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Unit 5 Medical Ultrasound
Unit 5 Medical Ultrasound
1. Nature of ultrasound
Ultrasounds have frequencies and wavelengths, just like all other types of waves. The wavelength
of ultrasound limits the fineness of details that it can detect. Details significantly smaller than the
wavelength of a probe cannot be detected. This is true for all types of waves. Because the
wavelength of visible light is significantly longer than atoms, we can not see atoms with visible
light.
● a larger difference between the acoustic impedance of the two media, will lead to more
ultrasound being reflected and less being refracted.
● when an ultrasound image is taken of the body, gel is applied to the skin, to eliminate the air
between the skin and the transducer so that a larger portion of the ultrasound will enter the body
Ultrasound is better at detecting density than x-rays. The amount of ultrasound reflected depends
on the acoustic impedance changes, and acoustic impedance changes depend on density differences.
The largest amount of ultrasound is reflected at the places of the greatest density changes.
4. Pulse echo measurement 超音波厚度量測
Ultrasound can be used to detect the thickness of a medium much like sonar is used to detect depth.
The time it takes for the ultrasound to travel the length of the medium, and bounce back is
measured. From this, the thickness traveled by the ultrasound can be calculated.
Peak one comes from the reflection from boundary one, and peak two comes from the reflection
from boundary two. The time interval between peak one and peak two is the time it took for the
ultrasound to travel from boundary one to boundary two and back to boundary one.
‘A scans’ are commonly used to measure the thickness of the lens in the eye before surgery.
Ultrasound usage in the medical community has many benefits, and no known side effects, unlike
the x-ray. The thermal heat caused by the ultrasound is too low to cause any harm. The intensity of
ultrasound used for diagnostic purposes is around 10-2 W/m2.
In the figure, the ultrasound scanner is swept across the abdomen to produce a 2D image of the
stomach.
How much details can ultrasound reveal?
Abdominal scans use 7 MHz ultrasound waves. The speed of sound in tissue: ~ 1540 m/s.
λ = vw / f = (1540 m/s) / (7×106Hz) = 0.22 mm
The maximum spatial resolution 空間取樣能力 is limited by wavelength.
The penetration depth is proportional to the wavelength. Typically penetration depth in tissue: ~
500λ . So For 7 MHz : penetration depth = 500 × 0.22 mm = 0.11 m
The Doppler effect: change in the perceived sound frequency due to movement of the source or the
observer.
Case (a): The sound waves heard by X have the same frequency heard by observer y since
they are both stationary.
Case (b): Observer X hears sound wave with a longer wavelength and lower frequency, while
observer Y hears sound wave with a shorter wavelength and a higher frequency.
Case (c): X and Y are moving instead of the car. However since the relative motion is the
same, the same effect is produced. A sound wave’s frequency increases when you
move towards it, and decreases when you move away from it.
The following equation calculates the frequency perceived by the observer when he/she is
stationary and the source is moving.
.
vw
f obs = f s
vw vs
The minus sign is used when the source is moving toward to observer, and the plus sign is used
when the source is moving away from the observer.
The following equation is used when the source is stationary and the observer is moving.
v vobs
f obs = f s w
vw
vobs = speed of the observer along a line joining the source and observer.
.
The plus sign is used when the observer is moving towards to source. The minus sign is used when
the observer is moving away from the source.
7. Doppler-shifted ultrasound
f =source frequency
v =the speed of the moving blood
vw =is the speed of sound in the tissue.
By calculating the frequency shift ∆ f, we can find the average speed of the blood.
Checklist
BMD is one of the key determinants of the need for pharmacologic therapy. BMD is typically
expressed in terms of the number of standard deviations (SD) the BMD falls below the mean for
young, healthy adults. This number is termed the T score. The NOF guidelines recommend that
pharmacologic therapy be initiated in women with T scores below –2 in the absence of other risk
factors, and in women with BMD T scores below –1.5 if other risk factors are present. Current
pharmacologic options include hormone replacement therapy, bisphosphonates such as alendronate
(Fosamax), selective estrogen receptor modulators (SERMs) such as raloxifene (Evista), and
calcitonin. While BMD measurements are typically used to determine the need for pharmacologic
therapy, serial monitoring of BMD to determine treatment response is also performed.
BMD can be measured with a variety of techniques in a variety of sites. Sites are broadly
subdivided into central sites (e.g. hip or spine) and peripheral sites (e.g. wrist, finger, heel). While
BMD measurements are predictive of fragility fractures at all sites, central measurements of the hip
and spine are the most predictive. Additionally, fractures of the hip and spine (e.g. vertebral
fractures) are the most clinically relevant.
Ultrasound densitometry is a relatively new technique for measuring BMD at peripheral sites,
typically the heel, but also the tibia and phalanges. Compared to osteoporotic bone, normal bone
demonstrates higher attenuation of the ultrasound wave and is associated with a greater velocity of
the wave passing through bone. Ultrasound densitometry has no radiation exposure, and machines
may be purchased for use in an office setting.
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