12-01-2011

Tutorial 1 - Basic physics of ultrasound

ICU Sonography
Demystifying sonology in intensive c are Home iSONO c ourse Home iSONO Tutorials Forums Gallery Links About us Contact us

Search

Site aids Minimum requirements Site instruc tions Legal and c opyright information

Tutorial 1 - Basic physics of ultrasound and the Doppler phenomenon

BASIC PHYSICS OF ULTRASOUND AND THE DOPPLER PHENOMENON

Medical ultrasound imaging c onsists of using high pitc hed sound bouncing off t issues t o generate images of internal body struc tures.

Login to post in the forums

Username: *

Frequency
Frequency refers to the number of cyc les of c ompressions and rarefactions in a sound wave per sec ond, with one c yc le per sec ond being 1 hertz. While t he term ultrasound generally refers to sound waves with frequenc ies above 20,000 Hz (the frequenc y range of audible sound is 20 to 20,000 Hz), diagnostic ultrasound uses frequenc ies in the range of 1-10 million (mega) hertz.

Password: *

Log in
Create new account Request new password

Wavelength
The wavelength is the distanc e t raveled by sound in one c yc le, or t he distance between two identic al points in the wave c yc le i.e. the distance from a point of peak c ompression t o t he next point of peak c ompression. It is inversely proportional to t he frequency. Wavelength is one of the main fac tors affec ting axial resolution of an ultrasound image. The smaller t he wavelength (and therefore higher t he frequenc y), t he higher t he resolution, but lesser penetration. T herefore, higher frequency probes (5 to 10 MHz) provide better resolution but c an be applied only for superfic ial struc tures and in c hildren. Lower frequenc y probes (2 t o 5MHz) provide better penetration albeit lower resolution and can be used to image deeper structures.

Propagation velocity
The propagation veloc ity is the veloc ity at whic h sound travels through a partic ular medium and is dependant on the c ompressibility and density of t he medium. Usually, t he harder t he t issue, the faster the propagation velocity. The average veloc ity of sound in soft tissues suc h as the c hest wall and heart is 1540 metres/sec ond.

ULTRASOUND TISSUE INTERACTIONS

Figure 1: Interactions of Ultrasound with tissue: Echocardiography, Bonita Anderson, Dutoit, WileyBlackw ell

The interac tion of ultrasound waves with organs and tissues enc ountered along the ultrasound beam c an be desc ribed in terms of attenuation, absorption, reflection, scattering, refraction and diffraction.

Attenuation
Sound energy is attenuated or weakened as it passes t hrough t issue bec ause parts of it are reflec ted, scattered, absorbed, refracted or diffrac ted.

Reflection
A reflection of the beam is c alled an ec ho and the produc tion and detection of ec hoes forms the basis of ultrasound. A reflec tion occ urs at the boundary between two materials provided that a c ertain property of the materials is different. T his property is known as the acoustic impedance and is the produc t of the density and propagation speed. If two materials have the same acoustic impedance, their boundary will not produc e an ec ho. If t he difference in acoustic impedanc e is small, a weak ec ho will be produc ed, and most of the ultrasound will c arry on t hrough t he second medium. If the differenc e

criticalecho.com//tutorial-1-basic-phy

1/6

12-01-2011

Tutorial 1 - Basic physics of ultrasound

in acoustic impedance is large, a strong ec ho will be produced. If the difference in ac oustic impedance is very large, all t he ultrasound will be totally reflec ted. T ypically in soft t issues, t he amplitude of an ec ho produc ed at a boundary is only a small percentage of t he inc ident amplitudes, whereas areas c ontaining bone or air can produc e such large echoes t hat not enough ultrasound remains t o image beyond the tissue interfac e.

Figure 2: Production of an echo depending on relative acoustic impedances of the two media: From: Aldrich: Crit Care Med, Volume 35(5) Suppl.May 2007.S131-S137

Table 1: Percentage reflection of ultrasound at boundaries: From: Aldrich: Crit Care Med, Volume 35(5) Suppl.May 2007.S131-S137

At a tissueair interface, 99% of the beam is reflec ted, so none is available for further imaging. Transducers, therefore, must be directly c oupled to t he patients skin without an air gap. Coupling is ac complished by use of gel between the transduc er and the patient.

Scattering
Not all echoes are reflec ted bac k to the probe. Some of it is scattered in all directions in a non-uniform manner. T his is especially true for very small objects or rough surfaces. T he part of the scattering t hat goes back t o reach the transducer and generate images is c alled bac kscatter.

Absorption
Tissue absorption of sound energy contributes most to the attenuation of an ultrasound w ave in tissues.

