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M scan/Time motion (TM) mode

1. repeated A scans along a single direction (T held


stationery as in A scan) intersecting a moving
boundary (e.g. a heart valve)
2. boundary movement causes echo time to
fluctuate fluctuation displayed as a
displacement along the vertical axis of monitor;
horizontal axis is the time base
3. facility often incorporated in B scan instruments
2D B scan used to select an appropriate line and
then this line displayed as a time-position plot
4. easy to time various events in the cardiac cycle (if a
synchronized ECG tracing is displayed along with it)1
M scan (cont..)
Represents movement of structures over time
Initially a 2-D image is acquired a single scan line
placed along the area of interest M-mode will
then show how the structures intersected by that
line move toward or away from the probe over time
The M-mode has good temporal resolution so
useful in detecting and recording rapid movements
M-mode tracings can also be correlated with ECG or
respiratory pressure waveforms traced alongside
Commonly used for measuring chamber dimensions
and calculating fractional shortening and ejection
fraction 2
Applications of M scan

Applications: Time versus motion info about heart


structures on slow speeds
Best method for diagnosing mitral stenosis - on the
M-mode recording, thickening of the leaflets and
reduction in their mobility can be appreciated
Study of aortic valve, tricuspid valve, pulmonary
valve
Detection of pericardial effusion
M mode of heart: only 1D image of heart structures
Now 2D echocardiography uses multi element T3
M mode scan of the mitral valve of the heart

CW: chest wall; RV: right ventricle; IVS: interventricular


septum; LV: left ventricle; AL: anterior mitral valve cusp;
PL: posterior mitral valve cusp; LVW: left ventricular wall;
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TV: tricuspid valve; RA: right atrium; LA: left atrium
TypicalM-mode
Typical M mode Images
images

From left ventricle


From the mitral valve

Measures:
(i)LV wall thicknesses
(ii)Chamber dimension for
quantitative estimation of LV
mass

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From the aortic valve
M-mode Imaging: a method of display in which tissue
interface position is displayed along one axis and time is
displayed along a second axis. M-mode is used frequently to
display echocardiographic data in which heart wall motion and
valve motion are displayed as functions of time. The images
shown are echo pattern records of the motion of the anterior
leaflet of the mitral valve (left, normal; right, stenosis)

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Pericardial
Typical effusion
M-mode images

M-mode echocardiogram showing moderate pericardial effusion


present anteriorly (PE) and posteriorly (PPE). RVW=right ventricular
wall; IVS=interventricular septum; endo=endocardium; epicardium; 7
MV=mitral valve; LA=left atrium
A, B and M scan
The reflected signals can
be displayed in three
different modes: (i) A-
mode shows the depth and
the reflected energy from
each scatterer (ii) B-mode
shows the energy as the
brightness (in this case
the higher energy is
shown darker, against a
light background) of the
point (iii) M-mode plot

M-mode
Bottom scatterer moving:
If depth shown in a time
plot, the motion is seen as
a curve (horizontal lines
for the non moving
scatterers) 8
A, B and M scan

stationary tissue
interface

anterior and
posterior wall of
a pulsating vessel

stationary
tissue
interface

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http://www.youtube.com/watch?v=FT2qygn4XjQ

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Aspects of RT ultrasonic imaging system

1) High resolution
2) Depth range
3) Adequate field of view
4) Sufficiently high frame rate

5) High detectivity

(1) Resolution
1-3 mm in all 3 spatial dimensions desirable for
diagnostic studies

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The three spatial resolution directions

Geometry of the US image plane and the


three spatial resolution directions 12
(2) Depth range

Varies for different anatomical studies, e.g.


Abdominal/obstetrical studies: range is 25-30 cm
Cardiac studies: chest wall-posterior heart wall
distance 15 cm
Superficial organs (breast/thyroid/carotid/femoral
arteries & infant studies): range of depth is
3-10 cm

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(3) Field of view

Large enough to display the entire ROI


To view small superficial structure (thyroid):
field of ~ 5cmx5cm can encompass the
desired region
For cardiac imaging: sector scans preferable
to rectilinear scans since a large structure is
to be viewed through a small window (600)

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Some important terms
PRF: no. of times a T is pulsed/sec
usually 2000-4000 pulses per sec (2-4 kHz)
PRP: Time b/w pulses (1/PRF)
An in PRF in echo listening time
The maximum PRF is determined by the time required
for echoes from the most distance surfaces to reach
the T PRFmax = c/2R
500 s PRP (PRF 2 KHz); max range of 38.5 cm
250 s PRP (PRF 4 KHz); max depth halved to 19.3cm
T freq (MHz) not to be confused with PRF (kHz); T
period (1/f) of u/s wave (s) not to be confused with
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PRP (ms)
Some important terms.

