Ultrasound - University of Washington

1 1 UltrasoundBasic Idea Send waves into body which are reflected at the interfaces betweentissue Return time of the waves tells us of the depth of the reflecting surfaceHistory First practical application, 1912 unsuccessful search for Titanic WW II brought massive military research - SONAR (SOund NavigationAnd Ranging) Mid-century used for non-destructive testing of materials First used as diagnostic tool in 1942 for localizing brain tumors 1950 s 2D gray scale images 1965 or so real-time imagingSonography relatively portable, inexpensive, and safe so is often the first choice ofa medical imaging method where feasibleSound waves Sound wave propagate by longitudinal motion(compression/expansion), but not transverse motion(side-to-side) Can be modeled as weights connected by springs2 Ultrasonic Waves and properties Mechanical waves are longitudinal compression waves Ultrasound refers to frequencies greater than 20kHz, the limit ofhuman hearing For Medical imaging typically 100 Times higher frequency than audibleby human typically 2 to 20 MHzTransmission and Reflection3 Propagation of Ultrasound waves in tissueScattering Specular reflector is a smooth boundary between media (conventional view of reflections acoustic scattering arises from objects that are size of wavelength or smaller Most organs have characteristic structure that gives rise to defined scatter signature Specular - echoes originating from relatively large, regularly shaped objects withsmooth surfaces.)

2 These echoes are relatively intense and angle dependent. ( ) - Reflection from large surfacesScattered - echoes originating from relatively small, weakly reflective, irregularlyshaped objects are less angle dependant and less intense. ( blood cells) -Reflection from small surfacesBasic Idea Along each line we transmit a pulse and plot thereflections that come back vs time4 The Speed of Sound The compressibility and density of a material,combined with the laws of conservation of mass andmomentum, directly imply the existence of acousticwaves Ultrasound waves travel at a speed of sound c, givenbyc=1!"Variations in Speed Speed of sound fordifferent materialsc=1!"5 Physics of acoustic Waves Three dimensional in nature and depend on time Whatever the physical quantities that are used to describe thesound waves, they must depend upon three spatial variables, x,y, z, and time, t Particle displacement u(x, y, z, t) associated with thecompression and expansion of the acoustic wave Particle velocity v(x, y, z, t) acoustic pressure p(x, y, z, t), which is zero if there is no waveFor longitudinal waves, it is straightforward to relate the acousticpressure to the underlying particle velocitywhere Z = c is called the characteristic impedance This is a like V=IR Note thatp=vZv!

3 C Speed of soundfor differentmaterials Impedancerelating pressureto particlevelocityVariations in Speed and Impedancec=1!"p=vZZ=!c=!"6 The acoustic pressure p must satisfy the three-dimensional waveequation For a plane wave traveling in the z-direction thus reduces to An example solution is,which has cyclic frequency (in Hertz) ofwhich also leads to the important relationWave Equation!2!x2+!2!y2+!2!z2"#$%&'p(x,y,z,t )=1c2!2p(x,y,z,t)!t2!2p(z,t)!z2=1c2!2p(z ,t)!t2p(z,t)=cosk(z!tc)f=kc2!f=c!Materia l 1 Material 2 Propagation of Ultrasound waves in tissue Ultrasound imaging systemscommonly operate at , which corresponds to awavelength of mmwhen c = 1540 When a wave passes fromone medium to another thefrequency is constant, andsince c changes then somust the wavelength!=cfsince 2 < 1we have c2 <c17 sin!ic1=sin!rc1=sin!tc2 Propagation of Ultrasound waves in tissue Bending of waves from onemedium to another is 'refraction' Follows Snell s Lawsince 2 < 1we have c2 <c1and 2 < 1incidentreflectedtransmittedTotal Internal Reflection Since 2 > 1 in this case, we have c2 > c1 and 2 > 1 There can be a 'critical' incident angle 1 = C where 2 = 90deg, there is no transmitted wave.

4 In that case there is'total internal reflection of the wave8 Attenuation of Ultrasound waves in tissueAttenuation is the term used to account for loss of wave amplitude (or signal )due to all mechanisms, including absorption, scattering, and mode conversionThe model of attenuation is phenomenological, meaning it agrees well in practicebut is not easily supported by theoryWe model amplitude decay aswhere A is called the amplitude attenuation factor and has units cm 1 Since 20 log10 (A(z)/A0) is the amplitude drop in decibels (dB), it is useful todefine theattenuation coefficient asThe absorption coefficient of a material is generally dependent on frequency f,and a good model for this dependency isThe rough approximation that b = 1 is often usedA(z)=A0e! Az!=20log10(e)" A# A!=afbAttenuation of Ultrasound waves in tissueAssuming b~1A(z,f)=A0e! Compensation Depth of signal is related to reflectiontime, so as time progresses, the signalwill be increasingly attenuated Time-dependent attenuation causessevere signal loss if not compensated All systems are equipped with circuitrythat performs time-gain compensation(TGC), a time-varying amplification In practice, most systems haveadditional (frequency dependent) slidepotentiometers, which allow the gain tobe determined interactively by theoperator.

