Ultrasound

Outline
Ultrasound
I. Basic Ultrasound
II. Ultrasound in Medicine
III. Devices Standard
IV. Ultrasound Instrument
V. Performance and Safety Testing
Bats!
Medical uses of ultrasound
Bats navigate using ultrasound
Bats: Navigating with ultrasound

Bats make high-pitched chirps which are too high for
humans to hear. This is called ultrasound
Like normal sound, ultrasound echoes off objects
The bat hears the echoes and works out what caused
them
Dolphins also navigate with ultrasound
Submarines use a similar method called sonar
We can also use ultrasound to look inside the

body
Bats: Navigating with ultrasound

If a bat hears an echo 0.01 second after it makes a chirp,
how far away is the object?
Ultrasound imaging
Clue 1: the speed of sound in air is 330 ms-1

Clue 2: The speed of sound equals the distance travelled
divided by the time taken
Answer: distance = speed x time
Put the numbers in:
distance = 330 x 0.01 = 3.3 m
But this is the distance from the bat to the object and back
again, so the distance to the object is 1.65 m.
Ultrasound imaging: What does it look

like?
Ultrasound imaging: How does it work?
An ultrasound element acts like a bat.

Emit ultrasound and detect echoes
Map out boundary of object
Ultrasound imaging: How does it work?
Ultrasound imaging: development of a

pregnancy
24 weeks
Now put many elements together to make a probe and create

an image
8 weeks gestation (out of a 40 week pregnancy)

18 weeks
Ultrasound imaging: more surface

rendering
Ultrasound imaging: foetus feet
This is a 2D ultrasound scan

through the foot of a foetus. You can
see some of the bones of the foot.
We can process the image in a

computer to find the outline of the foot.
This is called surface rendering. Here,
the foot has been surface rendered
Ultrasound imaging: imaging the heart
Ultrasound imaging: kissing!
atrium
heart valves
ventricle
Ultrasoundaudible sound (1520,000

Hz) vs. therapeutic ultrasound (800 KHz
3.0 MHz)
Form of inaudible, high frequency acoustic

energy which produces vibrations within
tissues
Produces both thermal and non-thermal
effects
Within medicine proper, utilized for
diagnosis, destruction of tissue, and
treatment
ATs only utilize therapeutic ultrasound
Ultrasound is generated by the

vibration of a crystal in an alternating
electrical currentreferred to as the
reverse piezoelectric effect
Basic Principles of
Ultrasound
Theory and Practice
Examples of oscillation
ball on
a spring
pendulum
rotating
earth
Pulse
The ball starts to oscillate as soon as it is pushed
Movement of the ball over time
Oscillation
Frequency
The actual displacement a is

termed as:
Time
From the duration of one
oscillation T the frequency f
(number of oscillations per
second) is calculated:
One full
oscillation
T
Time
90
180
270
360
Phase
Gelombang
ialah satu gangguan yang membawa
tenaga melalui medium.
Dua ciri umum bagi semua gelombang
iaitu
gelombang adalah satu travelling
disturbance.
gelombang membawa tenaga dari satu
tempat ke satu tempat.
Sinusoidal pressure source
28
"Gelombang melintang
Sound propagation
"Gelombang melintang" (Transverse

wave) ialah gelombang yang
menyebabkan zarah-zarah medium
bergetar berserenjang dengan arah
gerakan gelombang.
Transverse wave
Direction of oscillation
Direction of propagation
29
"Gelombang membujur
Sound propagation
"Gelombang membujur" (Longitudinal

wave) pula menyebabkan getaran zarahzarah medium selari dengan arah gerakan
gelombang.
Longitudinal wave Direction of propagation

Direction of
oscillation
31
What is Ultrasound
Wave propagation
Longitudinal waves propagate in all kind of materials.
Transverse waves only propagate in solid bodies.
Due to the different type of oscillation, transverse
waves
travel at lower speeds.
Sound velocity mainly depends on the density and Emodulus of the material.
Air
Water
Steel, long
Steel, trans
330 m/s
1480 m/s
5920 m/s
3250 m/s
Ultrasound is sound with a frequency greater

than the upper limit of human hearing, this limit
being approximately 20 kilohertz (20,000 hertz).
It is generated by applying an alternate current
to a piezoelectric crystal. This crystal contracts &
expands at the same frequency at which current
changes polarity. The sound field generated by
this crystal in turn makes the molecules in the
sound filed vibrate and oscillate.
34
What is Ultrasound
Spectrum of sound
Frequency range
Hz
Description
Example
0 - 20
Infrasound
Earth quake
20 - 20.000
> 20.000
Audible
sound
Ultrasound
Speech, music
Bat, Quartz
crystal
The crystal commonly used in US units is synthetic

plumbium zirconium titanate (PZT)
The quality of the crystal is what makes your US
expensive
Crystal quality depends on the following:
Beam nonuniformity ratio: ranges from 2 to 6 the
smaller the better.
Effective Radiating Area: as close to sound head area as
possible
Therapeutic ultrasound has a frequency range of 0.7 and 5.0
MHz
Most clinic will have 1 MHz and 3 MHz sound head.

36
Sound wave physics
Atomic structures
Solid and liquid consists of molecules held together by elastic forces that behave like
rubber bands connecting each molecule to each of its nearest neighbors.
If one molecule is set in vibration, then it will cause its immediate neighbors to
vibrate, and it turn their neighbors, and so on until the vibration has propagated
throughout the entire material. This is a wave.
A sound wave is sound energy that is transmitted from one molecule to the next.
A sound wave cannot travel by itself. It needs a medium for transmission (solid,
liquid, gas)
Energy contained within a soundbeam is decreased as it travels through tissue.
Energy is lost to :
Reflection or scattering of the soundbeam when it strikes a
reflecting surface
Absorption energy lost by the sound wave as it overcomes internal
friction that exists in tissue while traveling through it.
Higher the frequency, the more rapidly the molecules are forced to move against this
friction. The more they move, the more energy is consumed (absorbed); the
soundbeam will therefore have less sound energy available to propagated further
through the tissue.
liquid
gas
low density
weak bonding
forces
solid
medium density high density

