Basic Ultrasound 2013 Cachard Archamps

Basic principles of ultrasound
Christian CACHARD
Christian.cachard@creatis.univ-lyon1.fr
CREATIS
www.creatis.insa-lyon.fr
Universit Lyon 1
Teresa Robinson
Consultant Clinical Scientist
Head of the Vascular Studies Unit, United Bristol Healthcare NHS Trust
Cachard ESMP 2013 Archamps
Universit de Lyon
CREATIS is a key european laboratory

for biological and medical imaging
Simulation of dose distribution
for radiotherapy
at the interface between

engineering, computer sciences
and living sciences
Elastography
About 200 persons

3D modelling of human heart

based on MRI
3
Development of
imaging methods,
3D augmented reality
new algorithms,
and instrumental systems to answer medical questions
In vivo quantification
of metabolite concentration
(MR spectroscopy at 4.7T)
3D imaging of cardiac muscular fibers
MR spectroscopy
Segmentation and tracking
of carotid artery wall in US
6 research teams
Diffusion Tensor Imaging

of the brain
1 - Imaging of the Heart-Vessels-Lungs

2 - Images et models
3 Ultrasound Imaging
4 - Tomographic imaging and therapy with radiation
5 - MRI and Optics : Methods and Systems
6 Brain imaging
Multi-organs segmentation
Microarchitecture and micro-vasculature

of trabecular bone(1 voxel=1,4m)
Dynamic model of the heart

5
Ultrasound imaging platform
3 research ultrasound scanners,

motorized and automated acquisition system
Imaging biological deformation in vivo

2D ultrasound elastography ultrasonore
Breast cancer, Coll. HCL and
Institute of Cancer Research, Londres
6
Medical applications
3D dynamic model of the heart

including fiber orientation.
Coll. Auckland Bioengineering Institute
MRI sequences for cardiac
function quantification
Cardio-vascular:
atherosclerosis and ischemia
3D tomographic reconstruction
of a stent, Coll. GEHealthcare
High resolution simulation

of diffusion tensor imaging
Coll. Harbin Institute of Technology
Real-time quantification of
Carotide wall movement
Coll. HCL et Hopital Univ. Sydney
Clinical protocol SARD
7
Basic principles of ultrasound
1: Overview
2: Sound waves
3: Ultrasound generation
4: Ultrasound in tissue
5
10
Ultrasound scanning
Scanner
Probe
Ultrasound imaging is Non Destructive Testing

11
12
The place of ultrasound in medical imaging
Public Hospitals in Lyon (2012)
9 MRI
11 scanners
8 gamma (scintillation) cameras

1 PET (Positron Emission Tomographie)
More than 100 ultrasound scanners

13
Real time imaging
10 to 60 frames/s
14
The place of ultrasound in medical imaging

Ultrasound has the last ten years been the fastest growing
imaging modality for non-invasive medical diagnosis.
Of all the various kinds of diagnostic produced in the world,
one of four is an ultrasound scan.
Reasons for this are the ability to image soft tissue and
blood flow
the real time imaging capabilities,

the harmlessness for the patient and the physician (no radiation)
the low cost of the equipment.
no special building requirements as for X-ray, Nuclear, and Magnetic
Resonance imaging.
Limitations are that ultrasound imaging cannot be done

through bone or air (limitations on chest imaging).
15
Mechanical wave
Knocking the bell inside the vacuum chamber

no sound propagates
Vacuum chamber
Sound is a mechanical wave
Created by a vibrating object
Propagated through a medium

