UltrasoundUltrasound

Spring 2013Spring 2013

Week 7 Week 7

RT 255 CRT 255 C

Ultrasound AKA:Ultrasound AKA:

1)Diagnostic Medical 1)Diagnostic Medical SonographySonography

2)Sonography2)Sonography

3)Ultrasonography3)Ultrasonography

4)Vascular Sonography4)Vascular Sonography

5)Echocardiography5)Echocardiography

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Principles of Diagnostic Principles of Diagnostic UltrasoundUltrasound

NON- ionizingNON- ionizing

Uses high frequency sound wavesUses high frequency sound waves By giving reflections from parts in the bodyBy giving reflections from parts in the body

MobileMobile

Cost effectiveCost effective

Invasive?Invasive?

Can be imaged in sectional, coronal and oblique Can be imaged in sectional, coronal and oblique planesplanes

33

What makes a good What makes a good Sonographer?Sonographer?

Knowledge of detailed anatomy and Knowledge of detailed anatomy and PathophysiologyPathophysiology 3D antatomy3D antatomy

Good communicationGood communication

Be able to work under stressBe able to work under stress

44

Repetitive Motion InjuriesRepetitive Motion Injuries Poor ergonomic habitsPoor ergonomic habits

Poor equipment design Poor equipment design Poor posturePoor posture

80% have muscloskeletal 80% have muscloskeletal injuriesinjuries Shoulder (rotator cuff) Shoulder (rotator cuff) Elbow Elbow Neck Neck Lower Back Pain Lower Back Pain Wrist lesions or pain Wrist lesions or pain

(carpal tunnel, (carpal tunnel, ganglions, tendonitis) ganglions, tendonitis)

Eyesight problemsEyesight problems

Why?Why?

Sustained pressure and force Sustained pressure and force

Awkward scanning techniques Awkward scanning techniques

Assisting with patient Assisting with patient movement movement

Body habitusBody habitus

Inadequate work breaks Inadequate work breaks

Overall job stressOverall job stress

55

Still a NeonateStill a Neonate

Fairly new technology compared with Fairly new technology compared with xrayxray

First used for navy sonar in World War IIFirst used for navy sonar in World War II

1940’s 1940’s US waves transmitted and returned US waves transmitted and returned

66

1947 – Through- 1947 – Through- TransmissionTransmission

Used to detect Used to detect tumors and tumors and intracranial intracranial lesionslesions

With 2 With 2 transducers transducers opposite sides of opposite sides of the headthe head

Called through-Called through-transmissiontransmission

77

1948 First Ultrasound1948 First UltrasoundDouglas HowryDouglas Howry

88

Contact Compound ScannerContact Compound Scanner

19571957 Tom Brown and Ian Tom Brown and Ian

DonaldDonald Obstetric Obstetric

techniquestechniques

99

Present DayPresent Day

Smaller machinesSmaller machines Increased Increased

resolutionresolution Real time scanningReal time scanning PortablePortable MobileMobile

1010

Properties of Sound WavesProperties of Sound Waves

Acoustic wavesAcoustic waves Energy that moves back and forth or vibrates at a Energy that moves back and forth or vibrates at a

steady ratesteady rate

Audible sound wavesAudible sound waves 16,000 – 20,000 cycles/sec16,000 – 20,000 cycles/sec

Ultrasound wavesUltrasound waves 1- 10 million cycles/sec1- 10 million cycles/sec High frequency mechanical vibrations through a mediumHigh frequency mechanical vibrations through a medium

Transmitted by particles of gas, liquid or solid mediumTransmitted by particles of gas, liquid or solid medium

1111

Piezoelectric EffectPiezoelectric Effect

AC applied across piezoelectric crystalsAC applied across piezoelectric crystals Crystals grow and shrinkCrystals grow and shrink

Conversion of electrical energy to Conversion of electrical energy to mechanical energymechanical energy

US is produced from a transducer by US is produced from a transducer by this effectthis effect

1212

Acoustic ImpedanceAcoustic Impedance Has properties similar to lightHas properties similar to light