medium bonding strong bonding
forces
forces
crystallographic
structure
37
Understanding wave propagation:
T
Ball =
atom
Spring = elastic bonding

force
distance travelled
10
Sound wave physics

During one oscillation T the wave
front propagates by the distance
:
The velocity of the wave travel depends on the closeness of the molecules of the
medium. The closer the molecules, the quicker they collide with each other and
sooner they respond to disturbance, the faster they loose energy in a short distance.
So a 3MHz sound head will affect more superficial tissues while a 1 MHz sound head
will affect deeper tissues.
Example :
Sound travels through air easily and can go far (yelling out in the back yard). Sound
can go further because there is little energy loss by absorption. Air molecules are
easily compressed.
Energy finial = Energy initial (Ereflected + Eabsorbed)
Distance travelled
From this we derive:
Wave equation
or
Sound does not travel easily through a brick wall that is denser (someone yells from
the outside of the house and you cant hear him from the inside). Brick molecules are
a lot of closer together, harder to compress. Brick therefore absorbs more of the
sound energy going through it.
42
Frequency
< 20 Hz
Infrasound
20 Hz 20 kHz
Sound
0.001 15 Seismolo 200

Hz
gy
8kHz
0.01 20
Hz
Nature
Sound
Human
Speech
Electromagnetic Wave
> 20 kHz
Ultrasound
20 kHz
60 kHz
Sonar
70 kHz
500 kHz
Sonoche
mestry
500 kHz NDT

3 MHz
1 20
MHz
USG
100 Mhz
3 GHz
Micros
copy
EEG: 0.5 100 Hz
43
1.1. Wave Properties
EMG: 7 20 Hz
44
11
Definition
Definition
Ultrasound Velocity (m/s)
V, the velocity is the speed at which sound waves travel

through a particular medium. Velocity is equal to the
frequency x wavelength. The velocity of US through
human soft tissue is 1540 meters per second. Velocity
varies with medium.
Z, acoustic impedance is dependent on the density of
the material in which sound is propagated through. The
greater the impedance the more dense the material.
I, the intensity of the ultrasound beam describes the
amount of energy flowing through a unit cross-sectional
area each second. The intensity is proportional to the
square of the pressure amplitude, particle-displacement
amplitude or particle velocity amplitude.
Acoustic Impedance (kg/m2s = Rayls)
Intensity (joules/cm2 = watts/m2)
45
Penyelesaian
pengiraan panjang gelombang
Contoh
Kirakan panjang gelombang bagi isyarat
ultrabunyi 10 MHz di dalam kanta mata
Panjang gelombang di dalam kanta

Halaju gelombang, = frekuensi, f panjang gelombang,
f = 10 MHz isyarat ultrasonik
= 1620 m/s (daripada jadual)
Jadual: Kelajuan ultrabunyi dan acoustic impedance di dalam bahan umum.Data

daripada Wells (1969); Goss, Johnston, Dunn (1978); and Bamber (1986).
Bahan
46
Kelajuan (m/s)
Acoustic impedance (g/cm2s)
Aqueous humour
1500
1.50 105
Kanta mata
1620
1.84 105
Kulit
1600
Tulang
3500
7.80 105
47
48
12
Acoustic Properties
Material
v (m/s)
kg/m3)
Z (MRayls)
Chloroform
987
1490
1.47
Glycerin
1904
1260
2.34
Honey
2030
1420
2.89
Water at 20C
1480
1000
1.483
Water at 60C
1550
1000
1.55
Bone
4080
1912
7.8
Blood
1570
1040
1.64
Tissue
1540
1006
1.55
Fat
1450
952
1.38
Muscle
1567
1040
1.63
Air
331
1.2
0.0004
PZT
3791
7650
29
Interaction of Ultrasound with Tissue
Reflection- pantulan
Refraction- pembiasan
Scattering- selerak
Diffraction- pembelauan
Interference- gangguan
Absorption- serapan
49
50
I. Basic Ultrasound
Reflection and Transmission
Reflection
As soon as a sound wave comes to a change in material

characteristics ,e.g. the surface of a workpiece, or an
internal inclusion, wave propagation will change too:
51
I. Basic Ultrasound
13
Behaviour at an interface
Medium 1
Medium 2
Incoming wave
Transmitted wave
The basis of diagnostic ultrasound imaging is the reflection of the

transmitted ultrasound signal by an interface between media of
different acoustic impedances.
If the interface separates two media with the same acoustic
impedance, the ultrasound is not reflected, but continues to
propagate (to be transmitted).
When the interface separates media with different acoustic
impedances, part of the ultrasound is reflected and the remaining is
transmitted.
The amount of reflected ultra-sound energy is proportional to the
difference in acoustic impedance of the two media (the greater the
acoustic mismatch, the greater the amount of sound reflected).
Optimal return (maximal reflection) occurs when the ultra-sound
wave strikes the interface perpendicularly (the angle of incidence is
90).
At any other angle of incidence, less energy is reflected back. The
angle of reflection is equal to the angle of incidence.
The strength of the recorded (reflected) echo is a function of both
the acoustic mismatch at the interface and the angle of incidence.
Reflected wave
Interface
54
I. Basic Ultrasound
Scattering
Echo Type
The scattering occurs

because the interfaces
are smaller than the
diameter of the sound
beam or the interfaces
are less than one
wavelength in size.
The wave is reflected in
all directions. These non
specular reflection have a
strong frequency
dependence.
55
1.2. Ultrasound Interaction
56
14
Echo Type
Absorption
Absorption is the only process whereby sound
energy is dissipated in a medium.
Absorption is the process whereby ultrasound
energy is transformed into other energy form,
primarily heat. (Principle of therapeutic
ultrasound)
The absorption of the ultrasound beam is related
to the frequency of the beam, the viscosity of
medium and the relaxation time of medium.
Specular - echoes originating from relatively

large, regularly shaped objects with smooth
surfaces. These echoes are relatively intense
and angle dependent. (i.e. IVS, valves)
Scattered - echoes originating from relatively
small, weakly reflective, irregularly shaped
objects are less angle dependant and less
intense. (ie. blood cells)
A= ampitude of the beam at a distance x.

