FRCR US Lecture 1

The Physics of
Diagnostic Ultrasound
FRCR Physics Lectures

Mark Wilson
Clinical Scientist (Radiotherapy)

Hull and East Yorkshire Hospitals
NHS Trust
mark.wilson@hey.nhs.uk

Session 1 & 2

Session 1 Overview
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Session Aims:

Basic physics of sound waves
Basic principles of image formation
Interactions of ultrasound waves with matter

Basic Physics

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Basic Physics
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Wave Motion

Basic Physics
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Sound Waves
Sounds waves are mechanical pressure waves which propagate
through a medium causing the particles of the medium to oscillate
backward and forward
The term Ultrasound refers to sound waves of such a high frequency
that they are inaudible to humans
Ultrasound is defined as sound waves with a frequency above 20 kHz
Ultrasound frequencies used for imaging are in the range 2-15 MHz
The velocity and attenuation of the ultrasound wave is strongly
dependent on the properties of the medium through which it is travelling

Basic Physics
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Wave Propagation
Imagine a material as an array of molecules linked by springs
As an ultrasound pressure wave propagates through the medium, molecules
in regions of high pressure will be pushed together (compression) whereas
molecules in regions of low pressure will be pulled apart (rarefaction)
As the sound wave propagates through the medium, molecules will oscillate
around their equilibrium position
Basic Physics
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Power and Intensity
A sound wave transports Energy through a medium from a source. Energy is
measured in joules (J)
The Power, P, produce by a source of sound is the rate at which it produces
energy. Power is measured in watts (W) where 1 W = 1 J/s
The Intensity, I, associated with a sound wave is the power per unit area.
Intensity is measured in W/m
2

The power and intensity associated with a wave increase with the pressure
amplitude, p
Intensity, I p
2
Power, P p
Basic Physics
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Frequency (f):
Number of cycles per second
Unit: Hertz (Hz)

Speed (c):
Speed at which a sound wave
travels is determined by the
medium
Unit: Metres per second (m/s)

Air 330 m/s
Water 1480 m/s
Av. Tissue 1540 m/s
Bone 3190 m/s
Basic Physics
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Wavelength ():
Distance between consecutive
crests or other similar points on
the wave
Unit: Metre (m)

A wave from a source of
frequency f, travelling through a
medium whose speed of sound is
c, has a wavelength
= c / f
Basic Principles of
Image Formation

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Basic Principles of Image Formation
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Pulse-Echo Principle
)
)
)
)
)
D
)
)
)
)
)
)
)
)
)
)
Source of sound
Distance = Speed x Time
2D = c x t
Sound reflected at boundary
Reduced signal amplitude
No signal returns
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Pulse-Echo in Tissue
Ultrasound pulse is launched into the first tissue
At tissue interface a portion of ultrasound signal is transmitted into the second
tissue and a portion is reflected within the first tissue (termed an echo)
Echo signal is detected by the transducer

Transducer
Can transmit
and receive US
Tissue 1 Tissue 2 Tissue 3
B-Mode Image
A B-mode image is a cross-sectional image representing tissues and organ
boundaries within the body
Constructed from echoes which are generated by reflection of US waves at
tissue boundaries, and scattering from small irregularities within tissues
Each echo is displayed at a point in the image which corresponds to the
relative position of its origin within the body
The brightness of the image at each point is related to the strength
(amplitude) of the echo
B-mode = Brightness mode

