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Abstract
Medical ultrasound (also known as diagnostic sonography or ultrasonography) is a diagnostic
imaging technique, or therapeutic application of ultrasound. It is used to create an image of
internal body structures such as tendons, muscles, joints, blood vessels, and internal organs. Its
aim is often to find a source of a disease or to exclude pathology. The practice of
examining pregnant women using ultrasound is called obstetric ultrasound, and was an early
development and application of clinical ultrasonography.
Ultrasound are sound waves with frequencies which are higher than those audible to humans
(>20,000 Hz). Ultrasonic images, also known as sonograms, are made by sending pulses of
ultrasound into tissue using a probe. The ultrasound pulses echo off tissues with different
reflection properties and are recorded and displayed as an image.
Tematikat qe jane trajtuar
1) Aplikimet ne mjekesi (fq 4 – 13)
2) Ultratingujt ne natyre ( 15 -22)
Application
• Ultrasound Imaging is used in following medical working Areas
Hospital
General Practise
Physical Therapy practice
Obstetrics centres
Veterinary centres
Following medical specialism may use
Ultrasound Imaging
• Internal Medicine
• Radiology
• Surgery
• Cardiology
Goals
• Diagnosis
• Treatment
Ultrasound treatment is performed to treat prostate cancer (HIFU), for example, or for kidney stone removal
(lithotripsy) or during physical therapy. The intensity of ultrasound determines whether it is suitable for
diagnostic or therapeutic purposes.
Intensive care Unit
• Intensivist deploys ultrasound to
assess heart function, the status of
fluid in the lungs and for guiding
interventions.
• The use is focused on quick and
easy assessments.
• If more profound ultrasound
examination is required, they will
refer the patient to a more
specialized sonographer.
• They use Ultrasound for the
insertion of central venous catheter.
Physiotherapy
• Physiotherapist uses to
assess structures such as
tendons, muscles, bones,
joints, capsules, ligaments
and nerves, among others.
• Ultrasound helps her to
confirm or disprove earlier
diagnoses, refer the patient
earlier to specialised
physicians, or even change
their own therapy
approach.
Radiology
• Radiologist and sonographers uses
ultrasound to visualize the anatomy as well
as physiology of all the regions of body. For
Example: they may focus on the abdominal
organs, which are very suitable for
ultrasound assessment.
• The liver, gall bladder, pancreas, spleen,
kidneys, aorta, and urine bladder may be
examined.
• Only those organs containing air - such as
the stomach and intestines - are more
difficult to assess.
Obstetrics
• During pregnancy, women
visits sonographers multiple
times and get various pieces
of information about their
future child - like gender*,
growth, potential
abnormalities, and/or a 3D
impression.
Vascular Surgery
• Doppler imaging is
frequently used here, to
analyse blood flow
velocity and direction.
• The health of all kinds of
blood vessels can thus be
checked upon, including
vessel lumen narrowing,
widening and
insufficiency.
In this ultrasound image you see that there is a structure
measured. What structure is measured here most likely?
• Spleen
• Kidney
• Liver
• Aorta
• Stomach
This is a typical dimension of a kidney in this orientation. Make also note of the typical structure of the kidney, where
you can see that is located next to the liver, making this the right kidney.
In this ultrasound image there is an overlay with coloring.
What is indicated with the blue and red colors here?
• A artery and a Vein
• And in this way, using ultrasound, he could image the ventricles of the
brain.
There is the use of ultrasound in nature by
animals, and in ships for safety, and we have
seen the ultrasound for medical purposes. So
ultrasound is everywhere, but you just can't
hear it.
How can we make and detect Ultrasound
Transducer
• a transducer is a system that transforms one form of energy into
another form of energy.
• Abdomen
Linear Probe 1
• straight surface
• Arteriel or Musculoskeletal
Linear Probe 2
• Small probe / window
• Traingular field
• Cardiography
Based of frequency
• High Frequency transducer
• Low Frequency transducer
High frequency Transducer
• emit waves of short wavelength and a frequency of 7-18 MHz.
• are unable to travel very far, are used to image superficial structures or
organs close to the skin surface.
• result in a higher resolution means superficial tissue is seen in greater
detail
• Z=dxc
Acoustic Impediance continue
• It is easier for sound waves to travel through fluid, more difficult to
travel through an organ like the liver and virtually impossible to travel
through bone.
• Sound Wave can be :
1. Reflected
2. Refracted
3. Absorbed or
4. Scattered
• Angle of incidence Equals
Reflection angle of reflection.
• Best Reflection: face of
transducer parallel to
interface
• Improves Quality
• Structures consisting of
calcium will reflect sound
completely and there will
not be any transmission of
the sound wave past these
highly reflective interfaces.
This causes a dark shadow
(posterior shadowing)
behind the bright
(hyperechoic) reflective
interface.
Refraction
• When the sound wave strikes a
curved surface it is refracted.
There are many curved structures
within the body (cyst, gallbladder,
renal contour) that can cause a
refraction artifact.
• The sound wave is refracted away
from the curved interface
resulting in no sound returning to
the transducer from immediately
below the rounded interface,
creating a black void on the
image.
Scattering
• Scattering occurs when the
reflective interfaces are very
small. This occurs through out
the organs but is most easily
demonstrated when we scan
organs containing air.
• The tiny air molecules contained
in bowel gas and lungs are
strong reflectors, due to the
difference in acoustic impedance
with the surrounding tissue,
meaning they appear white on
the screen.
• Air also scatters the sound wave
so the image that is formed
appears irregular and ill defined.
Absorption
Modes of Ultrasound
A mode
•A for Amplitude
•1 dimension
•display of amplitude spikes
of different heights.
• Hardly Used now
• Brightness mode
B mode • display of 2D map of B-Mode data,
• most common form of ultrasound
imaging.
• Unlike A-Mode, this based on
brightness
with the absence of vertical spikes.
Therefore,
the brightness depends upon the
amplitude
or intensity of the echo.
B-Mode will display an image of large
and small dots, which represent strong
and weak echoes, respectively
• M-Mode, or Motion Mode (also
M Mode called Time Motion or TM-Mode),
is the display of a one-dimensional
image that is used for analyzing
moving body parts commonly in
cardiac and fetal cardiac imaging.
• accomplished by recording the
amplitude and rate of motion in
real time by repeatedly measuring
the distance of the object from the
single transducer at a given
moment.
• The single sound beam is
transmitted and the reflected
echoes are displayed as dots of
varying intensities thus creating
lines across the screen.
Characteristics of Sonographic Image
• Sonographer must be able to analyzea mass to determine its border
are smooth, irregular, poorly defined, thin , or thick to further define
its characteristics .
• hypoechoic lesion is
characterized by very
low-level echoes with
a good posterior
border.
Isoechoic
• An isoechoic mass shows
nearly the same texture
pattern as the
surrounding parenchyma
with no significant
change in the through
transmission
Anechoic
• An anechoic mass
shows no internal
echoes, has smooth
walls, and displays
increased through
transmission.
Why Ultrasound Image is with so much noise
• Speckles: mark with large number of small spots or patches of colour.
Doppler Effect
•Christian Doppler in 1842
Expected advancements
include further developments in
transducer design, image resolution, tissue
characterization applications, color
flow sensitivity, and four-dimensional reconstruction
of images.
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