Medical Ultrasound Imaging
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History of Ultrasound
The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.
In 1880 the Curie brothers discovered the piezoelectric effect in quartz. Converse piezoelectricity was mathematically deduced from fundamental thermodynamic principles by Lippmann in 1881.
In 1917, Paul Langevin (France) and his coworkers developed an underwater sonar system (called hydrophone) that uses the piezoelectric effect to detect submarines through echo location.
In 1935, the first RADAR system was produced by the British physicist Robert Watson-Wat. Also about 1935, developments began with the objective to use ultrasonic power therapeutically, utilizing its heating and disruptive effects on living tissues. In 1936, Siemens markets the first ultrasonic therapeutic machine, the Sonostat.
Shortly after the World War II, researchers began to explore medical diagnostic capabilities of ultrasound. Karl Theo Dussik (Austria) attempted to locate the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Other researchers try to use ultrasound to detect gallstones, breast masses, and tumors. These first investigations were performed with A-mode.
Shortly after the World War II, researchers in Europe, the United States and Japan began to explore medical diagnostic capabilities of ultrasound. Karl Theo Dussik (Austria) attempted to locate the cerebral ventricles by measuring the transmission of ultrasound beam through the skull. Other researchers, e.g. George Ludwig (United States) tried to use ultrasound to detect gallstones, breast masses, and tumors. This first experimentally investigations were performed with A-mode. Ultrasound pioneers contributed innovations and important discoveries, for example the velocity of sound transmission in animal soft tissues with a mean value of 1540 m/sec (still in use today), and determined values of the optimal scanning frequency of the ultrasound transducer.
In the early 50`s the first B-mode images were obtained. Images were static, without gray-scale information in simple black and white and compound technique. Carl Hellmuth Hertz and Inge Edler (Sweden) made in 1953 the first scan of heart activity. Ian Donald and Colleagues (Scotland) were specialized on obstetric and gynecologic ultrasound research. By continuous development it was possible to study pregnancy and diagnose possible complications.
After about 1960 two-dimensional compound procedures were developed. The applications in obstetric and gynecologic ultrasound boomed worldwide from the mid 60's with both, A-scan and B-scan equipment. In the late 60's B-mode ultrasonography replaced A-mode in wide parts.
In the 70's gray scale imaging became available and with progress of computer technique ultrasonic imaging gets better and faster.
After continuous work, in the 80's fast realtime B-mode gray-scale imaging was developed. Electronic focusing and duplex flow measurements became popular. A wider range of applications were possible.
In the 90's, high resolution scanners with digital beamforming, high transducer frequencies, multi-channel focus and broad-band transducer technology became state of the art. Optimized tissue contrast and improved diagnostic accuracy lead to an important role in breast imaging and cancer detection. Color Doppler and Duplex became available and sensitivity for low flow was continuously improved.
Actually, machines with advanced ultrasound system performance are equipped with realtime compound imaging, tissue harmonic imaging, contrast harmonic imaging, vascular assessment, matrix array transducers, pulse inversion imaging, 3D and 4D ultrasound with panoramic view.

Picture Archiving and Communication System
(PACS) A system used to communicate and archive medical imaging data, mostly images and associated textural data generated in a radiology department, and disseminated throughout the hospital. A PACS is usually based on the DICOM (Digital Imaging and Communications in Medicine) standard.

The main components in the PACS are: acquisition devices where the images are acquired;
short and longer term archives for storage of digital and textural data;
a database and database management;
diagnostic and review workstations;
software to run the system;
a communication network linking the system components;
interfaces with other networks (hospital and radiological information systems).

Acquisition devices, which acquire their data in direct digital format, like a MRI system, are most easily integrated into a PACS.
Short term archives need to have rapid access, such as provided by a RAID (redundant array of independent disks), whereas long term archives need not have such rapid access and can be consigned, e.g. to optical disks or a magnetic.
High speed networks are necessary for rapid transmission of imaging data from the short term archive to the diagnostic workstations. Optical fibre, ATM (asynchronous transfer mode), fast or switched Ethernet, are examples of high speed transmission networks, whereas demographic textural data may be transmitted along conventional Ethernet.
Sophisticated software is a major element in any hospital-wide PACS. The software concepts include: preloading or prefetching of historical images pertinent to current examinations, worklists and folders to subdivide the vast mass of data acquired in a PACS in a form, which is easy and practical to access, default display protocols whereby images are automatically displayed on workstation monitors in a prearranged clinically logical order and format, and protocols radiologists can rapidly report worklists of undictated examinations, using a minimum of computer manipulation.
Radiology Information System
(RIS) Radiology information system means a computer system that stores and processes the information for a radiology department and can be linked to the hospital information system.
The principal purpose of a RIS consists of taking over the general functions of the administration inclusive planning, monitoring and communication of all data regarding patients and its investigations in the radiology. The correct images should reach, at the correct time, the correct users. For this reason the RIS must contain a workflow management in order to simplify and steer the data flow at the individual view stations or devices (laser cameras etc.). The Radiology Information System is optimally complemented with a Picture Archiving and Communication System (PACS).

RIS Tasks:
collection, storage and administration of patient master data;
archives administration;
treatment of requirements;
work scheduling;
account;
communication (with the hospital information system, MRI scanner, other devices etc.);
statistic evaluations.

Siemens Medical Systems
www.siemensmedical.com The range of diagnostics and imaging systems of Siemens Medical Systems covers ultrasound, nuclear medicine, angiography, magnetic resonance , computer tomography and patient monitoring.
In September 2000 Siemens Medical Engineering Group, bought Acuson Corporation (Mountain View, California) for approximately $700 million.


Ultrasound Systems:

Ultrasound Systems (older):
ACUSON 128/128XP
Contact Information
SonoSite, Inc.
www.sonosite.com 'SonoSite, Inc. is the worldwide market and technology leader in high performance, hand-carried ultrasound. Through its expertise in ASIC design, SonoSite is able to offer imaging performance typically found in ultrasound systems weighing more than 300 pounds in a system architecture that is approximately the size and weight of a laptop computer and provides a significant price to performance advantage compared to conventional systems. This breakthrough is transforming and expanding the worldwide diagnostic ultrasound market by serving existing clinical markets more efficiently and creating new point-of-care applications where ultrasound was either too cumbersome or too expensive to be used before. With over 15,000 systems sold since 1999, SonoSite products are known for exceptional performance, ease of use and durability.'

'SonoSite began as a division of ATL Ultrasound in 1997 focused on the development of all-digital, handheld ultrasound devices. In February 1995, the U.S. Defense Advanced Research Project Administration (DARPA) had awarded to ATL a two-year matching grant to develop a highly portable ultrasound device for use on the battlefield or in natural or man-made disasters to diagnose victims of severe trauma. This program culminated with a prototype in October 1998. ATL spun off SonoSite as a public company on April 6, 1998.'

In March 2012 Fujifilm Holdings completes the acquisition of SonoSite.

Ultrasound Systems:
Contact Information
MAIL
SonoSite, Inc.
U.S. Headquarters
21919 30th Drive SE
Bothell, WA 98021-3904
PHONE
+1 425 951 1200
(+1 888 482 9449)
FAX
+1 425 951 1201
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