Alpha is amplitude absorption coefficient
57
58
Intensity
A-Half Value Layer (HVL)
The intensity of the ultrasound beam is the

amount of energy flowing through a unit crosssectional area each second.
The intensity is the rate at which the energy is
being transmitted by the wave over a small area.
The units are joules/s.cm2 or watt/cm2
The intensity is proportional to the square of
pressure amplitude.
I = Intensity at the point of interest.
Myu= the intensity absorption coefficient.
HVL is the amount of material that reduces the

intensity to one-half its original value (-3dB).
Material
Air
Water
Blood
Bone
Fat
Tissue
1 MHz
0.25
1360
17
0.2
5
4.3
59
2 MHz
0.06
340
8.5
0.1
2.5
2.1
5 MHz
0.01
54
3
0.04
1
0.86
10 MHz
14
2
0.5
0.43
60
15
How can we use US in Medical

Application
Bagaimanakah gelombang ultrasonik boleh
Ultrasound, as the name implies, is sound at a frequency

too high for the human ear to perceive. The instrument
that produces these sound waves is called a
transducer. The doctor can position the transducer on a
portion of the body and send ultrasound waves into the
tissues below.
The sound waves bounce back off internal structures
and return to the transducer where they are collected.
A computer takes these returning sound waves and
creates a picture of the internal structures on a video
screen.
Denyutan bunyi berfrekuensi tinggi dihasilkan oleh

pemancar dan ditujukan ke dalam badan.
Seperti mana di dalam sonar, pantulan akan berlaku.
Ianya akan berlaku setiap masa denyutan bertemu
sempadan di antara dua tisu yang mempunyai
ketumpatan berbeza atau sempadan di antara tisu dan
cecair bersebelahan.
Dengan pengimbasan gelombang ultrasonik
keseluruhan badan dan mengesan gema (echo) yang
dihasilkan daripada pelbagai lokasi dalaman, maka imej
atau sonogram anatomi di dalam badan manusia
diperolehi
digunakan untuk tujuan diagnosis
61
Acoustic impedan
Acoustic impedance of muscle

Acoustic impedan (g/cm2s) = speed(cm/s)
density (g/cm3)
Formula
Acoustic impedan (g/cm2s) = speed(cm/s)
density (g/cm3)
Kelajuan bunyi di dalam
62
Ketumpatan
otot
= 1580 m s-1
otot
= 1.076 103 kg m-3
tulang
= 3500 m s-1
tulang
= 2.23 103 kg m-3
63
64
16
Speed of ultrasound and acoustic impedance in some common Materials. Data from
Wells(1969); Gros, Johnston, Dunn (1978); and Bamber (1986). The acoustic impedance
cannot be calculated where the density of the material is not known.
Acoustic impedance of bone

Acoustic impedan
(g/cm2s)
Material
= speed(cm/s)
density (g/cm3)
65
Nisbah pantulan keamatan (reflected

intensity) kepada incident intensity
Apabila gelombang ultrasound bertemu dengan
sempadan yang memisahkan dua media yang
berlainan di dalam badan manusia,
Nisbah pantulan keamatan (reflected intensity) kepada
incident intensity diberikan seperti di bawah
Acoustic impedance (g/cm2s)
Speed m/s
Amniotic fluid
1510
X 105
Aqueous humour
1500
1.50
X 105
Air (NTP)
330
0.0004
X 105
40
Blood
1570
1.61
X 105
161000
Bone
3500
7.80
X 105
780000
Brain
1540
1.58
X 105
158000
Cartilage
1660
X 105
Castor oil
1500
1.43
X 105
CSF
1510
X 105
Fat
1450
1.38
X 105
138000
Kidney
1560
1.62
X 105
162000
Lens of eye
1620
1.84
X 105
184000
150000
143000
Liver
1550
1.65
X 10
165000
Muscle
1580
1.70
X 105
170000
Perspex
2680
3.20
X 105
320000
Polythene
2000
1.84
X 105
184000
Skin
1600
X 105
Soft tissue (average)
1540
1.63
X 105
Tendon
1750
X 105
Tooth
3600
X 105
163000
Vitreous humour
1520
1.52
X 105
152000
Water (20oC)
1480
1.48
X 105
148000
66
Gelombang ultrasound bertemu dengan

sempadan yang memisahkan dua media
yang berlainan di dalam badan manusia
Sumber
Ultrasound
Pemindaharuh
Otot
Lemak
Antaramuka 1
Otot
Antaramuka 3
Antaramuka 2
67
68
17
Penyelesaian
Medium 1
Medium 2
Medium 3
Acoustic impedanace (g/cm2s)
Otot = 1.70 105
Lemak = 1.38 105
Udara = 0.00004 105
Pada antaramuka 1
100 %
Ultrasound
Probe
Tx & Rx
1
2
3
Interface 1
Interface 3
% reflection = 1.08%
Interface 2
1
+ 2
Hanya 100 % - 1.08 % = 98.92 % dipancarkan ke dalam lemak dan terkena pada antaramuka 2.
Manakal 1.08 % akan dipantulkan ke arah pemindaharuh penerima.
= Total % of Reflection
69
Pada antaramuka 2
70
Pada antaramuka 3
1.08 % daripada 98.92% iaitu 1.07 % yang terkena antaramuka 2 akan dipantulkan ke antaramuka
1. 1.07 %, ini daripada keamatan asal akan bergerak kembali menerusi antaramuka 1 di mana
1.08% akan dipantulkan kembali semula ke arah antaramuka 2.
98.92 % daripada 1.07 % iaitu 1.06 % akan menerusi antaramuka 1,
dan kembali ke Pemindaharuh Penerima yang asalnya daripada antaramuka 2.
71
99.88 % 97.85 % iaitu 97.73 %(daripada keamatan asal yang dipancarkan, dipantulkan kembali daripada
antaramuka 3 dan perlu melalui antaramuka 2 dan 1. (hampir 100% pantulan).
Apabila sampai ke antaramuka 2, 98.92% daripada 97.73 % iaitu 96.67 % akan menerusi antaramuka 2 dan
terus ke antaramuka 1.
Apabila mengenai antaramuka, 1.08 % daripada 96.67% iaitu 1.04 % akan dipantulkan kembali ke antaramuka
2. Manakala 98.92 % daripada 96.67% iaitu 95.62 %.
Jumlah peratus pantulan yang diterima pada pemindaharuh penerima adalah = 1.08 % + 1.06 % + 95.62 % =
97.76 %
(dengan mengabaikan pantulan berulang-ulang)
72
18

