What is research ultrasound system and Why Do We Use Them?

Diagnostic ultrasound. Diagnostic ultrasound is able to non-invasively image internal organs within the body. However, it is not good for imaging bones or any tissues that contain air, like the lungs. Under some conditions, ultrasound can image bones (such as in a fetus or in small babies) or the lungs and lining around the lungs, when they are filled or partially filled with fluid. One of the most common uses of ultrasound is during pregnancy, to monitor the growth and development of the fetus, but there are many other uses, including imaging the heart, blood vessels, eyes, thyroid, brain, breast, abdominal organs, skin, and muscles. Ultrasound images are displayed in either 2D, 3D, or 4D (which is 3D in motion).

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The ultrasound probe (transducer) is placed over the carotid artery (top). A color ultrasound image (bottom, left) shows blood flow (the red color in the image) in the carotid artery. Waveform image (bottom right) shows the sound of flowing blood in the carotid artery.

Functional ultrasound. Functional ultrasound applications include Doppler and color Doppler ultrasound for measuring and visualizing blood flow in vessels within the body or in the heart. It can also measure the speed of the blood flow and direction of movement. This is done using color-coded maps called color Doppler imaging. Doppler ultrasound is commonly used to determine whether plaque build-up inside the carotid arteries is blocking blood flow to the brain.

Another functional form of ultrasound is elastography, a method for measuring and displaying the relative stiffness of tissues, which can be used to differentiate tumors from healthy tissue. This information can be displayed as either color-coded maps of the relative stiffness; black-and white maps that display high-contrast images of tumors compared with anatomical images; or color-coded maps that are overlayed on the anatomical image. Elastography can be used to test for liver fibrosis, a condition in which excessive scar tissue builds up in the liver due to inflammation.

Ultrasound is also an important method for imaging interventions in the body. For example, ultrasound-guided needle biopsy helps physicians see the position of a needle while it is being guided to a selected target, such as a mass or a tumor in the breast. Also, ultrasound is used for real-time imaging of the location of the tip of a catheter as it is inserted in a blood vessel and guided along the length of the vessel. It can also be used for minimally invasive surgery to guide the surgeon with real-time images of the inside of the body.

Therapeutic or interventional ultrasound. Therapeutic ultrasound produces high levels of acoustic output that can be focused on specific targets for the purpose of heating, ablating, or breaking up tissue. One type of therapeutic ultrasound uses high-intensity beams of sound that are highly targeted, and is called High Intensity Focused Ultrasound (HIFU). HIFU is being investigated as a method for modifying or destroying diseased or abnormal tissues inside the body (e.g. tumors) without having to open or tear the skin or cause damage to the surrounding tissue. Either ultrasound or MRI is used to identify and target the tissue to be treated, guide and control the treatment in real time, and confirm the effectiveness of the treatment. HIFU is currently FDA approved for the treatment of uterine fibroids, to alleviate pain from bone metastases, and most recently for the ablation of prostate tissue. HIFU is also being investigated as a way to close wounds and stop bleeding, to break up clots in blood vessels, and to temporarily open the blood brain barrier so that medications can pass through.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/ ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ultrasound device, essentially, consists of a transducer, transmitter pulse generator, compensating amplifiers, the control unit for focusing, digital processors and systems for display. It is used in cases of: abdominal, cardiac, maternity, gynecological, urological and cerebrovascular examination, breast examination, and small pieces of tissue as well as in pediatric and operational review.

1. INTRODUCTION

In physics the term “ultrasound” applies to all acoustic energy with a frequency above human hearing (20,000 hertz or 20 kilohertz). Typical diagnostic sonographic scanners operate in the frequency range of 2 to 18 megahertz, hundreds of times greater than the limit of human hearing. Higher frequencies have a correspondingly smaller wavelength, and can be used to make sonograms with smaller details. Diagnostic sonography (ultrasonography) is an ultrasound-based diagnostic imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible pathology or lesions. Sonography is effective for imaging soft tissues of the body. Sonographers typically use a hand-held probe (called a transducer) that is placed directly on and moved over the patient. A water-based gel is used to couple the ultrasound between the transducer and patient (1, 2).

