Ultrasound Flashcards
What is range equation?
Speed (of sound in the medium) x Time / 2
What is axial resolution?
Known as Depth Resolution
(3x better than lateral resolution)
The min distance between 2 reflectors along the beam direction that can be distinguished
High frequency = high axial resolution
Dependent on:
- frequency
- pulse length (fewer and shorter pulses)
Independent of beam width
What is lateral resolution?
(Also known as Azimuthal Resolution)
How do you increase lateral resolution?
Ability to differentiate two reflectors side by side at the same depth in the same scan plane
Determined by:
- High frequency
- Focusing
- Transducer diameter
- Distance from transducer
- Is equal to the beam diameter
- Gets worse at increasing distance from transducer due to divergence
- A smaller transducer can improve lateral resolution when it is near the transducer
- Anything that increases length of near zone will improve lateral resolution. Once in far zone, the beam diverges, decreasing resolution
Independent of:
- Pulse length
- Damping
Increased by:
- Focusing the beam
- High Frequency (increases length of near zone)
- Increased number of scan lines
What is constructive interference?
What is destructive inteference?
Where two ultrasound waves meet in phase
Their amplitudes are then added together
Destructive
Where two out of phase waves meet
They are added together and their signal is nulled
For both constructive and destructive, waves have to be of same wavelength
What happens if object is larger than the beam wavelength?
It wil be reflected or will change direction
What happens if the object is smaller than the beam wavelength?
It will scatter
What measures increase near field and reduce the angle of beam divergence?
- Increasing frequency
- Increasing transducer diameter
Near field length is equal to the transducer diameter2
Transducer Build
Backing layer is matched to the impedence of the transducer (but not the same) so that waves can travel backwards and be scattered within the probe itself without relfection
Matching layer is 1/4 wavelength thick to reduce impedence
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What is the thickness of piezoelectric crystals?
Crystals also known as discs
They are half the desired wavelength thick
Usually 256 crystals
Are made by heating the crystals above curie temp and polarizing with external voltage which is maintained until temp falls below curie point
What is the doppler frequency?
The difference between the Transmitted and Received frequency
Known as the doppler shift
The higher the frequency of the doppler shift the higher the velocity
Change in frequency is inversely proportional to the velocity of sound in the medium
Aliasing occurs when the doppler shift frequency exceeds half the PRF
Doppler shift frequency is directly proportional to the frequency of US Beam
What factors does doppler frequency depend on?
- Speed of sound
- Frequency of US beam
- Cosine of Angle the wave strikes the object
The max doppler frequency that can be detected is equal to half the PRF
Sound velocity is NOT DEPENDENT on blood velocity (just dependent on density and compressibility
Harmonic Imaging
As sound waves pass through tissue they become distorted
Distortion only occurs in the central high energy part of the beam
Distorted wave is made up of several harmonic frequencies which are multiples of first harmonic
E.g. If a 2MHz pulse is sent out then the returned harmonic frequencies are 4,6,8
Done by:
- Harmonic filter
- Pulse inversion
How do we use harmonic imaging?
Harmonic Filter
Harmonics are produced in the RETURNING echo
Using a harmonic filter the fundamental harmonic (transducer frequency) is removed
Done by:
- Harmonic filter
Advantages
- Second harmonic is one used
- Better visualisation of low contrast lesions
- Better visualisation of gallbladder and bladder (liquid filled cavities)
- Improves lateral resolution
What type of transducers needed for Harmonics?
- Heavily damped
- High frequency
- Broad bandwidth
Harmonic imaging
What happens in pulse inversion?
Odd harmonic frequencies (including first one) are removed
The remaining harmonic frequencies are doubled
- Gives better axial resolution
- Broad bandwidth and short pulses so no filtering required
Subject to motion artefact however as multiple pulses
What is speckle artefact?
Interference from many small structures
Causes textured appearance
What is reverberation artefact?
Due to a strong reflector near the surface
Caused by multiple reflections to and fro between tranducer face
Produced a series of delayed echoes
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What is acoustic shadowing?
Where a strongly attenuating structure causes shadowing behind them
- Bowel gas
- Lung
- Bone
- Gallstones
*
What is acoustic enhancement?
Occurs in fluid filled structures
Increase intensity of echoes behind
TGC makes acoustic enhancement worse
What size are US contrast microbubbles and how are they destroyed?