16
The acoustic pressure

Ultrasound energy is exactly like
sound energy, it is a variation in the
pressure within a medium.
Sound is a pressure wave
The acoustic pressure is the change of pressure around the

static (ambient) pressure
p (Pa)
105
Acoustic pressure amplitude

Ambient pressure
t
17
Frequency of Sound
20 000 000 Hz
Diagnostic Medical
Ultrasound
(3-7 MHz)
20 MHz
2 MHz
2 000 000 Hz
Ultrasound
20 kHz
20 000 Hz
20 Hz
Audible Sound
Infrasound (earthquake)
20 Hz
18
The probe: transmitter and receiver
The same probe is used first as transmitter,

second as receiver
Probe
Loudspeaker + Microphone
19
Ultrasound scanner and sonar
Ultrasound scanner works as sonar
20
Diagnostic Ultrasound
Sound waves
directed into
patient
Which pulse(s)?
Echoes
return
Pictures
analysed
Processed into
picture
Which processing?
21
tf
Probe
time of flight
Time
c= 1500 m/s
(sound velocity in water)
d=?
Depth
or time
c t
d
2
Range of depth and time of flight
0.75 cm < depth < 15 cm
Target
10 s < tf: time of flight < 200 s
22
Reflection and transmission
One transmitted pulse gives rise to a train of

received echoes.
Time
Depth
We can calculate where the echoes have come

from by timing how long they take to get back.
23
....
The probe includes
128 to 512
transducer elements
24
....
128 to 512
transducer
elements
TPRF
Depth /
time
Amplitude
Time of frame acquisition

Width
25
0.75 cm < depth < 15 cm

10 s < time of flight < 200 s
TPRF >> maximum time of flight

PRF: Pulse Repetition Frequency
PRF = 1/ TPRF
Depth /
time
TPRF
TPRF > 5 x (maximum time of flight)

1 kHZ < PRF < 20 kHZ
26
Range
Frequency
1 MHz < frequency< 10 MHz
Time of flight
Pulse Repetion Frequency
27
Echoes from ONE pulse
Amplitude
The echo
amplitudes are
converted to
shades of grey
A-Mode
(amplitude)
B-Mode
(brightness)
28
B (Brightness) Mode Image

64 to 512
transducer elements
One
Frame
10 to 60 frames/s
29
B mode image 1970

1970
Visible scan
lines (48)
30
Range
Frequency
Time of flight

Number of elements
Frame acquisition (PRF = 5kHz)

64 <Nelt < 512
10 frame/s < Nframe <80 frame/s
31
Shapes of the images: linear or sectorial
Ovarian Cyst
Gall bladder & stone
B (Brightness) Mode Images
Popliteal artery
Thyroid mass
32
32
Shapes of the images: linear or sectorial
Linear probe
Sectorial probe
33
Scanning of pressure beam with

a sectorial probe
34
B mode and M mode
B-mode
t1
t2
t3
M-mode
(or TM mode,
Time Motion)
time
35
Imaging modes
Envelope Signal
Scan plane
Distance
(cm)
Time
(s)
A mode
One frame: 20 to 50 ms
Depth (cm)
Depth (cm)
B mode
TM mode
One continuous image of 5 s
36
Doppler modes: velocity measurements
Ultrasonic
Doppler Modes
Piero Tortoli
Spectral Doppler
Colour Doppler
37
37
Basic Principles of Ultrasound
1: Overview
2: Sound Waves
3: Ultrasound generation
4: Ultrasound in Tissue
38
Wave Motion: transverse wave

Particle movement
Wave propagation
Up and down
39
Wave Motion: transverse wave
Stadium wave
Direction of energy transport

40
40
Wave motion: Longitudinal Wave
41
Wave motion in tissue
Transverse Wave
Longitudinal Wave
Particle movement
Particle movement
Wave propagation
Wave propagation
42
Pressure amplitude
Molecules do not travel from one

end of the medium to the other.
No flow of particles
Elastic deformable medium

gas, liquid or solid.
compression
rarefaction
Depth
wave velocity c
43
Depth
wave velocity c
At each spatial position , the material points are oscillating around their
equilibrium position with a particle velocity v
if u is the displacement of the material point, v = du/dt
Molecules do not travel from one end of the medium to the other.
Valeur de u pour une pression donne
44
The Nature of a Sound Wave in tissue (liquids)
Sound is a mechanical wave

Created by a vibrating object
Propagated through a medium
Sound is a pressure wave

