Medical Ultrasound Imaging
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Ultrasound Machine
Ultrasound machines, widely used in medical imaging, are essential tools in the field of diagnostic ultrasound. These devices utilize high-frequency sound waves to create real-time images of internal body structures. Ultrasound machines consist of several key components that work together to generate diagnostic images. These include:
The transducer is a handheld device that emits and receives sound waves. It converts electrical energy into sound waves and captures the returning echoes to create images.
The control panel houses the interface where the sonographer adjusts imaging parameters such as depth, frequency, and gain. It allows for customization of imaging settings based on the clinical requirements. The transducer pulse controls change the amplitude, frequency and duration of the pulses emitted from the transducer probe.
The central processing unit (CPU) serves as the brain of the ultrasound machine, processing the acquired data and transforming it into images. It handles complex calculations, image optimization, data storage and contains the electrical power supplies for itself and the transducer probe.
The display monitor (oscilloscope, tablet, computer monitor, etc.) showcases the real-time ultrasound images produced by the machine. It provides visual feedback to the sonographer, aiding in the interpretation and analysis of anatomical structures. Handheld ultrasound devices and mobile ultrasound probes can be connected wirelessly to a smartphone or tablet via Bluetooth or WiFi. These end device serves then as the ultrasound monitor.
Data input and measurements are done with the keyboard cursor (trackball). Ultrasound devices used for handheld point of care ultrasound (HPOCUS) are operated via the touch screen of the control panel.
Images are captured, reviewed, stored and transmitted digitally, using a standard format for digital imaging and communications in medicine (DICOM). Disk storage devices (FDD, HDD, CD, DVD) are outdated, but may be used in older machines to store the acquired images if no picture archiving and communication system (PACS) connection is possible.
The displayed ultrasound pictures are usually digitally stored in a PACS. The images from portable ultrasound machines can be stored and conveniently managed on the end device itself, the inserted memory card or in the cloud. With a QR scanner, the images can be accessed via the Internet in the cloud. Often there is also the possibility to get a picture of a baby sonography as a printout.

B-mode machines represent the vast majority of machines used in echocardiology, obstetrical scans, abdominal scans, gynecological scans, etc. B-mode ultrasound machines usually produce the sector (or pie segment-shaped) scans. These ultrasound scans require either a mechanical scanner transducer (the transducer moves to produce the sector scan), or a linear array transducer operated as a phased array.


Ultrasound machines come in different types, each catering to specific clinical needs. The two primary types are stationary and portable ultrasound machines:

Stationary units are typically larger in size and are installed in dedicated imaging rooms. These machines offer advanced imaging capabilities and a wide range of specialized features. They are commonly found in hospitals, clinics, and university medical centers where comprehensive imaging services are provided.
Portable units (see Portable Ultrasound Machine), as the name suggests, are compact and lightweight, designed for on-the-go imaging. These machines are highly versatile and offer excellent mobility, allowing healthcare professionals to bring the ultrasound system directly to the patient's bedside. Portable ultrasound machines are particularly useful in emergency settings, rural healthcare facilities, and point-of-care applications.

See also Handheld Ultrasound, Ultrasound System Performance, Equipment Preparation, Coaxial Cable, and Microbubble Scanner Modification, Environmental Protection and Ultrasound Accessories and Supplies.
Ultrasound System Performance
Ultrasound machines, with their various components and types, have revolutionized the field of medical imaging. These devices enable healthcare professionals to visualize internal structures, assess conditions, and guide interventions with real-time imaging capabilities. Today, medical ultrasound systems are complex signal processing machines. Assessing the performance of an ultrasound system requires understanding the relationships between the characteristics of the system, such as the point spread function, temporal resolution, and the quality of images. Image quality aspects include the detail resolution, contrast resolution and penetration. Systems with microbubble scanner modification are particularly suitable for contrast enhanced ultrasound.

Low-performance systems constitute approximately 20% of the world ultrasound market. These ultrasound machines are characterized by basic black and white imaging and are primarily used for basic OB/GYN applications and fetal development monitoring. They are often purchased by private office practitioners and small hospitals, with a unit cost below $50,000. These scanners commonly come equipped with a transvaginal probe.
Mid-performance sonography systems also hold around 20% market share. These machines are basic gray scale imaging, color and spectral Doppler and are used for routine examinations and reporting. They typically utilize a minimum number of scanheads and find applications in radiology, cardiology, and OB/GYN. The cost of these systems ranges between $50,000 and $100,000. Refurbished advanced and high-performance ultrasound machines with fewer optional features can also be found in this price range.
High-performance ultrasound systems generally provide high-resolution gray scale imaging, advanced color power and spectral Doppler capabilities. They usually include advanced measurement and analysis software, image review capabilities, and a variety of probes. These high-performance sonography devices have a market share of approximately 40% and cost between $100,000 and $150,000.
The remaining 20% of the market consists of premium or advanced performance ultrasound systems, typically sold for over $150,000. Premium performance systems offer high-resolution gray scale imaging, advanced color flow, power Doppler, and spectral Doppler, as well as features like tissue harmonic imaging, image acquisition storage, display and review capabilities, advanced automation, and more. Premium systems are equipped with a wide assortment of transducer scanheads.

