Ultrasound Technology

Ultrasound wave is produced when an electric current is applied to an array

of piezoelectric crystals. This causes distortion of the crystals, makes them
vibrate and produce this acoustic wave. The summation of the waves
produces an ultrasound beam.
The ultrasound waves are produced in pulses. Each pulse is 2-3 cycles of the
same frequency. The pulse length is the distance each pulse travels. The
pulse repetition frequency is the rate at which the transducer emits the
pulses. The pulses have to be spaced. This allows enough time between
pulses so the beam has enough time to reach the target and return to the
transducer before the next pulse is generated.
Ultrasound image is produced when the pulse wave that is generated travels
through the body, reflects of the tissue interface (echo0 and returns to the
transducer. When the wave is transmitted back to the transducer its
amplitude is represented by its brightness or echogenicity. It is represented
as a dot. The final image is produced by the combination of these dots.
Strong reflections produce bright dots (hyperechoic images) e.g. bone,
weaker reflections produce grey dots (hypoechoic images) e.g. solid organs.
No reflection produces anechoic images, e.g. blood vessels
Frequency and Resolution
Ultrasound frequency is above 20,000 Hz or 20 KHz. Medical ultrasound is in
the range of 3 -15 MHz. Average speed of sound through most soft human
tissues is 1,540 meters per second. This can be calculated multiplying the
wavelength with frequency. The higher frequency wavelength will have
shorter wavelength whereas lower frequency wavelength will have longer
wavelength. The wavelength for the 2.5 MHz is 0.77 mm whereas that for 15
MHz is 0.1 mm
Image resolution determines the clarity of the image. Such spatial resolution
is dependent of axial and lateral resolution. Both of these are dependent on
the frequency of the ultrasound. Axial resolution is the ability to see the two
structures that are side by side as separate and distinct when parallel to the
beam. So a higher frequency and short pulse length will provide a better
axial image. Lateral resolution is the image generated when the two
structures lying side by side are perpendicular to the beam. This is directly
related to the width of the ultrasound beam. Narrower the beam better is the
resolution. The width of the beam is inversely related to the frequency.
Higher the frequency narrower is the beam. If the beam is wide the echoes
from the two adjacent structures will overlap and the image will appear as
one.
Attenuation
When the ultrasound beam travels through the tissues there is some energy
loss and this is called attenuation. Attenuation of the signal is due to
absorption, reflection and scattering. Attenuation is represented by the
attenuation coefficient and each tissue ahs its own coefficient. Blood has the
lowest coefficient and bone ahs the highest coefficient. In the soft tissue 80%
of the attenuation is because of absorption. Attenuation is also results from

reflection and scattering. Reflection depends on the difference in acoustic

impedances of the tissues at the interface. Acoustic impedance is the
resistance offered by the tissues to the transmission of the sound. Higher the
difference in impedance greater is the reflection of the wave. Scattering
occurs when the ultrasound wave encounters an interface that is not
perfectly smooth. Scattering provides most of the information for diagnostic
imaging.
Color Doppler
Color Doppler characterizes the flow. There is a moving target and a
stationary transducer. When the transducer is positioned on a blood vessel
the red cells are moving. They cause a change in the returning echoes. If the
cells are moving towards the transducer it is perceived as a higher frequency
and is displayed in red. If it is moving away form the transducer it is a lower
frequency and is displayed as blue. So depending how the transducer is
angled on the blood vessel the color could be blue or red. This color Doppler
detection is worst when the transducer is placed 90 degrees to the blood
vessel.
Transducers
The transducers (probes have a bandwidth of 7-15 MHz. For superficial
structures like supraclavicular block it is ideal to use a probe that has a
frequency greater than 7 MHz. These give best resolution if the structures
are only 2-3 cm below the skin. When the structures are deeper than 4com it
is advisable to use the lower frequency transducer (probe). The image
resolution is poor compared to higher frequency transducer. The probes are
liner and curvilinear. They can be with a large foot print or small foot print to
accommodate for the anatomy. So it is important to remember
Higher frequency - High resolution poor penetration
Lower frequency - Poor resolution deeper penetration
Ultrasound Probes
The high frequency probes are used to scan superficial structures and low
frequency probes are used to scan deeper structures. High frequency probe
provides high resolution as it scans the superficial structures. The low
frequency probe penetrates deeper but loses some resolution
Each machine ahs 2 probes
Sonosite: Both the probes for this machine are high frequency probes. One
has a short footprint and the other has a long footprint. The one with the
long footprint will be able to penetrate to a depth of 10cm
GE logic Q: It has two probes. The linear probe is a high frequency probe and
the curved probe is a low frequency probe.