They act by increasing the reflections from the tissue containing agent
Microbubbles <4µm (Microaggregated albumin)
Nanoparticles <1µm (Perflurorcarbons)
Destroyed by high energy US or within a few hours by the body
- Usually have a gaesous core (MAA)
- Reasonance frequency falls within diagnostic US range
- Mainly accumulate in blood but can be uptake by endothelial cells in liver or spleen
- Perfluorocarbon nanoparticles dont have gaseous core
- can stay in circulation longer
- have a low echogenicity
- can only be imaged after accumulation
- can potentially be used as multi-modality contrast agents
Ultrasound Safety
What is Time averaged intensity limit?
Should never exceed:
100mW/cm2
- average energy for an exam is 10mW/cm2
Total sound energy should never exceed 50J/cm2
What is Thermal index (TI) ?
Estimated temperature rise
Equal to: power output/power required to raise temp by 1 degrees
Are three types:
- Soft tissue TIs
- Bone TIb (scanning through soft tissue into bone)
- Cranial TIc (scanning through bone into soft tissue)
TI up to 1 is safe
Generally aim TI < 0.7
- No restrictions on scanning TI <0.7
- 60 min restriction on scanning 0.7 - 1.0
- 30mins scanning in TI >1.0 in fetal scanning
Should never used TI >3 in fetal scanning
TI <1 in ophthalmology
- TIs soft tissue should be monitored
Pulsed Doppler has greatest potential to increase temperature due to high PRF
What should mechanical index be set at?
Risk of cavitation
Should be < 0.9 or 0.7
- MI < 0.5 for fetal scanning
- Above 0.7 should never be used for contrast US
Acoustic Impedence
Acoustic impedence = density x velocity
Acoutic impedence increases proportionally with square root of density
Units: kg/sq metre/sec
INDEPENDENT OF FREQUENCY
High impedence = less able to pass through
Large difference in Z = more energy reflected
Small difference in Z = more energy transmitted
No difference = full transmission
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What is the attenuation of US in soft tissue and in air?
Soft tissue: loses 1Db per cm for every 1MHz
Air: loses 40Db per cm for every MHz
How is intesnity measured?
Amplitude2
Intensity is proportional to the acoustic impedence and to the amplitude2
What is damping?
High Q = low damping and longer pulse
Low Q = high damping and short pulse length
Pulse repition frequency equation
Number of pulses emitted by transducer per second
Frame rate x lines per frame
Lower PRF = higher depth of view
Higher PRF = shallow depth of view
What is best doppler angle?
Less than 60 degrees
Doppler shift frequency is proportional to Cosine of angle
-
Side lobes cause artefact in doppler
*
What is Continuous Wave Doppler?
Hand held doppler
- Transmission frequency 2-10MHz used
- Uses 2 diferently angled transducers (one to transmit and one to receive)
- Received freq subtracted from initial transmitted freq
How do we calculate length of near field?
Frequency x beam diameter
How to estimate pressure in a stenosed vessel?
Bernoulli Formula = 4 x velocity2
How to measure Echo intensity?
(or amount of reflected echoes)
Z2 - Z1 / Z2 + Z1
The difference in impedence of two tissues divided by the sum of impedence of two tissues
Display of Echoes in A Mode and B Mode
A mode = spikes
B mode = dots
What is Mechanical Index?
Can cause cavitation if >0.7
- lungs are prone to cavitation
- not fetal lungs however as they arent aerated
- in neonates possibility of lung or intestine damage occurs with MI >0.3
Peak rarefaction (negative) pressure/square root of frequency of US beam
Should be less than 0.7
Lower frequencies cause higher MI
How to measure power of an US probe?
- Calorimeter (measures heat output)
- Force balance
Continuous wave ultrasound
Only a single frequency is emitted
Good depth of view
High Q is best (low damping)
How to calculate Q value?
Q value = Mean frequency / Bandwidth
Bandwidth = FWHM
(spectrum of frequencies used)
Short pulses and LOW Q(high damping) have a wide bandwidth
Long pulses and high Q (low damping) have a narrow bandwidth
Pulsed Ultrasound (Lower penetration depth)
A range of sound waves with different frequencies are emitted
Uses Wider bandwidth (low Q)
Is there lateral resolution in A mode imaging?