Sumber
Ultrasound
Pemindaharuh
Lemak
Otot
Antaramuka 1
Solution
Tulang
Antaramuka 3
Antaramuka 2
73

Sumber
Ultrasound
Pemindaharuh
Tulang
Otot
Antaramuka 1
74
Solution
Lemak
Antaramuka 3
Antaramuka 2
75
76
19
Sound energy & effect on soft

tissue
Sound energy & effect on soft

tissue
So how does sound wave behave when it travels through human

tissues?
From the air medium, it must enter the skin/fat which has significantly
higher density. There is 100% reflection of the sound wave at the airskin interface. If we put a coupling medium such as a gel to create a
sound head-gel-skin interface, reflection is reduced to only 0.1%; the
rest of the sound energy will be transmitted through the skin barrier. As
noted in the absorption coefficients table, sound energy travels through
much of the soft tissue without much absorption until it reaches tissues
with high collagen (bundles of protein fibres) content, namely bone,
periosteum, ligaments, capsules, fascia, tendons, and tissue interface
(bursa).
Ultrasound at high intensity near bony areas can be detrimental to the
periosteum (dense layer of connective tissue around a bone) because
of high energy accumulation and heating effect on the soft tissue as
sound wave hits the bone (transverse or shear wave).
Ultrasound energy is absorbed mostly in

tissue with high collagen (bundles of protein
fibres) content (bone, periosteum, ligaments,
capsules, fascia, tendons, and tissue
interface i.e. bursa & synovium).
77
What happens to the tissues that

absorb sound energy?
78
Why US is not good for bone

imaging
Ultrasound has selective
interfacial effects at the bone
surface resulting from bone
having a high absorption
coefficient, a high relative
acoustic impedance, and an
ability to propagate shear
waves.
Unlike x-rays, ultrasound will
not go through bone or
air. Therefore, ultrasound is
not a good way to diagnose
bone or lung disease. Its real
value comes from the
examination of internal organs.
Sound energy is non-ionizing radiation and

therefore its use does not impose the hazard,
such as cancer and chromosome breakage,
attributed to ionizing radiation.
Sound energy has two physiological effects:
1. Enhance inflammatory response and tissue repair.
2. Heat soft tissue
79
80
20
Ultrasound Transducer
Pieozoelectric
81
1.3. Ultrasound Transducer
82
I. Basic
1.3.
Ultrasound
Ultrasound
Transducer
Piezoelectric Effect
+
Battery
Piezoelectrical
Crystal (Quartz)
The crystal gets thicker, due to a distortion of the crystal

lattice
21
Sound wave
with
frequency f
U(f)
+
The effect inverses with polarity change
An alternating voltage generates crystal oscillations at the

frequency f
Reception of ultrasonic waves

A sound wave hitting a piezoelectric crystal, induces
crystal vibration which then causes electrical voltages
at the crystal surfaces.
Short pulse
( < 1 s )
Electrical
energy
Piezoelectrical
crystal
Ultrasonic wave
A short voltage pulse generates an oscillation at the crystals

resonant
frequency f0
22
Fungsi pemindaharuh ultrasonik
A transducer is a device that can convert
one form of energy into another.
Ultrasonic transducers are used to convert
an electric signal into ultrasonic energy
that can be transmitted into tissues, and to
convert ultrasonic energy reflected back
from the tissues into an electric signal
The piezoelectric (pressure-electric) effect
enable transducer to transmit and receive the
ultrasound signal (pressure wave).
The crystal has a natural vibrational frequency
that is related to the distance between two
surfaces.
For example 1.5 MHz transducer corresponding
to wavelength of 2.7 mm in the crystal material
has a crystal thickness of 1.35 mm. A higher
frequency transducer that produces a shorter
wavelength has an even thinner crystal.
89
I. Basic
1.3.
Ultrasound
Ultrasound
Transducer
90
I. Basic
1.3.
Ultrasound
Ultrasound
Transducer
Transducer Construction
Transducer Construction
The construction of the transducer can be viewed as a crystal of piezoelectric

material with electrodes on each side of the crystal. The entire crystal is housed in
an acoustically and electrically insulated casing. The backing material should
absorb all the energy, and the matching layer should transfer the output maximally.
91
92
23
The general composition of an

ultrasonic transducer
Transducer Design
The most important component is a thin (approximately 0.5mm) piezoelectric crystal element located near the face of the
transducer.
The front and back faces of the crystal are coated with a thin
conducting film to ensure good contact with the two electrodes
that will supply the electric field used to strain the crystal.
The term strain refers to deformity of the crystal caused
when a voltage is applied to the crystal.
The surfaces of the crystal are plated with gold or silver
electrodes.
The outside electrode is grounded to protect the patient from
electrical shock, and its outside surface is coated with a
watertight electrical insulator.
The inside electrode abuts against a thick backing block that
absorbs sound waves transmitted back into the transducer.
The housing is usually a strong plastic.
An acoustic insulator of rubber or cork prevents the sound
from passing into the housing.
A large variety of sizes and shapes of transducers are
available to perform specific functions, but they all have this
general design
94
Advantages of ultrasound transducer which is

made with Piezoelectric Ceramics material
A great advantage of piezoelectric
Ceramics is that they can be formed
into different shapes.
Piezoelectric crystals can be
designed to vibrate in either the
thickness or radial mode
Medical crystals are designed to
vibrate in the thickness mode.
They still vibrate to a lesser extent in
the radial mode, however, so the
receiving amplifier is gated to tune
out all frequencies except those from
the thickness mode
Ketebalan & frekuensi salunan

