1. Ultrasound Spring 2013 Week 7 RT 255 C

2. Ultrasound AKA: 1)Diagnostic Medical Sonography 2)Sonography3)Ultrasonography 4)Vascular Sonography 5)Echocardiography 2

3. Principles of Diagnostic Ultrasound NON- ionizing NON- ionizing Uses high frequency sound waves Uses high frequency sound waves By giving reflections from parts in the body By giving reflections from parts in the body Mobile Mobile Cost effective Cost effective Invasive? Invasive? Can be imaged in sectional, coronal and oblique planes Can be imaged in sectional, coronal and oblique planes 3

4. What makes a good Sonographer? Knowledge of detailed anatomy and Pathophysiology Knowledge of detailed anatomy and Pathophysiology 3D antatomy 3D antatomy Good communication Good communication Be able to work under stress Be able to work under stress 4

5. Repetitive Motion Injuries Poor ergonomic habits Poor ergonomic habits Poor equipment design Poor equipment design Poor posture Poor posture 80% have muscloskeletal injuries 80% have muscloskeletal injuries Shoulder (rotator cuff) Shoulder (rotator cuff) Elbow Elbow Neck Neck Lower Back Pain Lower Back Pain Wrist lesions or pain (carpal tunnel, ganglions, tendonitis) Wrist lesions or pain (carpal tunnel, ganglions, tendonitis) Eyesight problems Eyesight problems Why? Sustained pressure and force Sustained pressure and force Awkward scanning techniques Awkward scanning techniques Assisting with patient movement Assisting with patient movement Body habitus Body habitus Inadequate work breaks Inadequate work breaks Overall job stress Overall job stress 5

6. Still a Neonate Fairly new technology compared with xray Fairly new technology compared with xray First used for navy sonar in World War II First used for navy sonar in World War II 1940’s 1940’s US waves transmitted and returned US waves transmitted and returned 6

7. 1947 – Through- Transmission Used to detect tumors and intracranial lesions Used to detect tumors and intracranial lesions With 2 transducers opposite sides of the head With 2 transducers opposite sides of the head Called through- transmission Called through- transmission 7

8. 1948 First Ultrasound Douglas Howry 8

9. Contact Compound Scanner 1957 1957 Tom Brown and Ian Donald Tom Brown and Ian Donald Obstetric techniques Obstetric techniques 9

10. Present Day Smaller machines Smaller machines Increased resolution Increased resolution Real time scanning Real time scanning Portable Portable Mobile Mobile 10

11. Properties of Sound Waves Acoustic waves Acoustic waves Energy that moves back and forth or vibrates at a steady rate Energy that moves back and forth or vibrates at a steady rate Audible sound waves Audible sound waves 16,000 – 20,000 cycles/sec 16,000 – 20,000 cycles/sec Ultrasound waves Ultrasound waves 1- 10 million cycles/sec 1- 10 million cycles/sec High frequency mechanical vibrations through a medium High frequency mechanical vibrations through a medium Transmitted by particles of gas, liquid or solid medium Transmitted by particles of gas, liquid or solid medium 11

12. Piezoelectric Effect AC applied across piezoelectric crystals AC applied across piezoelectric crystals Crystals grow and shrink Crystals grow and shrink Conversion of electrical energy to mechanical energy Conversion of electrical energy to mechanical energy US is produced from a transducer by this effect US is produced from a transducer by this effect 12

13. Acoustic Impedance Has properties similar to light Has properties similar to light Focused, refracted, reflected or scattered Focused, refracted, reflected or scattered Dependent on the density and elastic properties of medium Dependent on the density and elastic properties of medium Velocity of sound Velocity of sound Sound waves are sent and received Sound waves are sent and received Velocity is different among bone, air and soft tissue Velocity is different among bone, air and soft tissue Poor impedance in air Poor impedance in air Pitch and sound waves are picked up by computer and produce images: based on depths and speeds Pitch and sound waves are picked up by computer and produce images: based on depths and speeds 13

14. Properties similar to light http://www.e- echocardiography.com/chapters/physicalpr inciples/02.php http://www.e- echocardiography.com/chapters/physicalpr inciples/02.php http://www.e- echocardiography.com/chapters/physicalpr inciples/02.php http://www.e- echocardiography.com/chapters/physicalpr inciples/02.php 14