Refraction
The change in the direction of a sound wave on being inc ident upon a t issue interface at an oblique angle is refraction and is determined by Snells law. Follow this link for an explanation of t his law: http://www.ndt-ed.org/EducationResources/CommunityCollege/Ultrasonics/Ph...

TRANSDUCERS
Inside the c ore of the transduc er are a number of peizo- elec tric c rystals that have the ability to vibrate and produce sound of a partic ular frequenc y when elec tric ity is passed through them. T his is how ultrasound waves are formed. T hese transduc ers also ac t as receivers for the reflec ted echoes as t hey generate a small elec tric signal when a sound wave is inc ident upon it.

Duty factor
In most modes of ultrasound operation, only 1% of the time is spent in generating a pulse of ultrasound waves and 99% of the t ime is t hen spent listening for t he ec hoes. This is c alled the duty fac tor1% in suc h a c ase.

Pulse repetition frequency (PRF)

The PRF is t he number of pulses (send and listen cyc les) of ultrasound sent out by the transduc er per sec ond. It is dependent on the veloc ity of sound and on the depth of t issue being interrogated. The deeper t he tissue being examined, the longer the transduc er has t o wait for ec hoes t o come back, henc e a lower PRF.

Beam
The ultrasound beam is focused by the t ransduc er so as to be as c lose t o a flat plane as possible. T he beam is made up of tens t o hundreds of sc an lines.

Orientation

criticalecho.com//tutorial-1-basic-phy

2/6

12-01-2011

Tutorial 1 - Basic physics of ultrasound

There is usually a dot, groove or light on one ends of t he t ransduc er to assist orientation. A c orresponding marking is also displayed on the screen to help give an orientation to the images.

Resolution
Axial resolution:The ability t o resolve objects in the line of t he ultrasound beam. Factors affec ting axial resolution include Spatial Pulse Length (SPL) and frequency. Lateral resolution: Resolution at 90 to t he direction of t he beam. Factors affec ting lateral resolution are width of t he beam, distance from t he t ransducer, frequenc y, side and grating lobe levels. Temporal resolution: Refers to t he ability t o detec t moving objects in the field of view in their true sequence. T he number of frames generated per sec ond (frame rate) determines temporal resolution.

DOPPLER EFFECT
Doppler shift is given by the following formula: F D = (V X F O ) / C where F D is t he Doppler shift F O is t he original frequenc y V is the veloc ity of blood C is the speed of sound in tissues Therefore V = (FD X C) / F O A further refinement of t his formula is: V = (FD X C) / (2F O X Cos) The original frequency is multiplied by 2 because t he Doppler shift occ urs t wice when the original wave is incident on t he moving RBC and when the moving RBC reflec ts it bac k. Cosine t heta (Cos) is applied as a c orrec tion for t he angle between the ultrasound beam and the direc tion of blood flow. Cos = 1 if the beam is parallel to t he direc tion of blood flow and maximum veloc ity is measured. Cos = 0 if the beam is perpendicular to t he direction of blood flow and zero velocity is measured It is noteworthy that for Doppler, maximum velocity information is obtained with the ultrasound beam aligned parallel to t he direction of t he blood flow being studied. Otherwise the peak veloc ity and c onsequently the pressure gradient (see below) will be underestimated. T his is in sharp c ontrast t o c onventional ec ho where t he best image quality is obtained with the ultrasound beam aligned perpendic ular to the struc ture being studied. Sinc e the original frequenc y value (2FO ) is in the denominator in the equation, it is important t o remember that maximum velocity information is obtained using low frequenc ies (usually 2 MHz). T his is in c ontrast t o c onventional 2- D ec ho where higher frequenc ies deliver higher resolutions. There is a direc t relationship between the peak flow velocity t hrough a narrow valve and the pressure gradient across it. Understandably, when the valve orific e is small, blood flow has to ac celerate in order to ejec t t he same stroke volume. T he smaller the orific e, t he higher t he ac celeration and velocity. T his inc rease in velocity c an be measured using Doppler echo. T he pressure gradient across the valve c an be c alculated using the simplified Bernoulli equation: Pressure gradient = 4 v 2 Where v is the peak flow veloc ity of t he jet t hrough the orific e. This equation is frequently used during Doppler evaluation of stenotic valves, regurgitant lesions and intra-c ardiac shunts. T he veloc ity information provided by Doppler c omplements the anatomic al information provided by M-mode and 2-D ec hoc ardiography. Analysis of the returning Doppler signal not only provides velocity information but also information about flow direc tion. By c onvention, velocities towards the transduc er are displayed above the baseline and velocities away from the t ransduc er are displayed below the baseline. The returning Doppler signal is a spec tral t race of velocity against a t ime axis. T he area under the c urve (AUC) of this spectral trace is known as the Velocity Time integral (VTI).also known variably as T VI or FVI (flow veloc ity integral). The value of t he VTI is determined by peak flow veloc ity and ejection time and can be calc ulated by the processor of most ec ho mac hines.