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B-Mode Image Formation
A 2D B-mode image is formed from a large number of B-mode lines, where each
line in the image is produced by a pulse echo sequence
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Transducer
Arrays
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Linear
Curvilinear Phased
Rectangular FOV
Useful in applications
where there is a need
to image superficial
areas at the same time
as organs at a deeper
level
Trapezoidal FOV
Wide FOV near
transducer and even
wider FOV at deeper
levels
Sector FOV useful for
imaging heart where
access is normally
through a narrow
acoustic window
between ribs
B-Mode Image How Long Does it Take?
1. Minimum time for one line = (2 x depth) / speed of sound = 2D / c seconds
2. Each frame of image contains N lines
3. Time for one frame = 2ND / c seconds
E.g. D = 12 cm, c = 1540 m/s, Frame rate = 20 frames per second
Frame rate = c / 2ND
N = c / 2D x Frame rate = 320 lines (poor - approx half of standard TV)
Additional interpolated lines are inserted between image lines to boost image
quality to the human eye
4. Time is very important!!!
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Time Gain Compensation (TGC)
Deeper the source of echo Smaller signal intensity
Due signal attenuation in tissue and reduction in initial US beam intensity by
reflections
Operator can TGC use to artificially boost the signals from deeper tissues
(like a graphic equaliser)
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M-Mode Image
Can be used to observe the motion of tissues (e.g. Echocardiography)
One direction of display is used to represent time rather than space

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Transducer at fixed point
Time
Depth
M-Mode Image of Mitral Valve
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Ultrasound
Interactions in Matter

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Ultrasound Interactions

Reflection
Scatter
Refraction
Attenuation and Absorption
Diffraction

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Speed of Sound, c
The speed of propagation of a sound wave is determined by the medium it is
travelling in
The material properties which determine speed of sound are density, (mass
per unit volume) and elasticity, k (stiffness)
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Atom / Molecule
Bond
Speed of Sound, c
Consider a row of masses (molecules) linked by springs (bonds)
Sound wave can be propagated along the row of masses by giving the first
mass a momentary push to the right
This movement is coupled to the second mass by the spring

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m
m m m K K
K
Sound wave
Stiff spring will cause the second mass to accelerate quickly to the right and
pass on the movement to the third mass
Smaller masses are more easily accelerated by spring
Hence, low density and high stiffness lead to high speed of sound
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m
m m m K K
K
Small masses (m) model a material of low density linked by springs of high
stiffness K
Weak spring will cause the second mass to accelerate relatively slowly
Larger masses are more difficult to accelerate
Hence, high density and low stiffness lead to low speed of sound
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M M M M
k k
k
Large masses (M) model a material of high density linked by springs of low
stiffness k
Speed of Sound c = \ k /
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Material C (m/s)
Liver 1578
Kidney 1560
Fat 1430
Average Tissue 1540
Water 1480
Bone 3190
Air 330
Ultrasound Interactions - Reflection
Reflection of Ultrasound Waves
When an ultrasound wave travelling through one type of tissue encounters an
interface with a tissue with different acoustic impedance, z, some of its energy
is reflected back towards the source of the wave, while the remainder is
transmitted into the second tissue
- Reflections occur at tissue boundaries where there is a change in acoustic
impedance
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Transducer

z
1

z
2

Acoustic Impedance (z)
The acoustic impedance of a medium is a measure of the response of the
particles of the medium to a wave of a given pressure
The acoustic impedance of a medium is again determined by its density, ,
and elasticity, k (stiffness)
As with speed of sound, consider a row of masses (molecules) linked by
springs
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m
m m m K K
K
Sound wave
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A given pressure is applied momentarily to the first small mass m
The mass is easily accelerated to the right and its movement encounters little
opposing force from the weak spring k
This material has low acoustic impedance, as particle movements are
relatively large in response to a given applied pressure
m
m m m k k
k
Small masses (m) model a material of low density linked by weak springs of low
stiffness k
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In this case, the larger masses M accelerate less in response to the applied
pressure
Their movements are further resisted by the stiff springs
This material has high acoustic impedance, as particle movements are
relatively small in response to a given applied pressure

M M M M
K K
K
Large masses (M) model a material of high density linked by springs of high
stiffness K
Acoustic Impedance z = \ k
Acoustic Impedance z = c
Can also be shown
Amplitude Reflection Coefficient (r)
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r =
Z
2
Z
1

Z
1
+ Z
2

z
1
z
2

p
i
, I
i

p
t
, I
t

p
r
, I
r

p
i

p
r

=
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Intensity Reflection Coefficient (R)
R =
Z
2
Z
1