Although discovered 12 years before the X-ray ray (1883.), the ultrasound is a much later found application in medicine. The first practical application of ultrasound is recorded during the World War I in detecting of submarines. The application of ultrasound in medicine began in fifties of last century. First was introduced in the obstetrics, and after that in all the fields of the medicine (the general abdominal diagnostics, the diagnostics in the field of the pelvis, cardiology, ophthalmology and orthopedics and so on) (3). From the clinical aspect the ultrasound possesses the priceless significance because of its noninvasive, good visualization characteristics and relatively easy management (4,5). From the introducing of the processing of the signals of gray scale in 1974 B-mode of the sonography became the widely accepted method. The progress in the forming of the transducers has led to better space resolution and the imaging of very small structures in the abdomen (0.5-1 cm). The development of real-time system led to, even, to the possibility of the continued visualization or the ultrasound fluoroscopy (1). In the ultrasound diagnostics can be differed two techniques (2): transmission and reflection

Transmission technology is based on distinguishing the tissues with different absorbance of ultrasound. Due to uneven absorption of ultrasound images provides internal structure that consists of a mosaic of lighter and darker places. This technology is now abandoned (6,1).

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Reflection technology (echo) registers the pulse is reflected from the boundary of two tissues with different acoustic resistance. The technique is based on principle of functioning sonar (“Sonar Navigation and Ranging”). A sound wave is typically produced by a piezoelectric transducer encased in a probe. Strong, short electrical pulses from the ultrasound machine make the transducer ring at the desired frequency. The frequencies can be anywhere between 2 and 18 MHz’s The sound is focused either by the shape of the transducer, a lens in front of the transducer, or a complex set of control pulses from the ultrasound scanner machine. This focusing produces an arc-shaped sound wave from the face of the transducer. The wave travels into the body and comes into focus at a desired depth. Newer technology transducers use phased array techniques to enable the sonographic machine to change the direction and depth of focus. Almost all piezoelectric transducers are made of ceramic (1).

To generate a 2 D-image, the ultrasonic beam is swept. A transducer may be swept mechanically by rotating or swinging. Or a 1D phased array transducer may be use to sweep the beam electronically. The received data is processed and used to construct the image. The image is then a 2D representation of the slice into the body. 3D images can be generated by acquiring a series of adjacent 2D images. Commonly a specialized probe that mechanically scans a conventional 2Dimage transducer is used. However, since the mechanical scanning is slow, it is difficult to make 3D images of moving tissues. Recently, 2D phased array transducers that can sweep the beam in 3D have been developed. These can image faster and can even be used to make live 3D images of a beating heart.

Four different modes of ultrasound are used in medical imaging (1, 3).

These are:

• A-mode: A-mode is the simplest type of ultrasound. A single transducer scans a line through the body with the echoes plotted on screen as a function of depth. Therapeutic ultrasound aimed at a specific tumor or calculus is also A-mode, to allow for pinpoint accurate focus of the destructive wave energy.

• B-mode: In B-mode ultrasound, a linear array of transducers simultaneously scans a plane through the body that can be viewed as a two-dimensional image on screen.

• M-mode: M stands for motion. In m-mode a rapid sequence of B-mode scans whose images follow each other in sequence on screen enables doctors to see and measure range of motion, as the organ boundaries that produce reflections move relative to the probe.

Doppler mode: This mode makes use of the Doppler effect in measuring and visualizing blood flow. Doppler sonography play important role in medicine. Sonography can be enhanced with Doppler measurements, which employ the Doppler effect to assess whether structures (usually blood) are moving towards or away from the probe, and its relative velocity. By calculating the frequency shift of a particular sample volume, for example a jet of blood flow over a heart valve, its speed and direction can be determined and visualized. This is particularly useful in cardiovascular studies (sonography of the vasculature system and heart) and essential in many areas such as determining reverse blood flow in the liver vasculature in portal hypertension (6,7). The Doppler information is displayed graphically using spectral Doppler, or as an image using color Doppler (directional Doppler) or power Doppler (non directional Doppler). This Doppler shift falls in the audible range and is often presented audibly using stereo speakers: this produces a very distinctive, although synthetic, pulsing sound (8).

The transoesophageal echo cardiography (TEE) opened the window in the diagnostic imaging in the field of the cardiography, card surgery and anesthesia. Using TEE in 2-D mode, the anesthesiologist can monitor the heart movements, and cardiac surgeon will become the valuable information about the heart condition after the critical surgical procedure.

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