Pemindaharuh ultrabunyi direkabentuk supaya
mempunyai kepekaan yang tinggi terhadap
frekuensi tabii (natural frequency).
Ketebalan hablur piezoelektrik (piezoelectric
crystal) menentukan frekuensi tabiinya atau
dipanggil frekuensi salunan.
Selalunya hablur direkabentuk supaya
ketebalannya adalah bersamaan dengan
separuh daripada nilai panjang gelombang
ultrabunyi yang perlu dihasilkan oleh
pemindaharuh
95
96
24
Contoh
Penyelesaian
Ketebalan hablur PZT-4 = 0.001 m dan

halaju bunyi di dalam PZT-4 = 4000 m/sec
Kirakan frekuensi salunan pemindaharuh
ini
Diberi,
V (PZT-4) = 4000 m/sec
Ketebalan PZT-4 = 0.001 m
Oleh kerana, hablur akan menyalun (resonate) pada frekuensi (f)
bersamaan dua kali ganda ketebalan hablur.
Maka = 2f = 2 0.001 m = 0.002 m.
Dengan menggunakan formula berikut;
= f.
f (frekuensi) = /
= 4000 m/sec / 0.002 m
= 2,000,000/sec
= 2 MHz
97
Sekiranya ketebalan hablur

berkurang atau bertambah
98
Frequency Response
Ketebalan PZT-4 iaitu 0.001 m (1 mm), frekuensi

salunannya adalah 2 MHz
Ketebalan PZT-4 iaitu 0.002 m (2 mm), frekuensi
salunannya adalah 1 MHz
Daripada contoh ini dapat ditunjukkan bahawa
sekiranya ketebalan hablur yang digunakan berkurang
atau makin nipis, maka frekuensi salunan yang
dihasilkan adalah meningkat. Ini menunjukkan
bahawa sekiranya kita mengkehendaki hablur
menyalun pada frekuensi megahertz yang tinggi maka
ketebalan hablur yang diperlukan akan menjadi terlalu
nipis
Quality factor
Q = fo/f
Q = Estored/Elost
99
100
I. Basic
1.3.
Ultrasound
Ultrasound
Transducer
25
Frequency Response
Ultrasound Probes
Quality factor
Q = fo/f
Q = Estored/Elost
The Q value relates the damping characteristics to the pulse length and can
be viewed as the energy stored per cycle divided by energy lost per cycle.
A high Q transducer means that most of energy is stored and very little energy is
lost each cycle. Low Q for Diagnostic and High Q for therapeutic. Shorter pulse
length better axial resolution. Frequency increased, pulse length decrease,
improved axial resolution. Q indirectly proportional to BW. High Q has very narrow
bandwidth. Low Q transducer has broad bandwidth and better receiver of the
transducer. High Q better transmitter.
Sector Probe Convex Probe Linear Probe
101
I. Basic
1.3.
Ultrasound
Ultrasound
Transducer
102
Scanning Beam
Ultrasound in Medicine
Heart
Skin, Orthopedic
Abdomen
103
104
26
Modes
A Mode - amplitude mode. Where the signals are
displayed as spikes that are dependent on the amplitude
of the returning sound energy.
B Mode - brightness mode. Where the signals are
displayed as various points whose brightness depends
on the amplitude of the returning sound energy.
M Mode - motion mode. The application of B-mode and a
strip chart recorder allows visualization of the structures
as a function of depth and time.
2D Mode - 2 dimensional mode name is usually reserved
to indicate b-mode imaging of the heart. The spatially
oriented B-mode where structures are seen as a function
of depth and width. The beam is rapidly swept back and
forth to create a cross section of the imaged structures.
2.1. Ultrasound Diagnostic

A Mode
B Mode
M Mode
D Mode
3D / 4D Mode
2.2. Ultrasound Therapeutic

2.3. Biological Effects
105
A-mode Ultrasound
106
A-mode
Amplitude of reflected signal vs. time
27

A-Mode Ultrasound
On an oscilloscope, this simple clap-echo
system would look like this.
The initial spike from the clap would be
followed some time later by the echo. The
earliest "A-Mode" ultrasound machines
worked in this way. You could know how far
the echo has traveled, and how loud the echo
was when it got back to you.
There were (and are) several problems with
this simple system:
A-Mode
You don't know the exact direction it came

from.
You don't know for sure what the echo
bounced off of.
You don't know what the object generating the
echo looks like.
109
110
B-Mode
B-mode Ultrasound
111
28
B-mode Example
Cardiac Ultrasound
Standard Sites for Echocardiograms
29
Conventional Cardiac 2D Ultrasound
Short-axis Interrogation
B-mode Image of Heart
B-mode
30
Mitral stenosis
M-Mode
M-mode Ultrasound
M Mode - motion mode. The application of

B-mode and a strip chart recorder allows
visualization of the structures as a function
of depth and time.
123
II. Ultrasound
2.1.
Ultrasound
inDiagnostic
Medicine
31
M-mode
M-Mode
126
II. Ultrasound
2.1.
Ultrasound
inDiagnostic
Medicine
Doppler Mode
Doppler Mode
DOPPLER PRINCIPLES
Christian Johann Doppler described the effect of motion of sound
sources and its effect on the frequency of the sound to the observer.
In medical applications we find that the frequency of the reflected
signal is modified by the velocity and direction of blood flow. If blood
cells are moving towards the transducer, they increase the
frequency of the returning signal. As cells move away from the
transducer, the frequency of the returning signal decreases.
Doppler techniques are dependent on the transducers used. The
transducer operating in continuous wave mode utilizes one half of
the element(s) and are continuously sending sound energy while the
other half is continuously receiving the reflected signals.
If the transducer is being used in a pulsed wave mode, the whole
transducer is used to send and then receive the returning signals.
The display of Doppler velocity data is the Doppler frequency shifts
versus time. Included in the display are the Doppler settings such as
frequency, calibration, range, and timing markers.
127
II. Ultrasound
2.1.
Ultrasound
inDiagnostic
Medicine
128
II. Ultrasound
2.1.
Ultrasound
inDiagnostic
Medicine
32
kesan Doppler (Doppler Effect)
Doppler Principle
Kesan Doppler adalah pengurang di

dalam frekuensi yang diterima oleh
pemerhati daripada sumber bunyi apabila
ianya bergerak melepasi dan berundur
(bergerak menjauhi) daripada pemerhati
129
Doppler
Doppler measurements
33
Doppler angle
Normal flow
Diseased flow
Blood Flow Measurements
34
3-D Mode
4-D Mode
137
II. Ultrasound
2.1.
Ultrasound
inDiagnostic
Medicine
138
II. Ultrasound
2.1.
Ultrasound
inDiagnostic
Medicine

