USS Physics

USS probes -2MHz-

17MHz
wavelength X Frequency =Velocity
A
M
P
L
I
T
U
D
E
USS transducers
PIEZO ELECTRIC EFFECT
Ultrasound can undergo a range of
interactions in soft tissue
Reflection
Scattering
Refraction
Attenuation
Pulse Echo Principal
Basic idea
Attenuation

compressional energy to heat

 Correct for attenuation –time gain
compensation or depth gain compensation
 Compensation (TGC)
Body attenuation varies from 0.5 dB/cm/MHz
TGC allows manual fine tuning of compensation vs.
delay
TGC curve often displayed graphically

M mode imageis one line image

 Different Modes
M mode( motion mode) –One line image
A mode (amplitude mode)
B mode (Brightness mode)-2 D
3D
 M mode ( motion mode)

All of the reflectors along this line are displayed along the

time axis.
Brightness (B) mode uses each individual
echo strength to build up a 2D image

Time
(depth)

A
m
p
li Time
t (depth)
u
d
eA
m
p
li Time
t (depth)
u
d
Ae
m
p
liMore reflective structures appear
t brighter
u
d
e
 Real-time Scanning

Each pulse generates one line

Except for multiple focal zones
one frame consists of many individual
scan lines
In imaging, it’s ALL about
resolution!
 Resolution
Spatial Temporal
Ability to distinguish two points as
seperate in space Ability to detect
that an object has
Axial Lateral moved over time.
Temporal resolution
is synonymous with
frame rate for
axi
al practical purpose
Later
al
Higher frequency - better resolution
less penetration
Lower frequency - poorer resolution
better penetration
Higher frequency - greater resolution, poorer
penetration
Lower frequency - poorer resolution, greater
penetration
Higher frequencies are attenuated more than
lower frequency waves.
 Lateral Resolution

Nea
r
zon
e
Near zone length
Far
zon
e

CORRECT POSITIONING OF THE FOCAL ZONES IS

CRITICAL TO GAINING THE BEST LATERAL RESOLUTION
FOR A GIVEN TRANSDUCER
 Focal Zones
Decreases the beam diameter
Adjustable by operator.
Place in area of interest

Focus the Image

 Multiple Focal Zones

Multiple pulses to generates one line

Each pulse generates portion of line
Beam focused to that portion

1st focal zone

2nd focal zone

3rd focal zone

Temporal resolution (Frame rate )
Temporal resolution deals with the quality of
the image presented over time.

• If too much time elapses between images

(even with exceptional axial, etc resolution),
our cine loops appear choppy and potentially
impactful information may not be seen.
Temporal resolution (Frame rate)
Frame rate - the number of ultrasound images
displayed in one second and is expressed in
Hertz (Hz
Temporal resolution (Frame rate)
Echocardiography should have high temporal
resolution.

High frame rates enable us to see rapidly

moving structures (such as heart valves)
without motion artifacts, and also perform
velocity and deformation analysis (i.e. tissue
Doppler). 
 Temporal resolution (frame rate): how to
improve –decrease depth and sector width
Depth too much !
Fundamental and Harmonic imaging

Superharmonic
BEAM STEERING
When the operator increases the gain
settings of the machine
A. The mechanical index increases
B. The axial resolution increases
C. The lateral resolution increases
D. The temporal resolution increases
D. The signal to noise ratio does not change
Temporal resolution is increased by
A. Increasing sector width
B. Decreasing frame rate
C. Decreasing depth
D. Increasing depth
 Common means to improve FRAME
RATE
A. Narrowing the image sector ,which decreases
the time it takes to scan one frame
B. Decreasing the depth
C. Decreasing the line density ,which requires
fewer lines to scan one frame (at the cost of
spatial resolution )
D. Turning off multi focus
 Which of the following statement regarding spatial
resolution in echocardiography is CORRECT

A. Spatial resolution is defined as the smallest

distance between two points distinguishable as
separate points
B. Axial resolution is the ability to differentiate points
perpendicular to the ultrasound beam
C. Lateral resolution is the ability to differentiate
between points along the path of the ultrasound
beam
D.

