SIMPLE ULTRASOUND

BASIC DEFINITIONS
AMPLITUDE:
• Highest peak point
• It is the difference b/w maximum and minimum value in a wave.
OR
• It is the distance between trough and base line
Depends on:
• Source and medium
• When sound waves strikes a medium and come back to their original position,
amplitude decreases.
POWER
• The rate of work done with respect of time.
OR
• The rate of energy transfer
• P= W/t or P= E/t
• Work/energy is same (Unit of energy= J/s)
• Unit of power= Watt
• Power is directly proportional to the square of amplitude
Pα Amplitude2
INTENSITY
• The concentration of energy in a sound beam.
OR
• Power carried by sound wave per unit area in direction perpendicular to that area is
acoustic intensity.

• The power of beam per unit area.

• I= P/A (where A= Cross-sectional area, Unit of intensity = W/m2)
• Intensity α Power
(As Power α Amplitude2 so Intensity α Amplitude2)
• Deep structures have low intensity
PULSE
• Pulse is a collection of waves that travel together.
• In diagnostic ultrasound imaging, short bursts, or pulses, of energy are
used to create anatomical images.
• Imaging probes are pulse probes that is they generate and receive
signals/waves.
• Continuous wave sound cannot create anatomic images
 Used in therapeutic ultrasound.
PULSE REPETITION PERIOD (PRP)
• Time from the start of one pulse to the start of the next pulse. It includes one
pulse duration and one “listening time”.
• When PRP increases, Pulse Repetition Frequency (PRF) decreases and vice
versa.
• As imaging depth increases, PRP increases and vice versa.
• Superficial structures has low PRP and as a result high image
quality/resolution.
• Deep structures has high PRP and as a result low image quality/resolution.
PULSE REPETITION FREQUENCY (PRF)
• Number of sound pulses emitted by transducer over a period of time. It is typically
measured as cycles per second or hertz (Hz)
OR
• Number of times ultrasound beam turned on and off per unit time.
• Range of PRF in medical imaging is 1 – 10 KHz.
RELATIONSHIP BETWEEN IMAGING DEPTH AND PRF
• The deeper the area of interest, the lower the PRF. As the imaging depth increases, PRP
increases and PRF decreases and vice versa.
SPATIAL PULSE LENGTH (SPL)
• The length or distance that a pulse occupies in space. The distance from the start
to the end of one pulse.
• Determines axial resolution
• Short pulse creates image of greater accuracy.
• Longer spatial pulse length results in worst resolution.
ATTENUATION AND FREQUENCY

• Attenuation depends on frequency of the sound.

• The higher the frequency, the greater the amount of attenuation will occur in any given
tissue.
For deep structures:
 If a structure has increasing image depth (10m), it will have

• Low frequency
• Low attenuation
• High penetration
• High PRP
• Low image quality
For superficial structures:
If a structure has decreasing image depth (5cm), it will have

• High frequency
• High attenuation
• Low penetration
• Low PRP
• High image quality

Range of linear probe frequency is 5 – 7.5 MHz.

REAL TIME IMAGING
• It involves the generation of images of the same cross section respectively and at a
rate exceeding about 25 frames per second which is high enough to create the
impression of events in time.
• This facilitates the observation of motion in any part of the subject within the
cross section being scanned.
• Initially 2D image in ultrasound.
• Image is known as frame i.e. one image is frame.
• To allow adequate real time image, sufficiently large number of frames must be
scanned per second.
TEMPORAL RESOLUTION
• It the time from the beginning of one frame to the next.
• This is the ability of the system to display events occurring at different times as
separate images.
• Measured in frames per second.
• More frames produced in minimum time, better will be the image quality.
• It is reduced by:
Greater number of focal zones

Having doppler on

Deeper object (echo takes longer to return)

Large sector width

FRAME RATE:

• No. of whole images (frames) that are displayed per second (measured in Hz) is
frame rate or frames/second.
• Directly proportional to temporal resolution i.e. more frame rate more temporal
resolution, better image quality and vice versa.
• Frame rate decreases as:
Image depth increases