Z
1
+ Z
2

I
i

I
r

=
(
)
2
Strength of reflection depends on the difference between the Z values of the
two materials
Ultrasound only possible when wave propagates through materials with
similar acoustic impedances only a small amount reflected and the rest
transmitted
Therefore, ultrasound not possible where air or bone interfaces are present
Intensity Transmission Coefficient (T)
T = 1 - R
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Interface R T
Soft Tissue-Soft Tissue 0.01-0.02 0.98-0.99
Soft Tissue-Bone 0.40 0.60
Soft Tissue-Air 0.999 0.001
Reflection at an Angle
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z
1
z
2

i
r
For a flat, smooth surface the angle of
reflection, r = the angle of incidence, i

In the body surfaces are not usually
smooth and flat, then r = i
Ultrasound Interactions - Scatter
Scatter
Reflection occurs at large interfaces such
as those between organs where there is a
change in acoustic impedance
Within most organs there are many small
scale variations in acoustic properties
which constitute small scale reflecting
targets
Reflection from such small targets does
not follow the laws of reflection for large
interfaces and is termed scattering
Scattering redirects energy in all
directions, but is a weak interaction
compared to reflection at large interfaces
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Ultrasound Interactions - Refraction
Refraction
When an ultrasound wave crosses a tissue boundary at an angle (non-normal
incidence), where there is a change in the speed of sound c, the path of the
wave is deflected as it crosses the boundary
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c
1
c
2
(>c
1
)
i
t
Snells Law
sin (i)
sin (t)
c
1

c
2

=
Ultrasound Interactions - Attenuation
Attenuation
As an ultrasound wave propagates
through a medium, the intensity
reduces with distance travelled
Attenuation describes the reduction
in intensity with distance and includes
scattering, diffraction, and absorption
Attenuation increases linearly with
frequency
Limits frequency used trade off
between penetration depth and
resolution

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Distance, d
Intensity, I
Low freq.
High freq.
I = I
o
e
- od

Where o is the attenuation coefficient
Ultrasound Interactions - Attenuation
Absorption
In soft tissue most energy loss (attenuation) is due to absorption
Absorption is the process by which ultrasound energy is converted to heat in
the medium
Absorption is responsible for tissue heating

Decibel Notation
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Decibel, dB = 10 log
10
(I
2
/ I
1
)
Attenuation and absorption is often expressed in terms of decibels
Ultrasound Interactions - Diffraction
Diffraction
Diffraction is the process by which the ultrasound wave diverges (spreads out)
as it moves away from the source
Divergence is determined by the relationship between the width of the source
(aperture) and the wavelength of the wave
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Low Divergence
Aperture small compared to
High Divergence
Aperture large compared to
Break

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Session 2 Overview
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Session Aims:

Construction and operation of the ultrasound transducer
Ultrasound instrumentation
Ultrasound safety

Ultrasound
Transducer

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Ultrasound Transducer
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Transducer
The transducer is the device that converts electrical transmission pulses into
ultrasonic pulses, and ultrasonic echo pulses into electrical signals
A transducer produces ultrasound pulses and detects echo signals using the
piezoelectric effect
The piezoelectric effect describes the interconversion of electrical and
mechanical energy in certain materials
If a voltage pulse is applied to a piezoelectric material, the material will
expand or contract (depending on the polarity of the voltage)
If a force is applied to a piezoelectric material which causes it to expand or
contract (e.g. pressure wave), a voltage will be induced in the material

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Transducer
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Transducer
A transducer only generates a useful ultrasound beam at one given frequency
This frequency corresponds to a wavelength in the transducer equal to twice
the thickness of the piezoelectric disk This is due to a process known as
Resonance!
Choice of frequency is important remember that attenuation increases with
increasing frequency
Image resolution increases with frequency
Therefore, there is a trade-off between scan depth and resolution for any
particular application
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Beam Shape Diffraction

NEAR FIELD FAR FIELD
NFL
a
Near Field Length, NFL = a
2
/
a = radius of transducer
= Wavelength
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Beam Shape - Diffraction
In the near field region the beam energy is largely confined to the dimensions
of the transducer
Need to select a long near field length to achieve good resolution over the
depth you wish to scan too
Near field length increases with increasing transducer radius, a, and
decreasing wavelength,
Short wavelength means high frequency not very penetrating
Large transducer radius Wide beam (poor lateral resolution)
Trade-off between useful penetration depth and resolution!!