Basic Principle:
Ultrasound Waves
Compression & Rarefaction
Molecular Vibration in
Tissue Thermal Effect
(Heating) & Non Thermal
Effect (Micro massage)
Ultrasound Therapeutic
Frequency = 3 MHz,
Wavelength in Tissue = 0.5
mm
139
140
35
Ultrasound Absorption in Tissue
Ultrasound Absorption in Tissue

Although cartilage and bone are at the upper end of this scale,
the problems associated with wave reflection mean that the
majority of US energy striking the surface of either of these
tissues is likely to be reflected. The best absorbing tissues in
terms of clinical practice are those with high collagen content
LIGAMENT, TENDON, FASCIA, JOINT CAPSULE, SCAR
TISSUE (Watson 2000, ter Haar 99, Nussbaum 1998, Frizzel &
Dunn 1982)
The application of therapeutic US to tissues with a low energy
absorption capacity is less likely to be effective than the
application of the energy into a more highly absorbing material.
Recent evidence of the ineffectiveness of such an intervention
can be found in Wilkin et al (2004) whilst application in tissue
that is a better absorber will, as expected, result in a more
effective intervention (e.g. Sparrow et al 2005, Leung et al
2004).
the tissues with the higher protein content will absorb

US to a greater extent
the tissues with high water content and low protein
content absorb little of the US energy (e.g. blood and
fat)
141
142

No acute harmful effects have been
reported after diagnostic ultrasound
examinations.
Biological effects observation: high
intensity level and long exposure time
To assess biological effects, the dose of
ultrasound must be known.
Dose: quantity of energy absorbed per unit
mass of absorbing medium = intensity in
the medium
Biological Effects
143
144
36
Interaction of Ultrasound with Matter

Three mechanism: Thermal, Cavitation, Mechanical
Thermal mechanism: Ultrasound energy is absorbed and
converted into heat. The increased temperature may cause
irreversible tissue damage. The rate of temperature rise depends on
TA (Temporal Average) intensity, absorption coefficient of the
medium and heat transport process (thermal conductivity and blood
flow). The absorption coefficient increases with frequency.
Interaction of Ultrasound with Matter

Mechanical mechanism: The ultrasonic wave is propagated through
the medium by interactions between neighboring particles. This
particles undergo considerable changes in velocity and acceleration.
An object of different density than that of the surrounding medium will
experience a torque in ultrasonic field. At high intensities, the wave
shape becomes distorted, resulting in micro streaming. These high
velocity gradients can fragment the macromolecules located in these
region.
Cavitation mechanism: As the ultrasound wave propagates

through the medium, regions of compression and rarefaction are
created. The localized regions in the medium are subjected to
increases and decreases in pressure in alternating fashion. These
pressure changes can cause gas bubbles to form and/or grow and
exhibit dynamic behavior.
145
146
FDA Regulation 1976
FDA Regulation 1993

The new regulations combine an overall limit of
I-SPTA of 720 mW/cm2 for all equipment with a
system of output displays to allow users to employ
effective and judicious levels of ultrasound
appropriate to the examination undertaken.
The new regulations allow an eight-fold increase
in ultrasound intensity to be used in fetal
examinations.
The output display is based on two indices, the
mechanical index (MI) and the thermal index (TI).
For spatial peak time-averaged intensity (ISPTA) (the measure most associated with
temperature rise), the maximum levels
were:
Ophthalmic
17 mW/cm2
Fetal and other
94 mW/cm2
Cardiac
430 mW/cm2
Peripheral vessel
720 mW/cm2
147
148
37
Medical Ultrasound
Advantages of
acoustic energy:
can be directed in a
beam
obeys the laws of
reflection and
refraction
reflected off object
borders
no known unwanted
health effects
Why Ultrasound in Cardiology?
Disadvantages of
acoustic energy:
propagates poorly
through a gaseous
medium
reflected off of borders
of small objects
quickly dissipates (as
heat)
Portable, relatively cheap

Non-ionizing
During the echocardiogram, it is possible for the
cardiologist to:
Watch the hearts motion in 2D real-time
Ascertain if the valves are opening and closing properly,
and view any abnormalities
Determine the size of the heart chambers and major
vessels
Measure the thickness of the heart walls
Calculate standard metrics of health/disease
e.g., Volume, EF, SV, CO
Dynamic evaluation of abnormalities

3.1. Ultrasound Medical Diagnostic
3.2. Ultrasound Medical Therapeutic
Devices Standard
151
152
38
IEC 60601
IEC 60601
IEC 60601-1: Medical electrical equipment - Part 1: General

requirements for safety
IEC 60601-1 ed 2.2: Medical electrical equipment- Part 1:
General requirements for safety
IEC 60601-1-1 ed 2.0: Medical electrical equipment- Part 1:
General requirements for safety-1. Collateral standard:
Safety requirements for medical electrical systems
IEC 60601-1-2 ed 1.0: Medical electrical equipment- Part 1:
General requirements for safety-2. Collateral Standard:
Electromagnetic compatibility - Requirements and tests
IEC 60601-1-4 ed 1.1: Medical electrical equipment-Part 1:
General requirements for safety-4. Collateral standard:
Programmable electrical medical systems
IEC 60601-2-37 ed 1.1: Medical electrical equipment- Part
2-37: Particular requirements for the safety of ultrasonic
medical diagnostic and monitoring equipment
153
This standard establishes general safety requirements for