5 This permits the user tomanually adapt the system to specialcircumstances requiring either more orless gain so that subtle features can beseen in the of Ultrasound A 'transducer' converts energy from one form to another The Piezoelectric effect was described 1880 Pierre and Jacques Curie Lead zirconate titanate, or PZT, is the piezoelectric material used in nearly all medical ultrasoundtransducers It is a ceramic ferroelectric crystal exhibiting a strong piezoelectric effect and can be manufactured innearly any shape The most common transducer shapes are the circle, for single crystal transducer assemblies, and therectangle, for multiple transducer assemblies such as those found in linear and phased arrays10 Beam Pattern Formation Simple Field Pattern ModelGeometric approximationFresnel regionFraunhofer (or far field) regionApproximate field pattern for a focused transducer11 Collect the EchoTransducers12 Phased-Array concept fortransmission and receptiondelayed pulsesarray ofpiezoelectric crystalsgenerated wave (transmission)sensitive region (reception)PlanarFocusedTransducer Arrays13 Array Transducers Linear arrays(composed of 256 to 512 discrete transducerelements) (~15 to 20 adjacent elementssimultaneously activated sequentially acrosssurface to sweep FOV) Phased array transducers(composed of 64, 128, or 256 elements) (phase delayvaried to sweep across FOV)Side-lobes Focused arrays typically have larger 'sidelobes' ofsignal power for transmission and sensitivity forreception14(Amplitude)

6 A-Mode Along each line we transmit a pulse and plot the reflections that comeback vs time Unfortunately, it is very difficult to associate a precise physical meaningwith the received signal amplitude vs timeUltrasonic Imaging Modes15 Ultrasonic Imaging ModesEcho Display Modes: A-mode (amplitude): display of processedinformation from the receiver versus time Speed of sound equates to depth (only used in ophthalmology applications now) B-mode (brightness): Conversion of A-modeinformation into brightness-modulated dots M-mode (motion): uses B-mode information todisplay the echoes from a moving organA-Mode ExampleTransmission pulse in red, reflected waves in blue16 Forming an Image The amplitude values are converted to brightness along a lineand displayed on a screen The line direction is swept across an angular range, eithermechanically or electromagnetic beamformingbeam sweepForming Clinical ImagesTwo common clinical Ultrasound examinations(L) an echocardiogram showing the four chambers of the heart(R) fetal Ultrasound , showing a normal fetus at the secondtrimester of locations17 Complete SystemAcquisition and Recon Time For external imaging: each line corresponds to 20cm.

7 velocity of sound in soft tissue is ~1540 m/s. Travel distance from and to transducer 40 cm Acquisition of line takes 260 s Typical image has 120 lines for total time of 31 ms. Images reconstructed in real So can have temporalresolution of ~30 Hz (30 images a second) Modern scanners collect multiple scan lines simultaneouslyusually frame rates of 70-80 Hz18 Clinical Uses - Cardiac Imaging B-mode image of a normal heartLeftventricleRightventricleRightatr iumLeftatriumExample of M-Mode below 2D B-mode Image19 Clinical Uses - Neonatal B-mode image of a fetus. The dark region is theuterus, which is filled with fluidDoppler Wave (CW) Doppler: Continuous sinusoidal wave transmitted with one crystal and reflectedwave received with second Wave (PW) Doppler: Pulsed waves transmitted at constant pulse repetition frequency and onlyone sample as function of time is Flow (CF) imaging:20 Doppler ImagingDoppler ImagingColor Flow (CF) imaging.

8 Doppler equivalent of B-mode pulses instead ofone are transmitted/received along each line Calculates phase shift between two subsequent pulses velocity information in color is superimposed on anatomical grayscale imageRed - flow towards transducerBlue - flow away from transducer213D Image FormationReordering of the knownslice locations providessurface-shaded, wiremesh, MIP, or otherrenditions of the anatomyComparing 2D to 3D US22 Dangers of Ultrasound very minimal in comparison to other methods development of heat - tissues or water absorb the ultrasoundenergy which increases their temperature locally formation of bubbles (cavitation) - when dissolved gasescome out of solution due to local heat caused by Ultrasound high intensity systems actually used for therapySome Ultrasound Uses (short list) Obstetrics and Gynecology measuring the size of the fetus to determine the due date checking the sex of the baby (if the genital area can be clearly seen) checking the fetus's growth rate by making many measurements over time detecting ectopic pregnancy, the life-threatening situation in which the baby isimplanted in the mother's Fallopian tubes instead of in the uterus determining whether there is an appropriate amount of amniotic fluid cushioning thebaby monitoring the baby during specialized procedures - Ultrasound has been helpful inseeing and avoiding the baby during amniocentesis (sampling of the amniotic fluidwith a needle for genetic testing).

9 Years ago, doctors use to perform this procedureblindly; however, with accompanying use of Ultrasound , the risks of this procedurehave dropped dramatically. seeing tumors of the ovary and breast Cardiology seeing the inside of the heart to identify abnormal structures or functions measuring blood flow through the heart and major blood vessels Urology measuring blood flow through the kidney seeing kidney stones detecting prostate cancer early23 Breast Cancer Example Not same dimension scale In US we terms like hypoechoic or hyporeflective for lowintensity regions, and hyperechoic or hyperreflective for highintensity regionsDynamic Fetal Ultrasound Imaging24 Brain scan exampleNormalFluid from intraventricular hemorrhag