Focused, refracted, reflected or scatteredFocused, refracted, reflected or scattered Dependent on the density and elastic properties Dependent on the density and elastic properties

of mediumof medium

Velocity of soundVelocity of sound Sound waves are sent and receivedSound waves are sent and received Velocity is different among bone, air and soft Velocity is different among bone, air and soft

tissuetissue Poor impedance in airPoor impedance in air

Pitch and sound waves are picked up by Pitch and sound waves are picked up by computer and produce images: based on depths computer and produce images: based on depths and speedsand speeds 1313

Properties similar to lightProperties similar to light

http://www.e-http://www.e-echocardiography.com/chapters/echocardiography.com/chapters/physicalprinciples/02.phpphysicalprinciples/02.php

1414

Types of Types of TransducersTransducers

1515

Elements of TransducersElements of Transducers

Capable of sending Capable of sending and receieving USand receieving US

1616

Advantages of USAdvantages of US 1. 1. Ultrasound examinations can be Ultrasound examinations can be

non-invasivenon-invasive

2. 2. Ultrasound methods are relatively Ultrasound methods are relatively inexpensive, quick and convenientinexpensive, quick and convenient

3. 3. No harmful effects have been No harmful effects have been detecteddetected

4. 4. Ultrasound is particularly suited to Ultrasound is particularly suited to imaging soft tissuesimaging soft tissues 1717

Disadvantages of USDisadvantages of US

1. 1. The major disadvantage is that the The major disadvantage is that the resolution of images is often limitedresolution of images is often limited. .

2. 2. Ultrasound is reflected very Ultrasound is reflected very strongly on passing from tissue to strongly on passing from tissue to gas, or vice versagas, or vice versa

3. 3. Ultrasound also does not pass well Ultrasound also does not pass well through bonethrough bone

1818

Real Time, DopplerReal Time, Dopplerand Color Flow Dopplerand Color Flow Doppler

Real time:Real time: Multiple rapid image frames per secondMultiple rapid image frames per second Ex: can see pulsative vascular, cardiac Ex: can see pulsative vascular, cardiac

structures, diaphragm motion & peristalsisstructures, diaphragm motion & peristalsis DopplerDoppler

Frequency change in laminar or turbulent flow Frequency change in laminar or turbulent flow in vascular structuresin vascular structures

Color DopplerColor Doppler Assigns a color scale to change in frequencyAssigns a color scale to change in frequency Red toward transducer and blue away from Red toward transducer and blue away from

transducertransducer1919

DopplerDoppler

2020

Color DopplerColor Doppler

2121

GallbladderGallbladder

2222

GallbladderGallbladder

2323

ProstateProstate

2424

ProstateProstate

2525

2626

BladderBladder

2727

KidneyKidney

2828

Abdomen - LUQAbdomen - LUQ

2929

Abdomen - RUQAbdomen - RUQ

3030

LiverLiver

3131

LiverLiver

3232

SpleenSpleen

3333

SpleenSpleen

3434

PancreasPancreas

3535

UterusUterus

3636

UterusUterus

3737

Ovary Ovary

3838

OvaryOvary

3939

BreastBreast

4040

BreastBreast

4141

TestesTestes

4242

4343

19 Week Fetus19 Week Fetus

4444

19 Week fetus19 Week fetus

http://images.google.com/imgres?http://images.google.com/imgres?imgurl=http://embryology.med.unsw.edu.au/imgurl=http://embryology.med.unsw.edu.au/movies/usound/movies/usound/19weeklabel2.jpg&imgrefurl=http://19weeklabel2.jpg&imgrefurl=http://embryology.med.unsw.edu.au/movies/embryology.med.unsw.edu.au/movies/usound/usound/Hum19w4D.htm&usg=__EfDiZ2qdLFEQ_ZGPy9Hum19w4D.htm&usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h=379&w=358&sz=11&hl=en&YS628QyPI=&h=379&w=358&sz=11&hl=en&start=71&tbnid=QqSTbyckVI-start=71&tbnid=QqSTbyckVI-jYM:&tbnh=123&tbnw=116&prev=/imagesjYM:&tbnh=123&tbnw=116&prev=/images%3Fq%3Dfetal%2Bultrasound%26gbv%3Fq%3Dfetal%2Bultrasound%26gbv%3D2%26ndsp%3D20%26hl%3Den%26sa%3D2%26ndsp%3D20%26hl%3Den%26sa%3DN%26start%3D60%3DN%26start%3D60

4545

HeartHeart

4646

HeartHeart

4747