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Beam Focusing
An improvement to the overall beam width can be obtained by focusing
Here the source is designed so that the waves converge towards a point in
the beam, the focus, where the beam achieves its minimum width
Beyond the focus, the beam diverges again but more rapidly that for an
unfocused beam with the same aperture and frequency

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Beam Focusing
a
W
F
Beam width at focus, W = F / a
At focal point:
Maximum ultrasound intensity
Maximum resolution
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Beam Focusing
For a single element source, focusing can be achieved in one of two ways:
1) A curved source
A curved source is manufactured with a radius of curvature of F and
hence produces curved wave fronts which converge at a focus F cm from
the source

F
Source Focus
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Beam Focusing
For a single element source, focusing can be achieved in one of two ways:
2) An acoustic lens
An acoustic lens is attached to the face of a flat source and produces
curved wave fronts by refraction at its outer surface (like an optical lens).
A convex lens is made from a material with the lower speed of sound
than tissue.

Source
Focus
Lens
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Beam Shape - Overlapping Groups of Elements

Fire elements
1-5 together
And then
Fire elements
2-6 together
And so on
Near field length increases as (N)
2

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Array Focusing
Waves from outer elements 1 and 5 have
greater path lengths than those from other
elements

Therefore signals do not arrive simultaneously
at the target and reflections do not arrive at all
elements at the same time
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Array Focussing
Introduce time delays to compensate for extra
path length on both transit and receive
Time delays
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Multiple Zone Focussing
Fire transducer several times with different focus to compile better image
However, more focus points decreases frame rate
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Resolution
Resolution in three planes
Axial
Slice Thickness
Lateral
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Resolution

Resolution Depends on Typical Value (mm)
Axial Pulse length 0.2 - 0.5
Lateral Beam width 2 5
Slice Thickness Beam height 3 - 8
Higher frequency improves resolution in all three planes
Slice thickness is a hot topic for improvement 2D arrays
Instrumentation

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Instrumentation
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Transmitter
Clock
TGC Generator Transducer Beam Controller
AD Converter
Signal Processor
Image Store
Archive Display
x, y
z
Instrumentation
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Clock
Command and control centre
Sends synchronising pulses around the system
Each pulse corresponds to a command to send a new pulse from the
transducer
Determines the pulse repetition frequency (PRF)

PRF = 1 / time per line = c / 2D
Where c is speed of sound and D is maximum scan depth
If there are N lines, then Frame Rate = c / 2ND
Instrumentation
Transmitter
Responds to clock commands by generating high voltage pulses to
excite transducer

Transducer
Sends out short ultrasound pulses when excited
Detects returning echoes and presents them as small electrical
signals

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Instrumentation
AD Converter
Converts analogue echo signals into digital signals for further
processing
Needs to:
Be fast enough to cope with highest frequencies
Have sufficient levels to create adequate grey scales (e.g. 256 or 512)

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Instrumentation
Signal Processor

Carries out:
TGC application
Overall gain
Signal compression fits very large dynamic range ultrasound signal
on to limited greyscale display dynamic range
Demodulation removal of the carrier (ultrasound) frequency

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Grey level
Input Amp
Linear
Liver
Heart
Instrumentation
Image Store
Takes z (brightness) signal from processor
Positions it in image memory using x (depth) and y (element position)
information from beam controller
Assembles image for each frame
Presents assembled image to display
Typically have capacity to store 100-200 frames to allow cine-loop

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Ultrasound Safety

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Ultrasound Safety
Hazard and Risk
Hazard describes the nature of the danger or threat (e.g. burning,
falling, etc)
Risk takes into account the severity of the potential consequences
(e.g. death, injury) and the probability of occurrence
There are two main hazards associated with ultrasound:
- Tissue heating
- Cavitation
But is there any risk???