E. Lateral resolution is better than axial resolution

 The dual focus of an ultrasound
machine affects
A. The resolution of the final image
B. The frame rate of the final image
C. The contrast of the final image
D. 1 and 2 are correct
E. None of the above
Mode with highest temporal resolution
A Mode
B mode
M mode
3D
 M mode- highest frame rate
sampling rate for M-mode is around 1000
to 2000 pulses per second, which is far
greater than the typical 2D frame rates of
between 30 to 100 frames per second.
Doppler effect
 Doppler effect - Frequency shift

If RBC (flow of blood) moves toward transducer, 

frequency of the reflected sounds wavelength increases

If RBC (flow of blood) moves away from the 

transducer, frequency of the reflected sounds 
wavelength decrease
 Why do we care about the velocity of
blood flow ?
Simplified Bernoulli equation
Modified Bernoulli equation

ΔP=
4V²

Gives us the ability to estimate pressure difference

between
two chambers (eg TR )
Stenotic lesions (eg AS)
 Doppler imaging

Continuous wave
Pulsed wave
Colour doppler
Tissue doppler
Tips for optimizing pulse doppler
Minimize angle of incidence
Use low frequency transducer
Use shallower depth setting
Shift baseline away from direction of flow
Set to high PRF ( increase scale ie set to high
Nyquist limit )
Nyquist LimitHighest detectable velocity It is equal to ½ PRF (Pulse
repetition frequency)
 Doppler Angle

angle between sound

travel & flow
0 degrees
flow in direction of sound travel θ

90 degrees
flow perpendicular to sound travel
Flow Components

Flow vector can be

separated into two
vectors

Flow parallel Flow parallel is

sensed by
to sound transducer

Flow
perpendicular to Not
sound sensed
 Doppler Sensing

Sensed flow always

< actual flow

Actual
flow

Sensed
flow
 PW & CW
Continuous wave
Pulse wave
One transducer crystal –
sent and receive
Sampling at specific
location
Limited at higher velocity
Transducer contains 2 crystal
one continuosly sent and
other receive
Lose ability to define exact
location
Samples highest peak velocity
along the line of interrogation
No theoretical upper limit of
velocity (as PRF is infinite)
 ALIASING

High frequency signal appearing low frequency as the frequency

sampling rate is too low that frequency that I end up getting a
lower frequency instead
Lower frequency probe –higher Nyquist
Limit

the lower the

carrier frequency, the higher
the velocity of the jet that can
be resolved.
Unlike B-mode imaging where
higher frequency  transducer
gives better resolution, here
lower frequency transducers
gives better resolution.
 Limit aliasing
Shift the baseline -To increase the Nyquist
limit in a particular direction

Doppler waveforms displayed above the zero-velocity baseline indicate

blood flow toward the ultrasound transducer, whereas waveforms
displayed below the baseline are associated with blood flow away from the
transducer
Aliasing
Tips for optimizing pulse doppler
Minimize angle of incidence
Use low frequency transducer
Use shallower depth setting
Shift baseline away from direction of flow
Set to high PRF ( increase scale ie set to high
Nyquist limit )
PW & CW
LVOTO doppler
The PW Doppler-
narrow band of velocities (as velocity is
only measured within the
sample volume (SV).)
the modal velocity - the brightest band
(velocity at which the majority of red
blood cells are traveling) When measuring
velocities with PW Doppler, the outer edge
of the modal velocity envelope should be
used
The CW Doppler –
entire length of the beam measured
wide range of velocities,
appear “filled-in.”
Spectral broadening

Laminar flow –narrow velocity

spectrum
spectral broadening
Turbulent flow –spectrum broadens
Long sample volume /increasing
beam width with depth –.
spectral waveform brightness
-greater volume of blood
- increased gain or power,
- increased sample volume
length
-reduced attenuation(low
frequency probe)
 Color Doppler
Is Pulse wave Doppler with multiple
sample volume  along multiple lines
Direction, velocity and variance
determined for each sample volume
Spectral Display(PW &CW)
shows frequency range directly
Color Doppler’s color
represents complete spectrum at
each pixel
 Color Doppler
Displayed as color information
Direction- red vs blue (toward
or away from  transducer)
Velocity- brightness (bright
blue higher velocity)
Variance (turbulence)- coded
green to give a mosiac
apperance. Aliasing seen
as bright turbulent flow
Overlays this information on
2D images
 Colour box size ,Gain & scale
Colour Gain
Colour box
Color box is an operator Colour gain should be
adjustable area within US adjusted to just below
image speckling ,however if the
Because frame rate colour box remains
decreases as box size underfilled then velocity
increases, image resolution scale should be decreased
and quality are affected by
box size and width
Box should be as small as
possible while still
providing necessary
information
 Colour velocity scale