No. of scan lines / no. of pulses increases

NOISE
• An inherent property of medical ultrasound imaging, and it generally tends to reduce the image
resolution/quality and contrast, thereby reducing the diagnostic value of this imaging modality.
Signal to Noise ratio (SNR Ratio)
• It is one of the parameters that has significant effect on quality of ultrasound images, especially
harmonic images
• Signals: gives meaningful information. All echoes reflect back to make image quality better.
• Noise: obscure signal clarity.
• More signal to noise ratio (1 : 0.5) more signals and more image quality will produced which
results in less noise.
• Less signal to noise ratio (5 : 10) less signals and less image will produced which results in more
noise.
SIGNAL AMPLIFICATION
• Overall gain
• Amplification is the conversion of the small voltages received from the transducer into
larger ones that are suitable for further processing and storage.
• Gain is a uniform amplification of the ultrasonic signal that is returning to the transducer
after it travels through the tissue. So rather than brightening the monitor, the image on
the screen is whitened by a uniform margin, as though the returning signal is stronger than
it is, to make it easier to see.
• More amplification of signals will result in full brightness of ultrasound image.
• Less amplification of signals will result in full dark image.
TIME GAIN COMPENSATION (TGC)
• TGC is an amplification technique to increase ultrasound echoes from tissue interfaces
that are deeper within the body.
• This is to compensate for the increasing attenuation of the echoes returning from these
deeper areas.
• This is one of the manual controls available to the sonographer to achieve a more uniform
grey-scale image.
• We can increase or decrease the gain of any part by our own.
• Can be varied by operator.
 BIOLOGICAL EFFECTS OF ULTRASOUND

The biological effects of ultrasound refer to the potential adverse effects that the imaging
modality has on human tissue. These are primarily via two main mechanisms: thermal and
mechanical. Despite this, ultrasound has a remarkable record for patient safety with no
significant adverse bio effects reported in the literature
 THERMAL EFFECT
• Increase temperature within a medium/organ
• Sonic energy is absorbed and converted into heat

Thermal effect depend on

1. Beam intensity
2. Tissue absorption co-efficient
3. Blood flow (Blood circulating through the tissue)
4. Exposure parameter (e.g. duration of exposure frequency)
5. Duration of ultrasound
Example: Transducer Self Heating
• Electrical energy is converted to thermal energy instead of sonic energy.
• More likely to occur with endocavity probes because
 The probe is enclosed within the body
 Stationary for several minutes.
• Clearly express thermal injury
• E.G. Trans-esophageal exams.
 MECHANICAL EFFECTS
• The mechanical bio effect of ultrasound refers to damage caused by the actual oscillation
of the sound wave on tissue.
OSCILLATION
• Oscillation refers to the repeated back and
forth movement of something between
two positions or states.
• A single oscillation is a complete
movement, whether up and down or
side to side, over a period of time.
CAVITATION
• Major factor in mechanical effect.
• Pressure changes in the medium may cause micro-bubbles (gaseous nuclei) to form in tissue
• Ultrasound contrast agent can act as a source of cavitation when injected into body before
ultrasound examination.
• This is more likely to occur with high intensity beams (b-mode imaging)

MECHANICAL INDEX
• Mechanical index is the primary indicator for the risk of cavitation.
• Mechanical index for fetal scanning is 0.5
 ARTIFACTS IN ULTRASONOGRAPHY
• Artifacts are any alterations in the image which do not represent an actual image of the examined
area. They may be produced by technical imaging errors or result from the complex interaction of
the ultrasound with biological tissues.
TYPES OF ARTIFACTS:
Reverberation:

• Multiple equally spaced echoes due to bouncing of sound waves between two strong reflecting
surfaces.
• Image will appear hyperechoic although it is not hyperechoic in real.
• Two types of reverberation artefact exists:
1. Comet tail: from metal or calcified objects
2. Ring down: from a collection of gas bubbles
COMET TAIL ARTIFACT
• It is a well-known useful reverberation artifact on sonograms.
• It is often accompanied by a thickened gallbladder wall lesion, such as gallbladder
adenomyomatosis.
RING DOWN ARTIFACT
• Ring down artifact is a special type of resonance artifact.
• Its appearance is similar to the ladder-like reverberation of comet-tail artifact. It appears as line or series of
parallel bands extending posterior to the collection of gas.
• The artifact is only associated with gas bubbles.
• The source of ring-down artifact is a small pocket of fluid trapped by surrounding air bubbles.
REFLECTION / MIRROR IMAGE ARTIFACT
• Mirror image artifact in sonography is seen when there is a highly reflective surface (e.g.
diaphragm) in the path of the primary beam.
ACOUSTIC SHADOWING ARTIFACT
• The phenomenon of acoustic shadowing (sometimes called posterior acoustic shadowing) on an ultrasound
image is characterized by a signal void behind structures that strongly absorb or reflect ultrasonic waves.
• It is a form of imaging artifact. This happens most frequently with solid structures, as sound conducts most
rapidly in areas where molecules are closely packed, such as in bone or stones.
• It occurs because of stones in kidney, gall bladder .
TWINKILING ARTIFACT
• Also called “color comet tail artifact”. It is a color doppler phenomenon that appears as a rapid change of color
immediately behind a stationary object.
• Appearance: It occurs in color flow doppler imaging mode, a region appears as a rapidly changing mix of colors.
• Cause: The presence of small strongly reflective objects within the Doppler study.