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Ultrasound Safety
Tissue Heating
During a scan some of the ultrasound energy is absorbed by the exposed
tissue and converted to heat causing temperature elevation
Elevated temperature affects normal cell function
The risk associated with this hazard depends on the:
- Degree of temperature elevation
- Duration of the elevation
- Nature of the exposed tissue

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Rate of energy absorption per unit volume
q = 2ovI
Where o = absorption coefficient, v = frequency, I = intensity
Ultrasound Safety
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Tissue Heating
Thermal effects in patient are complex
Temperature increase will be fastest at the focus resulting in a temperature
gradient
Heat will be lost from focus by thermal conduction
The transducer itself will heat up and this heat will conduct into tissue
enhancing the temperature rise near the transducer
The presence of bone in the field will increase the temperature rise
Blood flow will carry heat away from the exposed tissues
It is impossible to accurately predict the temperature increase occurring in the
body and a simple approach to estimate the temperature increase is used to
provide some guidance - Thermal Index (TI)
Ultrasound Safety
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Thermal Index (TI)
TI = W / W
deg

W = Transducer power exposing the tissue
W
deg
= The power required to cause a maximum temperature rise of 1
o
C
anywhere in the beam
TI is a rough estimate of the increase in temperature that occurs in the region
of the ultrasound scan
A TI of 2.0 means that you can expect at temperature rise of about 2
o
C
The difficulty with calculating the TI lies mostly in the estimation of W
deg

To simplify this problem there are three TIs

Ultrasound Safety
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Soft-Tissue Thermal Index (TIS)
Soft tissue
Maximum temperature
Bone-at-Focus Thermal Index (TIB)
Soft tissue
Maximum temperature
Bone
Ultrasound Safety
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Cranial (or Bone-at-Surface) Thermal Index (TIC)
Soft tissue
Maximum temperature
Bone
All three TI values depend linearly on the acoustic power emitted by the
transducer
Ultrasound Safety
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Does Temperature Rise Matter?
Normal core temperature is 36-38
o
C and a temperature of 42
o
C is largely
incompatible with life
During an ultrasound examination only a small volume of tissue is exposed and
the human body is quite capable of recovering from such an event
Some regions are more sensitive such as reproductive cells, unborn fetus, and
the CNS
Temperature rises of between 3 and 8
o
C are considered possible under certain
conditions
There has been no confirmed evidence of damage from diagnostic ultrasound
exposure
Ultrasound Safety
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Cavitation
Refers to the response of gas bubbles in a
liquid under the influence of an ultrasonic wave
Process of considerable complexity
High peak pressure changes can cause micro-
bubbles in a liquid or near liquid medium to
expand resonance effect
A bubble may undergo very large size variations
and violently collapse
Very high localised pressures and temperature
are predicted that have potential to cause cellular
damage and free radical generation
Ultrasound Safety
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Cavitation
Micro-bubbles grow by resonance processes
Bubbles have a resonant frequency, f
r
, depending on their radius, R.

f
r
R ~ 3 Hz m

This suggests that typical diagnostic frequencies (3 MHz and above) cause
resonance in bubbles with radii of the order of 1 micrometer
Ultrasound Safety
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Mechanical Index (MI)
The onset of cavitation only occurs above a threshold for acoustic pressure
This has resulted in the formulation of a mechanical index (MI)
Mechanical index is intended to quantify the likelihood of onset of cavitation

MI = p
r
/ \f
where p
r
is the peak rarefaction pressure and f is the ultrasound frequency
For MI < 0.7 the physical conditions probably cannot exist to support bubble
growth and collapse
Exceeding this threshold does not mean there will be automatically be
cavitation
Cavitation is more likely in the presence of contrast agents and in the
presence of gas bodies such as in the lung and intestine
The End

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FRCR US Lecture 1

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