Consists of repeating pattern of high and low pressure
regions
Sound is a longitudinal wave

Motion of particles is in a direction parallel to direction
of energy transport
45
The Frequency of a wave
A A0 sin2ft
Wave equation
T=1/f
Peak excess pressure

=
amplitude A0 of wave
46
rarefaction
Pressure
compression
Wavelength and frequency of the wave

Wavelength,
Spatial periodicity
Depends on velocity of sound, c

(depends on material)
Distance
Wavelength, = c T = c / f
Period, T=1/f
Depends on source
Temporal periodicity
Time
47
Velocity of the wave
If source is 3.3 kHz frequency
Air c = 330 m/s

= 330/ 3.3 .103 = 0.5 m
Water c = 1500 m/s

If source is 3 MHz frequency
= 1500/ 3 .106 = 0.5mm
48
48
Ultrasound Pulse
On ultrasound scanner the ultrasound wave is

emitted as pulses (not a continuous sine )
Length of pulse is about 3 to 5 periods
Pressure
f = 3 MHz
1 s < Tp < 1.66 s
Time
49
Range
Frequency
Time of pulse (length 3 periods)
Time of flight
Number of elements

0.3 s < TP< 3 s
64 <Nelt < 512
Frame rate (PRF = 5kHz)
10 frame/s < Nframe <80 frame/s
Time of frame(PRF = 5kHz)
12 ms < Time of frame< 100 ms
50
Range Equation
It is possible to predict the

distance (d) of a reflecting surface
from the transducer if the time (t)
between transmission and
reception of the pulse is
measured and the velocity (c) of
the ultrasound along the path is
known
d=
d
Pulse
Echo
t.c
2
t
51
Intensity
1m
Power
1m
The intensity associated with the wave is
defined as the power flowing through a
unit area (measured in W/m2 or mW/cm2 )
Ii (t,r)
p 2 (t,r)
rc
52
Intensity for a sinusoidal wave

Pressure
Ii (t,r)
p 2 (t,r)
P0
rc
Time averaged intensity (I) for

a sinusoidal wave (where P0 is
the peak-pressure amplitude)
Intensity
2
0
P
I
2 rc
53
Intensity for a pulsed wave

Pressure
Isptp (Temporal
Peak)
Intensity
Intensity
Isppa (Pulse
Average)
Ispta (Temporal
Average)
I spta
I sppa
TPRF
TPRF
time
1/200
54
Isptp
Isppa
Ispta
True time axis
55
1: Overview and History

2: Sound Waves
3: Ultrasound Generation
56
Sources of Sound Waves
Audio speaker system
Vocal chords
Sound production requires

a vibrating object
Collision!
Piezoelectric element
57
Ultrasound generation and detection

Piezoelectric effect
discovered in 1880
Pierre and
Jacques Currie
Piezoelectric materials
Quartz
PZT (Lead, Zirconate,Titanate- PbZrTi)
58
Ultrasound generation
Quartz
+
Expansion
Contraction
Apply a voltage between the two faces of a piezoelectric

material: result is deformation (inverse piezoelectric effect)
59
Ultrasound detection
Apply force to piezoelectric material:

result is electrical charge proportional
to force (direct piezoelectric effect)
Force
The frequency of the force applied will

affect the frequency with which a
voltage is generated
Force
60
Piezoelectric materials and transducers
Ultrasound
transducers
Herv Liebgott
61
Beam Shape
Beam width lateral resolution

62
Beam Shape
Diffraction
directional
w
W<<
Small point source
W>>
Spherical wave
Plane wave
63
Plane Disc Source: Intensity of the field

Non-uniform beam
Near field
Uniform beam
Far field
Intensity on axis
propagation
Near field
Far field
Intensity
Distance from probe
Avoid measurements in the near field