all aspects of medical devices from light boxes to beds to
high-end diagnostic equipment like ultrasound or magnetic
resonance (MR). Included are test requirements,
documentation, protection from electrical hazards,
protection from mechanical hazards, protection against
excessive or unwanted radiation, protection against
temperature, fire prevention, ingress of liquids, disinfection,
biocompatibility etc.
IEC 60601-1 is presently at edition 2.2 and was last
published in 1997. This standard is presently in the final
stages of a major overhaul to edition 3 due out in mid-2005.
As the release date gets closer, a separate column will
discuss the key differences of this future revision.
154
Potential sources of harm of

ultrasound diagnostic equipment
Marking and Display
Noise on a waveform, artifacts, distortion in an image

or error of a displayed numerical value which cannot
be attributed to a physiological effect and which may
alter the diagnosis
The display of inaccurate numerical values
associated with the diagnosis to be performed
The display of inaccurate safety related indications
The production of unintended or excessive
ultrasound output
The production of unintended or excessive transducer
assembly surface temperature
The production of unintended or uncontrolled motion
of transducer assemblies intended for intra-corporeal
use
Marking on the outside of equipment for:

Compliance with EMC requirement
Output adjustable
Physiological effect, symbol and warning
statements
Display of controls and instruments

A display of Thermal and Mechanical Index
A display of surface temperature of
ultrasonic transducer
A display of ultrasound output level
155
156
39
Marking
Standard in Therapeutic Devices
Identical to Diagnostic Devices and

replace with:
IEC 60601-2-5: Medical electrical
equipment - Part 2-5: Particular
requirement for safety of ultrasonic
physiotherapy equipment
The generator shall be provided following marking:

Acoustic working frequency in MHz or kHz
Waveform type
Description of output waveform (Duration, Pulse
Repetition Period, Duty factor)
The generator shall carry a nameplate, with unique
serial number
The treatment head shall be marked with its rated
output power in watts, the effective radiating area in
square centimeters, the beam non uniformity ratio,
beam type, a designation of the specific generator (if
applicable) and a unique serial number.
157
158
3.1. Ultrasound Medical Therapeutic
4.1. Ultrasound Machine
4.1. Ultrasound Machine

4.2. Block Diagram
159
160
40
4.2. Block Diagram
161
Performance Parameters
V. Performance & Safety Testing
5.1. Performance Testing

Parameters
Phantom
5.2. Safety Testing

Electrical Safety
MI/TI
Acoustic Power
5.3. Test Record
Resolution: Axial & Lateral

Dead Zone
Beam width
Focal Zone
Geometry Accuracy
TGC Characteristic
Uniformity
Sensitivity
Penetration
Low contrast detection
163
V. Performance & Safety Testing
164
5.1 Performance Testing
41
Test Objects and Phantom
AIUM STANDARD TEST OBJECT

Diagram of the AIUM
100 mm x 100 mm
standard Test Object
The rods are 0.75 mm
diameter stainless steel
wires placed at specific
locations with an
accuracy of 0.25 mm.
The material may be
water at 37oC, alcoholwater solution or NaClWater Solution
Test object is composed of material in

which the velocity of ultrasound is the
same as in tissue, but other properties of
the material with respect to sound
propagation may be very different from
that of tissue.
Phantom is tissue equivalent test object.
165
5.1. Performance Testing
166
Tissue-Equivalent Phantoms
Phantom
The tissue-equivalent phantom are composed of

animal hide gelatin impregnated with graphite
powder or polysaccharide gel (agar)
impregnated with graphite powder.
These materials mimic soft tissue in terms of the
speed of sound, attenuation, density and scatter.
Nylon fibers (0.3 mm in diameter) are placed at
various location to evaluate the same
parameters as discussed for test object.
167
168
42
Dead Zone
Geometric Accuracy
The dead zone corresponds to the region in

which no information is obtained.
Vertical Distance Accuracy
Horizontal Distance Accuracy
169
170
3-D Egg-Phantom
Axial Resolution
171
172
43
Lateral Resolution
Penetration (Maximum Depth)
173
174
5.2. Safety Testing
Visual Inspection
Visual / Mechanical: Probe, Cable, Connector

Electrical Safety
Mechanical Index & Thermal Index
Acoustic Power
Transducers free of cracks, delaminations

Cables in good shape
Transducers cleaned after each use
Viewing monitors clean
Air filters
Wheels, locks
175
5.2. Safety Testing
176
5.2. Safety Testing
44
Excessive Acoustic Power
Cable Failure
177
5.2. Safety Testing
178
5.2. Safety Testing
Probe Failure
Probe Failure
Array housing separating from the seam normally
occurs when the probe has been in use for some time.
This glue can deteriorate as a function of time as well
as to exposure to cleaning agents. This probe should
not be used as it may present an electrical shock
hazard to the patient and the sonographer. Further, if
cleaning agents get inside the probe they will normally
destroy the array. This type of failure can be repaired if
caught early.
Seam line separating from nose cone becoming the
site of fluid infiltration. Less obvious than the example
above, this is the beginning of the cap detachment.
The compromise of the seam can be seen with the
aide of a small magnifying glass. If the problem is
found at this stage, the probe is easily repairable.
179
5.2. Safety Testing
180
5.2. Safety Testing
45
Acoustic Power Measurement
Electrical Safety Testing
Existing ultrasound power measurement

devices generally use a force balance
approach.
The radiation force is a static force
produced by the rate of change of
momentum in the ultrasound beam.
Protective Earth Verification: Ground

Continuity Test
High Resistance: Insulation Resistance
Test
Leakage Current: Earth Leakage,
Touch/Chassis (Enclosure), Patient
Leakage & Patient Auxiliary Leakage
where
is the incident angle of the ultrasound.
181
5.2. Safety Testing
182
5.2. Safety Testing
Mechanical Index
Acoustic Power Measurement