ARTIFACTS
The following sec tion on artifac ts has been taken in toto from: Basic physics of ultrasound imaging; Critic al Care Medicine - Volume 35, Issue 5 Suppl (May 2007) Artifacts are errors in images. T hey are normally c aused by physic al proc esses t hat affec t the ultrasound beam and that in some way alter t he basic assumptions the operator makes about t he beam. To understand artifacts, one needs t o consider the basic assumptions made in produc ing an ultrasound image: Sound waves travel in straight lines. Reflec tions occ ur from struc tures along the central axis of the beam. Intensity of reflec tion corresponds to t he reflec tor sc attering strength Sound t ravels at exactly 1540 m/sec . Sound t ravels direc tly to t he reflec tor and bac k.

criticalecho.com//tutorial-1-basic-phy

3/6

12-01-2011

Tutorial 1 - Basic physics of ultrasound

These assumptions do not always hold true. T here are numerous c ases of exceptions to t hese assumptions. Although some of these artifacts may actually provide useful information or allow for novel interpretations, t he majority are potential pitfalls that may c onfuse the examiner if not considered. The major artifacts encountered in c ritic al c are ultrasound are outlined below.

Reverberation
Reverberation artifac ts appear as multiple equally spac ed lines along a ray line. Reverberation is caused by the sound bouncing back and forth between tissue boundaries and then returning to t he receiver.

Figure 3: Example of a reverberation artifact.

Ring Down
Ring-down artifacts are produced when small crystals such as c holesterol or air bubbles resonate at t he ultrasound frequency and emit sound. Bec ause the sound is emitted aft er t he transducer rec eives the initial reflec tion, t he system t hinks the emitted sound is c oming from structures deeper in the body. Air bubbles in the abdomen are shown.

Figure 4: Example of a ring-down artifact.

Mirror Images
Sound c an bounc e off a strong, smooth reflec tor such as t he diaphragm. T he surface acts as mirror and reflects the pulse t o another tissue interface. T he ultrasound system believes the sec ond interfac e is beyond the first surface, and this is where it appears on the scan. In Figure 5, t he arrow shows the real object, whic h appears as if reflec ted in a mirror.

Figure 5: Example of a mirror-image artifact.

Reflections

criticalecho.com//tutorial-1-basic-phy

4/6

12-01-2011

Tutorial 1 - Basic physics of ultrasound

Reflec tion is somewhat similar t o the mirror image desc ribed above but has a very different appearance and is c aused by multiple reflec tions. Sound c an bounc e off a strong, smooth reflec tor, suc h as the posterior bladder wall, and be reflec ted back t o the t ransduc er, giving the appearance of t he struc ture deep t o the bladder wall as would be seen with fluid c ollec tion.

Figure 6: Example of a reflection artifact.

Enhancement
Enhancement is seen as an abnormally high brightness. T his occ urs when sound travels t hrough a medium with an attenuation rate lower t han surrounding tissue. Reflec tors at depths greater than the weak attenuation are abnormally bright in comparison with neighboring tissues. Enhancement of tissues (See arrow in Fig. 7 below) deeper than cysts or duc ts is c ommon. The attenuation of the sound through the fluid in these tissues is less than that of the surrounding tissues and results in this abnormal brightness. T he tissues deeper than the gallbladder show abnormal brightness.

Figure 7: Example of an enhancement artifact.

Attenuation
Tissues deeper than strongly attenuating objects, such as c alcific ation, appear darker because t he intensity of the t ransmitted beam is lower. In the scan of the gallbladder in Figure 8 below, t he left side shows enhanc ement as desc ribed above; the right side shows dec reased beam intensity bec ause of attenuation in c alc ified gallstones (arrow).

Figure 8: In this scan of the gallbladder, the left side shows enhancement described above; the right side

criticalecho.com//tutorial-1-basic-phy

5/6

12-01-2011

Tutorial 1 - Basic physics of ultrasound

shows a hypoechoic shadow distal to a brightly echogenic stone

Website supported by the VARTHINI AND ARUNACHALAM ENDOWMENT FUND

Kishor e Pichamuthu 2009

criticalecho.com//tutorial-1-basic-phy

6/6