Doppler study of carotid stenosis. This increases sensitivity and allows imaging of organ perfusion .

.For example. this image (courtesy of GE) shows renal perfusion.

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