In summary, ultrasound machines have diverse performance levels and corresponding price ranges, catering to various medical imaging needs. From low-performance systems with basic imaging capabilities to high-performance and premium systems with advanced features, ultrasound technology continues to advance healthcare imaging capabilities.
See also Ultrasound Physics, Handheld Ultrasound, Environmental Protection, Equipment Preparation.
Ultrasound Technology
Ultrasound technology with its advancements is vital for delivering high-quality patient care. Innovations including high-frequency ultrasound, 3D//4D imaging, contrast enhanced ultrasound, elastography, and point-of-care ultrasound, have expanded the capabilities of ultrasound imaging and improved diagnostic accuracy.
B-Mode imaging, also known as brightness mode, is the fundamental technique in ultrasound imaging. It produces two-dimensional images based on the echoes received from tissues and organs. Understanding the principles of B-Mode imaging, such as gain adjustment, depth control, and image optimization, is crucial for obtaining diagnostically valuable images. M-Mode imaging, on the other hand, allows for the visualization of motion over time, enabling assessment of cardiac structures and function, as well as fetal heart rate.
High-frequency ultrasound refers to the use of ultrasound waves with frequencies greater than 10 MHz. This technology enables improved resolution, allowing for detailed imaging of superficial structures like skin, tendons, and small organs. High-frequency ultrasound has found applications in dermatology, ophthalmology, and musculoskeletal imaging.
Traditional 2D ultrasound has been augmented by the advent of 3D ultrasound technology. By acquiring multiple 2D images from different angles, this technique construct a volumetric representation of the imaged area. The addition of 4D ultrasound in real-time motion adds further value by capturing dynamic processes.
Doppler imaging employs the Doppler effect to evaluate blood flow within vessels and assess hemodynamics. Color Doppler assigns color to different blood flow velocities, providing a visual representation of blood flow direction and speed. Spectral Doppler displays blood flow velocities as a waveform, allowing for detailed analysis of flow patterns, resistance, and stenosis.
Contrast enhanced ultrasound employs microbubble contrast agents to enhance the visualization of blood flow and tissue perfusion. By injecting these agents intravenously, sonographers can differentiate between vascular structures and lesions. Elastography is a technique that measures tissue elasticity or stiffness. It assists in differentiating between normal and abnormal tissues, aiding in the diagnosis of various conditions such as liver fibrosis, breast lesions, and thyroid nodules.
Fusion imaging combines ultrasound with other imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). By overlaying or merging ultrasound images with those obtained from other modalities, the user can precisely locate and characterize abnormalities, guide interventions, and improve diagnostic accuracy. Fusion imaging has proven particularly useful in areas such as interventional radiology, oncology, and urology.
See also Equipment Preparation, Environmental Protection, Handheld Ultrasound, Portable Ultrasound and Ultrasound Accessories and Supplies.
Veterinary Ultrasound
Conventional, CT and MR imaging technologies are limited in their availability, to depict soft tissue, or to show dynamic activity, like cardiac muscle contractility and blood flow. Easy applicability, real-time sonography and biopsy facilitation are important advantages in veterinarian medicine. Veterinary ultrasound has a very high sensitivity to show the composition of soft tissues, but the low specificity is a disadvantage. High ultrasound system performance includes Doppler techniques, contrast enhanced ultrasound, 3D ultrasound, and tissue harmonic imaging to improve resolution.
Technical and physical requirements of veterinary ultrasound are the same as in human ultrasonography. The higher the sound frequency, the better the possible resolution, but the poorer the tissue penetration. Image quality is depended of the ultrasound equipment. For example, a 10 MHz transducer is excellent for imaging of superficial structures; a 3.5 or 5.0 megahertz transducer allows sufficient penetration to see inner structures like the liver or the heart. In addition, the preparation and performing of the examination is similar to that of humans. The sound beam penetrates soft tissue and fat well, but gas and bone impede the ultrasonic power. Fluid filled organs like the bladder are often used as an acoustic window, and an ultrasound gel is used to conduct the sound beam.
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