Incident ultrasound energy is reflected off a nominally perfect
reflector, thereby applying force to the reflector. With existing meters
this force is generally measured using a sensitive electronic
balance, or using a force feedback system.
When a reflecting or absorbing target is placed in an ultrasonic
beam within a fluid, it experiences a force known as the 'radiation
force'. The radiation force is a static force produced by the rate of
change of momentum in the ultrasound beam. This force, F,
depends only upon the total acoustic power (P), the velocity of the
sound in fluid (C) and the geometry of the target.
In the case of a large reflective target, the force, F, is related to the
total power P, in the ultrasonic beam by the equation
183
The mechanical index is an estimate of the maximum

amplitude of the pressure pulse in tissue.
It may be calculated using the spatial peak value of the

rarefactional pressure P3, derated by 0.3 dB/cm/MHz at
each point along the beam axis, divided by the square
root of the centre frequency fc
It gives an indication as to the relative risk of mechanical
effects (streaming and cavitation).
The FDA regulations allow a mechanical index of up to
1.9 to be used for all applications except ophthalmic
(maximum 0.23).
184
5.2. Safety Testing
46
Thermal Index
Thermal Index
For fetal scanning, the highest
temperature increase would be expected
to occur at bone and TIB would give the
worst case conditions.
The mechanical index and thermal index
must be displayed if the ultrasound system
is capable of exceeding an index of 1.
The displayed indices are based on the
manufacturers experimental and modelled
data.
The thermal index is the ratio of the power used to that

required to cause a maximum temperature increase of
1C.
A thermal index of 1 indicates a power causing a
temperature increase of 1C.
Because temperature rise is dependent on tissue type
and is particularly dependent on the presence of bone,
the thermal index is subdivided into three indices:
(1) TIS: thermal index for soft tissue;
(2) TIB: thermal index with bone at/near the focus;
(3) TIC: thermal index with bone at the surface (e.g. cranial
examination).
185
5.2. Safety Testing
186
5.2. Safety Testing
5.3. Test Record
Visual Inspection
Acceptance Testing for New Equipment by

Manufacturer / Supplier / Commissioner /
Technical Person
Acceptance Testing for After Repair Equipment
by Manufacturer / Supplier / Commissioner /
Technical Person
Routine Operation Testing by User / Operator
(daily or weekly)
Routine Maintenance Testing by Technical
Person / Engineer / Technician / Accreditation
Body (Every 1/3/6/12 months)
Calibration / Accreditation Testing by
Accreditation Body (Every 1/2/3/5 years)
Packaging
Documentation
Marking
Overall
Accessories
187
V. Performance and Safety Testing
188
5.3. Test Record
47
Functional Inspection for

Diagnostic
Safety Inspection
Image Quality:
Main Supply Connections

Earth Continuity
Insulation
Leakage Current
Probe Condition
Axial Resolution, Lateral Resolution, Dead Zone,

Sensitivity, Uniformity, Focal Zone Distance,
Photographic System, Horizontal Depth Marker
Error, Vertikal Depth Marker Error, Beam Width,
Geometry Accuracy, TGC Characteristics,
Penetration, Low contrast detection
Numerical Display: TI, MI

Acoustic Power
Surface Temperature
189
5.3. Test Record
190
5.3. Test Record
Functional Inspection for

Therapeutic
Effective radiating area

Rated output power
Acoustic Working Frequency
Beam Non Uniformity Ratio
Pulse Duration
Pulse Repetition Period
SPTA Intensity of unwanted ultrasound radiation (less than 100
mW/cm2)
Temperature of Radiating Surface (not exceed than 41oC)
Output power and Effective Intensity
Output Stability with supply variation
Output Stability with time
Timer Accuracy
191
5.3. Test Record
48

Ultrasound

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Outline

Bats navigate using ultrasound

Bats: Navigating with ultrasound

We can also use ultrasound to look inside the

Bats: Navigating with ultrasound

Clue 1: the speed of sound in air is 330 ms-1

Ultrasound imaging: What does it look

Ultrasound imaging: How does it work?

An ultrasound element acts like a bat.

Ultrasound imaging: How does it work?

Ultrasound imaging: development of a

Now put many elements together to make a probe and create

8 weeks gestation (out of a 40 week pregnancy)

Ultrasound imaging: more surface

Ultrasound imaging: foetus feet

This is a 2D ultrasound scan

We can process the image in a

Ultrasound imaging: imaging the heart

Ultrasound imaging: kissing!

Ultrasoundaudible sound (1520,000

Form of inaudible, high frequency acoustic

Ultrasound is generated by the

Movement of the ball over time

The actual displacement a is

Sinusoidal pressure source

"Gelombang melintang" (Transverse

"Gelombang membujur" (Longitudinal

Longitudinal wave Direction of propagation

Ultrasound is sound with a frequency greater

The crystal commonly used in US units is synthetic

Most clinic will have 1 MHz and 3 MHz sound head.

Sound wave physics

medium density high density

Understanding wave propagation:

Spring = elastic bonding

Sound wave physics

Energy finial = Energy initial (Ereflected + Eabsorbed)

From this we derive:

0.001 15 Seismolo 200

500 kHz NDT

EEG: 0.5 100 Hz

1.1. Wave Properties

1.1. Wave Properties

V, the velocity is the speed at which sound waves travel

Acoustic Impedance (kg/m2s = Rayls)

Intensity (joules/cm2 = watts/m2)

1.1. Wave Properties

pengiraan panjang gelombang

Panjang gelombang di dalam kanta

Jadual: Kelajuan ultrabunyi dan acoustic impedance di dalam bahan umum.Data

1.1. Wave Properties

Acoustic impedance (g/cm2s)

Interaction of Ultrasound with Tissue

1.1. Wave Properties

Interaction of Ultrasound with Tissue

Reflection and Transmission

As soon as a sound wave comes to a change in material

Interaction of Ultrasound with Tissue

The basis of diagnostic ultrasound imaging is the reflection of the

The scattering occurs

1.2. Ultrasound Interaction

1.2. Ultrasound Interaction

Specular - echoes originating from relatively

A= ampitude of the beam at a distance x.