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ULTRASOUND MADE SIMPLE

ULTRASOUND MADE SIMPLE. BY: Cathy Ruff, RVT. PURPOSE.

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ULTRASOUND MADE SIMPLE

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  1. ULTRASOUND MADE SIMPLE BY: Cathy Ruff, RVT

  2. PURPOSE • The purpose of this presentation is to provide a simplified explanation of how an “image is produced”. It is not intended to teach fundamentals and physics of ultrasound. If this is too simplified for your level of knowledge, I ask for your patients. This is a quick and brief explanation. Keep in mind everyone is at a different level within the learning process.

  3. DEFINITION • Inaudible sound. • Sound waves outside the hearing range of humans

  4. THE DOTS of the IMAGE • Individual “DOTS” which make up the image differ in BRIGHTNESS • Each Tissue type-DENSITY- affects the strength of the returning echo- (sound wave)- producing different brightness or strength of each individual DOT. • THE DENSER THE STRUCTURE WITHIN THE BODY THE BRIGHTER THE DOT…(HENCE BONE-VERY BRIGHT-SOFT TISSUE MORE GREY-BLOOD BLACK)

  5. Ultrasound in Medicine • Provides a method for visualizing internal body tissue and structures. (2 “basic” steps utilized) 1. Sending short PULSES of ultrasound into the body 2. Using REFLECTIONS received from various tissues to produce an image of the internal structures.

  6. DIAGNOSTIC ULTRASOUND VISUALIZATION • Operator controls the instrument • Instrument produces electrical voltages that drives the transducer • Transducer produces ultrasound pulses that travel into the body and interact with the tissues • Reflections generated in the tissues bring “acoustic information” back to the transducer • Transducer sends the instrument electric information corresponding to the received reflection • Instrument converts the electric information into a visual form –what is seen on the monitor.

  7. GREYSCALE • ADJUSTING appearance of DOT/PIXEL LOGIQ E offers the user several different Grey Maps. EASY to explain.

  8. Different gray maps • Map C/1 Map K/1

  9. Angle of INCIDENCE • Ultrasound is dependent on ANGLE of INCIDENCE-The Angle at which the sound wave strikes the structures within the body. An individual can have a high end system such as the LOGIQ 9 but if the angle of incidence is not mastered-you will never have an adequate image to view.

  10. Angle of incidence • Allows visualization of desired structure

  11. TERMINOLOGY Frequency-number of complete cycles of the acoustic variable (sound) in one second. (simply put the number of vibrations of the sound wave within one second of time)- Unit of measurement Hertz (Hz) (1 Hertz is one cycle or “vibration per second”) Megahertz (MHZ) (1 Megahertz is 1,000,000HZ per second) (Ultrasound travels at 20,000hz or higher-not audible to human ear.) Example-10Mghz transducer-sends 10,000,000 cycles (10Mhz) per second into the body-repeatedly.

  12. TRANSDUCERS • Generate and receive the Ultrasound waves • Piezoelectric Crystals within the head of the transducer are the elements that “vibrate” to produce the sound wave • Have the ability to “focus at a specific point”-especially multi frequency transducers • Multi frequency transducers such as GE’s are optimal to the user

  13. DEPTH • “THE HIGHER THE FREQUENCY THE BETTER THE RESOLUTION” • BUT • The deeper the structure/point of interest the LOWER the frequency needs to be to “send” the sound waves further/or deeper into the body. • FOR OPTIMAL IMAGE/best resolution- always utilize the highest frequency transducer possible for structure being imaged. (keeping in mind the deeper the structure the lower you will HAVE to go in order to send the sound wave to the point of interest)

  14. TGC’s TIME GAIN COMPENSATION • TGC amplifies the returning signals (reflections). The Deeper the sound wave has to travel into the body-the more sound waves (or information is lost) AS the sound travels in/strikes different tissues the sound “ATTENUATES”-some scatter, reflect, reverb…. To compensate for this the LOGIQ E allows the user to amplify the returning signal., (SLIDE PODS ON KEY BOARD)

  15. PROBE SELECTION • Higher the frequency less penetration Superficial structures (Neck, arms, legs, breast) • Lower the Frequency deeper penetration Abdominal, heart

  16. GE’s MULTIFREQENCY TRANSDUCERS 12L-RS Transducer- scans from 3Mhz to 11Mhz (MEGAHERTZ)-sends 3 and up to 11million cycles per SECOND, EVERY SECOND repeatedly over and over and over-as long as the machine is on the Crystals (the elements within the transducer scan head that Vibrate to produce the Cycles) within the transducer are “firing”

  17. ORIENTATION • TRANSVERSE- “cross sectional view” transducer is held horizontal to body. Always imagine what you are “looking at” within the body-then you will understand what the image will appear on the screen )marker on transducer is always to patients right side of body. • LONG, LONG AXIS, LONGITUDINAL Transducer is held Vertically to the body. Marker is held towards patients head