64
Ultrasound beam from a plane disc source
Near field
Intensity
Far field
Distance from probe

65
Imaging Resolution
Spatial Resolution
Temporal Resolution
Contrast Resolution
66
Spatial Resolution
Spatial (in space)
axial (along the beam)
lateral (across the beam)
azimuth (in the scan plane)
elevation or slice thickness
(perpendicular to the scan plane)
67
Axial Resolution
The minimum reflector

spacing along the axis of the
ultrasound beam that results
in separate, distinguishable
echoes on the display.
68
Axial Resolution
First definition
ra = number of cycles of the transmitted pulse x 3
Example 3 MHz transducer
c
1540m / s
0.5mm
f 3,000,000 Hz
ra =3 x 0.5 = 1.5 mm
Example 10 MHz transducer
c
1540m / s
0.15mm
f 10,000,000 Hz
ra =3 x 0.15 = 0.45 mm
Second definition
Resolution is length at half size

69
Lateral Resolution
The ability to distinguish two

closely spaced reflectors that
are positioned perpendicular to
the axis of the ultrasound
beam.
70
Elevational Resolution (slice thickness)
Works in a direction
perpendicular to the image
plane.
Dictates the thickness of the
section of tissue that
contributes to echoes visualized
on the image.
71
Temporal Resolution
The time interval between pulses

limits the temporal resolution
it is usually set so that there is sufficient time for the
most distant echo to return to the transducer before
the next pulse is launched
72
Temporal Resolution
Sequence of pulses from transducer
TPRF
Time
Interval to allow
echoes to return
Typical PRF = 5kHz

TPRF = 0.2 ms
TPRF can be chosen as the delay of five times the maximum

observed distance
73
Contrast Resolution
The ability to display regions of differing echo size
Low
High
74
Q-assurance of
US equipment
Jean Martial Mari
75
75
1: Overview and History

2: Sound Waves
3: Ultrasound Generation
76
77
Speed of Sound
78
78
Speed of Sound
Bulk modulus
Density
79
Speed of Sound
Air
Water
Fat
Blood
Muscle
Bone
330m/s
1480m/s
1460m/s
1560m/s
1600m/s
4060m/s
Average soft tissue

value = 1540m/s
Programme the
ultrasound
machine with...
This can lead to small errors in the estimated distance travelled because of the
variation in the speed of sound in different tissues.
80
81
Acoustic Impedance
z rk
Density
Bulk modulus
82
82
Acoustic Impedance
Acoustic impedance analogous to electrical impedance
P
z
v
U
z
I
P = local pressure
U : Potential
v = local particle velocity
I : Intensity
83
Acoustic Impedance
Air
Lung
Fat
Water
Blood
Muscle
Skull Bone
0.0004
0.18
1.34
1.48
1.65
1.71
7.80
x 106 rayls
x 106
x 106
x 106
x 106
x 106
x 106
Similar Values
84
85
Reflection at boundaries
The laws of optics apply to ultrasound
At the boundary between tissues

ultrasound is partially reflected
The relative proportions of the
energy reflected and transmitted
depend on the acoustic
impedance between the two
materials
Incident
wave
Reflected
wave
Transmitted wave
86
Reflection at interface perpendicular to the wave
Pt Pi Pr
vt vi vr
Replace v with P/z, the
reflexion coefficient is obtained
Pr z2 z1
Pi z2 z1
Pr , vr
Pi , vi
Z1
Pt , vt
Z2
87
Reflection at interface perpendicular to the wave
Pr z2 z1
Pi z2 z1
Pr , vr
Pr
0
Pi
z2 z1
Pi , vi
Z1
Pt , vt
Z2
complete transmission
z2 z1
Pr
1
Pi
complete reflexion
88
Specular Reflection
Perpendicular
Incidence
Non-perpendicular
Incidence
Reflected beam
travels off at an angle.
No wave go back to
the probe
Strong orientation dependence
89
Diffuse Reflection
Reflected waves
travel in various
directions away
from the interface
90
Diffuse Reflection
Reflected waves travel in

various directions away from
the interface
Some orientation dependence
91
Rayleigh Scattering
Waves are scattered and

travel off in all directions
Energy loss f 4
Particles size <<
92
Rayleigh Scattering
Waves are scattered and

travel off in all directions
Energy loss f 4
Particles size <<
Little orientation dependence