Set as high as possible while

allowing adequate filling of
colour box
Decrease to enhance
detection of low velocity flow
or when underfilling of box
By decreasing the colour
velocity scale to 30cm/s as
shown ,the full range of colour
is now devoted to detection of
lower velocity flow
 Tissue Doppler imaging - Pulse TDI
Colour
TDI

Routine Doppler targets blood pulse TDI

flow
Velocity of tissue along a particular sample volume 
High velocity
Low signal amplitude
Tissue Doppler (assessing the
movement of the 
myocardium) targets tissue
Low velocity
High signal amplitude
Different FiltersColor TDIVelocity of tissue
coded by color superimposed
on 2-D image Can derive
information such as strain,
strain rate, dyssynchrony etc.
 Color Doppler M-mode imaging

Pulse Doppler interrogation

done along a single line
Doppler velocity shift
recorded and color coded
Provides high temporal and
spatial resolution to the
assessment of flow
 You examine the pulmonary valve
using colour doppler and notice
aliasing of the colour signal .What
can u do to reduce/prevent this

A. Increase the sector width

B. Increase your colour gain
C. Increase the Nyquist limit
D. Decrease the Nyquist limit
In which of the following scenarios is it most appropiate
to use the simplified Bernoulli equation to estimate a
change in pressure
A. Severe pulmonary valve stenosis
B. Aortic coarctation with bicuspid aortic
valve
C. Patent ductus arteriosus
D. Subaortic stenosis
E.Blalock –Taussing shunt
The simplified Bernoulli equation ignores the
components of flow acceleration and viscous
friction
PDA /BT shunt –doppler velocity likely to be
underestimated due to viscous friction in these
tortuous structures and difficulty in alignment
Multiple obstruction –need to account for flow
acceleration proximal to distal site of obstruction
A patient has coarctation of aorta .PW doppler reveals a peak
velocity of 2m/s proximal to coarctation.A CW across the
coarctation is 4m/s.What is the pressure gradient across the
coarctation

A. 8 mm Hg
B.9 mm Hg
C.36 mm Hg
D. 48 mm Hg
E. 64 mm Hg
 Which of the following is the most likely error in
calculation of doppler flow velocity

A. Angle of incidence of the ultrasound beam

B. Depth of the vascular structure
C. Frequency of the transducer
D. Presence and imaging of the imaging artifact
E. Variations in heart rate
Which of the following is true regarding
CW doppler
A. Utilises a single ultrasound crystal that
continuously transmit and receive
B. No limit to maximal velocity measured
C. Excellent range resolution
D. Less dependent on angle of incidence
compared to PW doppler
E. Lower Nyquist limit compared to PW doppler
The dual focus selection improves the
resolution of the image in 2 different areas of
the image at the expenditure of its frame rate

In speckle tracking analysis examination,high

frame rate is required and thus the dual focus
setting of the machine should never be
selected.
There are 2 main hazards of ultrasound

Heating
Cavitation
But is there any risk?
MI And TI - ALARA principle (As Low as
Reasonably Achievable)
 Thermal Index(TI)
TIS (TI for soft tissue)
 TIB (TI for bone)
TIC (TI for cranial bone)
expresses the potential for rise in
temperature at the ultrasound beam's focal
point.
TI of 2 means that u can expect a
temperature rise of 2 degrees
 Cavitation

High pressure changes can

cause microbubbles in a
liquid to expand and
collapse violently
 Mechanical index(MI)
The MI is a measure of the power of an ultrasound
beam
The onset of cavitation only occurs above a
threshold for acoustic pressure
For MI less than 0.7, the physical condition does
not exist to support bubble growth and collapse
Cavitation is more likely in the presence of contrast
agents and in the presence of gas bodies such as
lungs and intestine
The FDA approved MI value of 1.9 is the maximum
threshold for diagnostic imaging. 
Thank You