15. Types of Transducers 15

16. Elements of Transducers Capable of sending and receieving US Capable of sending and receieving US 16

17. Advantages of US 1. Ultrasound examinations can be non- invasive 1. Ultrasound examinations can be non- invasive 2. Ultrasound methods are relatively inexpensive, quick and convenient 2. Ultrasound methods are relatively inexpensive, quick and convenient 3. No harmful effects have been detected 3. No harmful effects have been detected 4. Ultrasound is particularly suited to imaging soft tissues 4. Ultrasound is particularly suited to imaging soft tissues 17

18. Disadvantages of US 1. The major disadvantage is that the resolution of images is often limited. 1. The major disadvantage is that the resolution of images is often limited. 2. Ultrasound is reflected very strongly on passing from tissue to gas, or vice versa 2. Ultrasound is reflected very strongly on passing from tissue to gas, or vice versa 3. Ultrasound also does not pass well through bone 3. Ultrasound also does not pass well through bone 18

19. Real Time, Doppler and Color Flow Doppler Real time: Real time: Multiple rapid image frames per second Multiple rapid image frames per second Ex: can see pulsative vascular, cardiac structures, diaphragm motion & peristalsis Ex: can see pulsative vascular, cardiac structures, diaphragm motion & peristalsis Doppler Doppler Frequency change in laminar or turbulent flow in vascular structures Frequency change in laminar or turbulent flow in vascular structures Color Doppler Color Doppler Assigns a color scale to change in frequency Assigns a color scale to change in frequency Red toward transducer and blue away from transducer Red toward transducer and blue away from transducer 19

20. Doppler 20

21. Color Doppler 21

22. Gallbladder 22

23. Gallbladder 23

24. Prostate 24

25. Prostate 25

26. 26

27. Bladder 27

28. Kidney 28

29. Abdomen - LUQ 29

30. Abdomen - RUQ 30

31. Liver 31

32. Liver 32

33. Spleen 33

34. Spleen 34

35. Pancreas 35

36. Uterus 36

37. Uterus 37

38. Ovary 38

39. Ovary 39

40. Breast 40

41. Breast 41

42. Testes 42

43. 43

44. 19 Week Fetus 44

45. 19 Week fetus http://images.google.com/imgres?imgurl=http:// embryology.med.unsw.edu.au/movies/usound/1 9weeklabel2.jpg&imgrefurl=http://embryology. med.unsw.edu.au/movies/usound/Hum19w4D.ht m&usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h =379&w=358&sz=11&hl=en&start=71&tbnid=Q qSTbyckVI- jYM:&tbnh=123&tbnw=116&prev=/images%3F q%3Dfetal%2Bultrasound%26gbv%3D2%26nds p%3D20%26hl%3Den%26sa%3DN%26start%3 D60 http://images.google.com/imgres?imgurl=http:// embryology.med.unsw.edu.au/movies/usound/1 9weeklabel2.jpg&imgrefurl=http://embryology. med.unsw.edu.au/movies/usound/Hum19w4D.ht m&usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h =379&w=358&sz=11&hl=en&start=71&tbnid=Q qSTbyckVI- jYM:&tbnh=123&tbnw=116&prev=/images%3F q%3Dfetal%2Bultrasound%26gbv%3D2%26nds p%3D20%26hl%3Den%26sa%3DN%26start%3 D60 http://images.google.com/imgres?imgurl=http:// embryology.med.unsw.edu.au/movies/usound/1 9weeklabel2.jpg&imgrefurl=http://embryology. med.unsw.edu.au/movies/usound/Hum19w4D.ht m&usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h =379&w=358&sz=11&hl=en&start=71&tbnid=Q qSTbyckVI- jYM:&tbnh=123&tbnw=116&prev=/images%3F q%3Dfetal%2Bultrasound%26gbv%3D2%26nds p%3D20%26hl%3Den%26sa%3DN%26start%3 D60 http://images.google.com/imgres?imgurl=http:// embryology.med.unsw.edu.au/movies/usound/1 9weeklabel2.jpg&imgrefurl=http://embryology. med.unsw.edu.au/movies/usound/Hum19w4D.ht m&usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h =379&w=358&sz=11&hl=en&start=71&tbnid=Q qSTbyckVI- jYM:&tbnh=123&tbnw=116&prev=/images%3F q%3Dfetal%2Bultrasound%26gbv%3D2%26nds p%3D20%26hl%3Den%26sa%3DN%26start%3 D60 45

46. Heart 46

47. Heart 47