  18. TRANSVERSE VIEW • Artery appears in Cross sectional view

  19. LONGITUDENAL • Long axis view of artery

  20. PROPAGATION SPEED • The speed at which ultrasound travels through the body. The MAGIC number in Ultrasound is 1540 Meters/second FOR SOFT TISSUE-SOUND TRAVELS 1540meters per second in SOFT TISSUE

  21. TISSUE DIFFERENCES • Muscle • Bone • Liquid-blood, cysts, urine, amniotic fluid • Fat • Organs-Liver, kidneys, lung The difference in density/stiffness of each tissue type affects the grey scale-color- of the dot which makes the image

  22. BOUNCE BACK-REFRACTION • Sound waves enter the body and BOUNCE back to the transducer and an image is produced The sound waves are affected properties such as: Refraction Scattering Attenuation Impedance

  23. BONE Bouncing back • BONE-Most all the sound wave-”bounces back” to transducer-hence BRIGHTER DOT-BONE is SO DENSE the SOUND can not travel or Penetrate through it (causes Acoustic Shadowing)

  24. BONE • Bone-BRIGHT with Acoustic Shadow

  25. ACOUSTIC SHADOWING • Sound waves can not penetrate VERY DENSE structures- BONE, CALCIFICATION. The image will be “black” or have a “shadow posterior-beneath- the DENSE structure.

  26. ACOUSTIC SHADOW • Sound can not travel through DENSE

  27. SOFT TISSUE Bouncing Back • Soft Tissue-example Thyroid-the sound wave interfaces structure-some of the echo's bounce back and produce a more GREY DOT producing a “softer appearance”

  28. THYROID • Soft tissue-Homogeneous

  29. LIQUID BOUNCE BACK LIQUID-Sound wave travels right through-nothing to bounce off-(unless solid within the liquid-example-cystic/pus/plaque within vessel) No returning echo to produce a DOT-so no DOT is produced. Vessels and fluid filled structures appear BLACK on image. They also have “ENHANCEMENT” posterior to structure.

  30. ENHANCEMENT • Just posterior to a FLUID filled structure- (Cyst in Breast) is a brighter enhancement in the image. This is caused by the sound waves traveling through the liquid-then interfacing with the tissue beneath it.

  31. MUSCLE BOUNCE BACK • MUSCLES- tissue density varies within different types of muscle-hence the multi-grey scale appearance.

  32. MUSCLE • Muscle –Heterogeneous

  33. HOMOGENENOUS • Appearance of “DOTS” or echo's on the image area all SIMILAR in Brightness. SOFT Tissue such as thyroid or Liver appear “Homogeneous” on ultrasound. Also called HYPOECHOIC

  34. HOMOGENOUS • Soft tissue/Homogenous

  35. HETEROGENOUS • Appearance of DOTS or echo's on the image are of different Strengths- Different levels of Brightness –Also called Hyper echoic

  36. HETEROGENOUS • Structures of different densities

  37. ANECHOIC No Echo's within structure- BLOOD/LIQUID

  38. ANECHOIC • Fluid filled structures-No ECHOS-BLACK

  39. LOGIQ E • KEY SELLING POINTS- • IMAGE QUALITY-SUPERIOR TO ANY PRODUCT TO DATE CROSS BEAM TECHNOLOGY-multiple beams steered in different coplanar angles capture the image –vs- only straight beams

  40. PIXEL COUNT • HIGHER THAN COMPETITORS LOGIQ E 1024 X 768 The Logiq book is 800 X 600

  41. RAW DATA Able to manipulate image after aquire. Major time saver. Train staff to work with Anesthesiologist-grab photo -for billing during injection—manipulate/label post procedure. (just once example)

  42. PRESENTATION/TEACHING TOOL • Excellent-for teaching-storing/retrieving images-memory stick, connect to audio video equipment. Great for making power points.

  43. SIMPLE/COMPLEX • Logiq E is very simple-premium duplex imager for the non ultrasound user……BUT for the experienced (and all these physicians will be experienced soon) a very complex sophisticate state of the art Ultrasound Duplex Imager is waiting for them to utilize for the next application as technology and applications change.

  44. SOFT WARE • HUGE ADVANTAGE- (competitor uses this as a “bomb against us) GE’s commitment to continued research and development and the migration of technology form the higher end consoles—The LOGIQ E Hard drive/software platform allows for upgrades as needed.

  45. CONCLUSION • The very BASIC concept of image production by transmitting sound waves into the human body, is sometimes better understood if not complicated by the technical physics involved with the process. Having enough knowledge and confidence to compare it to a flash light and golf club, or any other simplified analogy, should give you enough confidence to interface with NON USERS of ultrasound such as General Surgeons, residents, Emergency Phys and some Anesthesiologist.

  46. HANDS on LOGIQ E DO NOT BE AFRAID

  47. QUESTIONS YOU HAVE BEEN AFRAID TO ASK?

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