93
Echo Amplitude - Beware!

The amplitude of the echoes (image grey level)
does not have a simple relationship with the tissue (unlike Xray CT [Hounsfield numbers]).
Echo size depends on
size of structure compared with
relative acoustic impedances across boundary
shape and orientation of boundary
94
Reflection or scattering?
In tissue:
Specular Reflection, Diffuse Reflection or Rayleigh Scattering?
Particles size <<

Specular reflection from
large flat boundaries
Strong
Diffuse reflection
from small structures
Weak
Rayleigh Scattering from

very small structures
Very weak
95
Coupling gel
96
Very weak
Reflection
Weak
Reflection
Strong
Reflection
97
Calcification
98
99
Attenuation
The energy of the ultrasound beam is reduced with distance
Energy is lost from the beam by:

Scattering (reflection out of beam confines,
refraction, divergence)
Absorption (conversion into heat)
100
Attenuation in an image
Dark
deep to
the defect
in the
phantom!
Bright deep to the cyst
Dark deep to the cyst
101
Attenuation Coefficient
The intensity, Iz, of an ultrasound beam is related

to distance from the source, z, thus:
I z I 0e
Iz
z
Where
I0
is the intensity at z = 0, the transducer face.

102
Attenuation Coefficient
Attenuation is approximately exponential,

the slope of the logarithmic graph is constant.
Attenuation coefficient is quoted in dB/cm
In addition, for soft tissue,
attenuation is proportional to frequency.
The attenuation coefficient for soft tissue is

0.5 - 0.7 dB/cm/MHz
103
Attenuation compensation: TGC

Average echo
Amplification
factor
Time
(distance)
Echo train
after compensation
For deeper distance noisy is amplified

104
TGC: Time Gain Compensation
depth
gain
105
106
Nonlinear propagation
+ = 0
The motion equation
The pressure is expanded using the Taylor series
linear
The celerity
Nonlinear
coefficient
Nonlinear
parameter
107
Nonlinear propagation: celerity
Nonlinear
coefficient
Nonlinear
parameter
After propagation
f0
f0 + 2 f0+ 3 f0 + ....
108
Non-Linear propagation
Under conditions of relatively high pressure amplitude the speed of
sound is NOT CONSTANT but varies over the propagation path (z)
= 0 + 1 +
()
2
Material
water (30C)
blood
liver
spleen
fat
B/A
5.2
6.3
7.6
7.8
11.1
109
After a sufficient distance, the faster

moving high-pressure parts of the wave
catch up to the slower low-pressure parts.
Higher
speed
Higher
speed
The result is a
sawtooth wave
Lower
Lower
speed
speed
The distorted wave has many harmonic frequencies
110
Higher
speed
Lower
speed
Higher
speed
Lower
speed
111
Nonlinear Propagation
112
Harmonics
Amplitude
Fundamental
2nd
3rd
f0
2f0
3f0
Frequency
The amplitude decreases is about 20 dB per harmonic
113
Harmonic Imaging
A relatively recent innovation in

diagnostic ultrasound imaging is
Tissue Harmonic Imaging
Discovered by accident it uses the

effects of non-linear propagation.
114
Ultrasound contrast agent
Contrast agents
in US
Thierry Bettinger
115
Native harmonic frequencies are used to improve images

How?
By tuning the receiver to the harmonic frequency (2Fo)
rather than the transmitted frequency Fo
Benefits
Reduces clutter (noise), increases resolution at depth,
improves sensitivity
116
117
117
118
Safety
Possible damage from ultrasound:

Thermal
tissue heating, cell death for T > 42oC
Mechanical
cavitation bubbles for pressures > threshold
o unfortunately threshold is frequency dependent
119
Mechanical and Thermal Indices
Thermal index
relates to temperature
potential for heating effects (metabolic rate)
Mechanical Index
relates to pressure
potential for bubble effects (cavitation)
120
Thermal Index
TI is the ratio between:

the power exposing the tissue, W
the power required to cause a 1oC temperature
rise, Wdeg
W
TI
Wdeg
121
Mechanical Index
MI describes the likelihood of the negative

pressure causing bubble activity
MI
P-d
f
P-d
f
megapascals
(megahertz) 1/2
is the derated pressure at the site in the body

is the frequency of the pulse
122
Medical Index (MI)

The transmitted pressure amplitude (Pascal) and
Medical Index (MI)
MPa
p
MI
f
MHz
Ultrasound medical scanner: 0.01 < MI < 2

Example: f = 2 MHz
P (MPa)
0,0
0,1
0,1
0,2
0,5
1,0
MI
0,01
0,04
0,07
0,14
0,35
0,71
123
Guidelines
MI > 3 Possibility of minor damage to neonatal lung or intestine
MI 2 Limitation of medical scanner
MI >0.7 Theoretical risk of cavitation.
TI>0.7 Restrict exposure time of a fetus
TI>1.0 Eye scanning not recommended
TI>3.0 Fetal scanning not recommeded
124
Therapeutic US
principles
Jean Martial Mari
125
125
126
Scanner settings
Fixed settings : MI, TCG, gain

Adjustement: focus, sector
size
127
PHILIPS
128
References
Ultrasound Imaging, Bjorn A. J. Angelsen, ISBN 82-995811-09, Emantec AS, Trondheim, Norway,
www.ultrasoundbook.com
Ultrasound in Medecine, Institute of Physics, Publishing
Bristol and Philadelphia
129

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Basic principles of ultrasound

CREATIS is a key european laboratory

at the interface between

About 200 persons

3D modelling of human heart

Diffusion Tensor Imaging

1 - Imaging of the Heart-Vessels-Lungs

Microarchitecture and micro-vasculature

Dynamic model of the heart

Ultrasound imaging platform

3 research ultrasound scanners,

Cachard ESMP 2013 Archamps

Imaging biological deformation in vivo

3D dynamic model of the heart

High resolution simulation

Basic principles of ultrasound

Cachard ESMP 2013 Archamps

Ultrasound imaging is Non Destructive Testing

Cachard ESMP 2013 Archamps

The place of ultrasound in medical imaging

Public Hospitals in Lyon (2012)

8 gamma (scintillation) cameras

More than 100 ultrasound scanners

Real time imaging

The place of ultrasound in medical imaging

the real time imaging capabilities,

Limitations are that ultrasound imaging cannot be done

Knocking the bell inside the vacuum chamber

Propagated through a medium

The acoustic pressure

The acoustic pressure is the change of pressure around the

Acoustic pressure amplitude

Cachard ESMP 2013 Archamps

The probe: transmitter and receiver

The same probe is used first as transmitter,

Cachard ESMP 2013 Archamps

Ultrasound scanner and sonar

Ultrasound scanner works as sonar

Cachard ESMP 2013 Archamps

Reflection and transmission

One transmitted pulse gives rise to a train of

We can calculate where the echoes have come

Time of frame acquisition

0.75 cm < depth < 15 cm

TPRF >> maximum time of flight

TPRF > 5 x (maximum time of flight)

1 MHz < frequency< 10 MHz

10 s < time of flight < 200 s

Pulse Repetion Frequency

Cachard ESMP 2013 Archamps

1 kHZ < PRF < 20 kHZ

Echoes from ONE pulse

Cachard ESMP 2013 Archamps

B (Brightness) Mode Image

B mode image 1970

Cachard ESMP 2013 Archamps

1 MHz < frequency< 10 MHz

10 s < time of flight < 200 s

Pulse Repetion Frequency

Cachard ESMP 2013 Archamps

1 kHZ < PRF < 20 kHZ

Shapes of the images: linear or sectorial

Gall bladder & stone

B (Brightness) Mode Images