No
A minimum of two pulses are required for lateral resolution
Probe terminology
Footprint = width of the probe
In linear probes the field of view is the same width as the footprint
Large nearfield in linear probes
In curvilinear probes the field of view is wider than the footprint
Phased array (curvilinear) can alter
- Beam direction
- Axial resolution
- Lateral resolution
- PRF
Ring Down artefact
(Also known as Comet Tail artefact)
Associated with gas bubbles
When US beam encounters a small fluid collection surrounded by gas bubbles
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Quality Assurance US
Resolution: Perspex box with water inside and parallel wires
When using perspex, adjustments need to be made as sound travels faster in perspex
Gelatine based phantons can also be used to mimic tissue
Dynamic range, Sensitivity and A scan calliper: persepex box with parallel vertical rods
B mode Grey scale and Doppler: Tissue phantoms using gelatine
Power output: force balance or calorimeter
Ultrasound Wavelength
Ranges from 0.1 - 1.5mm
What is specular reflection?
Happens when US encouters large smooth surfaces such as bone
US waves are reflected back in a uniform direction
The angle of specular reflection is equal to the angle of incidence
Enables visualisation of tissue boundaries
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What is Snells law?
Law of refraction
The angle of refraction depends on the velocities of US in the media on both sides of the boundary
In other words
The ratio of sines of the angles of incidence and refraction is equal to the ratio of velocities in the two tissues forming the boundary
What is the critical angle?
90 degrees
It is the angle of incidence, where the refracted beam travels parallel to boundary
How is length of near field calculated?
It is proportional to the Transducer diameter2
or
Frequency x Diameter2
Inversely proportional to the wavelength
Increasing frequency causes increased nearfield length and decreased far field divergence
How to obtain a shorter focal distance?
Long delay between energising the outer vs inner elements
What are grating lobes?
Are weak replicas of main US beam
Happen when crystals are larger than half the wavelength
Unique to array transducers
-not seen in annular transducers
Most transducers used are ARRAY
Apodization is a technique used to reduce side lobes where less power is sent to the outer elements
Typical Number of scan lines?
Usually 100 is sufficient
Scan lines = PRF / Frame rate
e.g. 2kHz 2000/25
=80 scan lines
Frame Rate = Speed of tissue / 2 x depth of view x number of scan lines
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What is restrictive index?
RI = Peak systolic flow - end diastolic flow / peak systolic flow
Examples of low RI structures:
- Renal artery
- uterine artery
- external carotid artery
What are flash artefacts?
Bursts of signal due to motion
Seen in power doppler more than continuous wave
Contrast US
- Microbubbles can be used for drug delivery to tissues
- Low MI scanning is used to characterise liver lesions and look for washout in arterial/pv phase
- Can be viewed in real time at low MI to prevent bursting
Perfluorocarbons do NOT have a gaseous core
What is string phantom used for?
Used for testing velocity in doppler mode
What should probe temperature be?
Should be less than 43 degrees celsuis internal and external
How to measure amount of wave reflection at an interface?
(Z1 - Z2)2 / (Z1 + Z2)2
Coupling Gel purpose
Allow passage of beam between:
Probe - Air - Tissue
Attenuation
A change of 3Db is approximately equal to a doubling or halving of power
Do Matching layers reduce acoustic impedence?
NO
They only allow easier tranmission of the pulse to the patient
Can an annular array focus in 2 dimensions?
Yes
How to calculate PRF?
Lines per frame x frame rate
The max PRF is limited by depth
What is reflection coefficient for soft tissues?
Always less than 5%
Muscle - soft tissue = 0.04%
Bone - soft tissue = 40% reflection
What is considederd attenuation?
- Absorption
- Scatter
- Reflection
Attenuation in bone is higher than soft tissue
How many US pulses required to build up a scan line?
Just 1
Does increasing US intensity help visualise deep structures?
Yes it will increase echo amplitude at depth
Processing of colour and pulse doppler
Pulsed doppler: Fourier transforms
Colour doppler: autocorrelation
What results in Range ambiguity in doppler??
High PRF
What is acoustic streaming?
Corresponds US being absorbed in a medium and inducing fluid flow
This has the potential to cause Cellular damage
What is comet tail artefact?
A type of reverberation artefact
Seen in adenomyosis of gallbladder
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