PRF: ranges from 200-2000 pulses/sec


Higher PRFs: for real time and Doppler imaging
(1000 pulses/sec to several kHz)
Scan line: position of the US beam axis during ONE
pulse echo sequence
Line density: No. of scan lines/image
Frame Rate: No. of complete scans carried out/sec

Pulse Duration (s): {no. of cycles in the T pulse /T


freq} = instantaneous on time
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Pulse Duration and Duty Cycle

Duty cycle: time that the transducer spends in an


active state as a fraction of the total time under
consideration

Duty cycle for RT imaging applications: 0.2-0.4%


99.5% of the scan time is spent listening to echoes
as opposed to producing acoustic energy

Duty Cycle: pulse duration/PRP


= fraction of on time

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(4) Frame Rate
Each frame is made up of a large no. of scan lines
A large no. of frames to be scanned/sec to follow
moving tissues
As PRF FR
30 frames/sec gives flicker-free display
To obtain good quality images with high resolution
in RT imaging
FR x no. of lines/frame = PRF

e.g.: 30 frames/sec each of 100 lines/frame requires a


PRF of?? 18
(4) Frame Rate (cont)

Typical images

120 scan lines in each image/frame


each scan line (say) ~ 20 cm long, then
each line has a time of flight of ~ 267 s

A single frame takes : 120 x 267 = 32 ms

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Depth of View
To image structures at depth each pulse MUST
have time to return journey from the deepest tissue
BEFORE the next pulse is generated
Depth of View as PRF
Depth of View = (0.5 x sound vel)/PRF
Hence, difficult to achieve both a high FR and high
scan line density AND at the same time produce an
image with a large depth of view one/more
aspects to be compromised
Depth of view x (scan lines/frame) x FR = Constant
e.g.: a depth of 20 cm allows 30 frames/s & 100
20
lines/frame
Frame Rate and Depth of View

As the depth of the sector determines Thus reducing the desired depth
the time before next pulse can be sent of the sector results in shorter
out, higher depth results in longer time time between pulses, and thus
for building each line, and thus longer shorter time for building each
time for building the sector from a line, shorter time for building the
given number of lines (i.e. lower frame same number of lines, i.e. higher
frame rate 21
rate)
Aspects of RT ultrasonic imaging system
(5) Detectivity:
Ability to effectively capture, process & display
the very wide dynamic range of signals for
detecting abnormality/lesion

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Transducer
Piezoelectric ceramic (Barium Titanate/PZT)
Crystal cut in such a way increased efficiency of
conversion of electrical energy to acoustic energy
V (~150V) of very short duration (~1s)
vibration at a natural resonance frequency
Selecting the frequency
preferential emission of u/s waves when thickness
of the crystal =
e.g: To achieve a 5MHz resonant ; element thickness?
=c/ 4000m/s =.80mm; t: x0.8 mm =0.4 mm
5x106m/s 23
Q factor
Q = resonant freq/bandwidth f0/(f2-f1)
f0 : resonant frequency (centre frequency) of the T
f2 : frequency above resonance at which A=A/2
f1 : frequency below resonance at which A=A/2
f2 - f1: band width of the sound (b/w the 6dB points) defined as
the FWHM of the freq spectrum
High Q transducer
Energy stored in the crystal (hence loses very little each cycle)

T vibrates (rings) with a relatively long lasting vibration a long
pulse u/s emitted with a narrow bandwidth (nearly "pure"
sound)
Low Q transducer
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T will vibrate for only a short time period a short pulse of u/s
the "quality" of sound emanating from an ultrasound transducer
after being struck by a short voltage pulse Q factor

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Damping a transducer
Need to DAMP a transducer
Transducer excited at its resonant frequency
continues to vibrate mechanically for some time
even after the electrical signal ceases after
ringing destroys the precision with which
emission/detection of a signal can be timed
Damping (ring down)
layered on the back of the T element
ensuring rear surface has high impedance and high

absorbance of u/s waves energy radiated does


not return to T to give rise to spurious echoes 26
Backing material in a transducer
Backing material (for damping)
thick for complete absorption of the backward
transmitted ultrasonic waves
epoxy resin loaded with a mixture of tungsten
and rubber powder
Q factor the bandwidth shortens the
ring-down time and consequently shorten the
transmitted pulse (shortens SPL) axial
resolution improved
What type of Q preferred in ultrasound imaging
systems? 27
Choice of piezo-electric material

Long ring-down time Short ring-down time

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Transducer

front electrode
earthed to
protect patient
from electric reduces
shock spatial
pulse-
leads connected to length
the top of the backing
layer & the front of
the crystal to receive
signals & provide the
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exciting voltage
Matching layer in a transducer
Impedance equalizer (allows max E transfer)
Placed on the front surface of the transducer to

improve the efficiency of transmission into the


patient
Material has Z = intermediate to those of soft
tissue and the transducer material
Matching layer thickness = the wavelength of
u/s in that material (quarter matching)
In addition, acoustic coupling gel (Z similar to
soft tissue) used b/w T & skin to eliminate air pockets
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that could attenuate and reflect the u/s beam
Transducer

metal case protects the probe


mechanically and electrically

cork or rubber prevents the


u/s from passing into the
plastic housing

Zm = (ZT Zsoft tissue) 31


Optimal impedance matching is achieved by
sizing the matching layer so that its thickness is
1/4 of the desired wavelength this keeps
waves that were reflected within the matching
layer in phase when they exit the layer 32

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