Medical Ultrasound Imaging
Wednesday, 8 May 2024
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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. •
Interventional ultrasound, also known as ultrasonography, encompasses a range of invasive or surgical procedures guided by ultrasound imaging. While its widest application lies in intravascular ultrasound imaging for measuring atherosclerotic plaque, it has proven valuable in various medical fields. In urology, ultrasound-guided interventions are employed for treatments like high intensity focused ultrasound (HIFU) in prostate conditions. The precise imaging provided by ultrasound aids in targeting the affected area and delivering therapeutic energy effectively. In intraabdominal conditions, endoscopic ultrasound is frequently utilized. This technique combines ultrasound imaging with an endoscope to visualize and evaluate structures within the gastrointestinal tract, allowing for precise diagnoses and targeted interventions. Ultrasound-guided procedures play a significant role in several medical specialties, including liver sonography, obstetric and gynecologic ultrasound, and thyroid ultrasound. These procedures involve interventions such as RF thermal ablation or biopsies, which are guided by real-time ultrasound imaging. For instance, in liver sonography, ultrasound guidance is crucial for performing biopsies or RF thermal ablation, a technique used to treat liver tumors by delivering localized heat to destroy the abnormal tissue. The real-time imaging allows for precise needle placement and monitoring during the procedure. In obstetric and gynecologic ultrasound, ultrasound-guided procedures, such as biopsies, can be performed to obtain tissue samples for diagnostic purposes. Additionally, ultrasound guidance is valuable during interventions like amniocentesis or fetal blood sampling, enabling accurate and safe procedures. Thyroid ultrasound procedures often involve ultrasound-guided fine-needle aspiration biopsy (FNAB), which allows for the sampling of thyroid nodules for cytological examination. The ultrasound image helps guide the needle into the targeted area, ensuring accurate sampling and minimizing potential complications. Overall, ultrasound-guided interventions provide minimally invasive and precise approaches to diagnosis and treatment. The real-time imaging capabilities of ultrasound contribute to enhanced accuracy, safety, and patient outcomes in procedures like biopsies, injections, and drainage. See also Transurethral Sonography, Endocavitary Echography, and B-Mode Acquisition and Targeting. •
Solid regions have internal ultrasound echoes and are classified as echo poor, hypoechoic or hypoechogenic if there are few internal echoes.
Hypoechoic structures appear dark in ultrasound imaging, more homogeneous structures are darker than heterogeneous. Soft atherosclerotic plaque, liver adenoma or FNH appear with a nodular hypoechogenicity. As metastases close the blood vessels they infiltrate, tumor tissues become hypoechogenic after injection of contrast agent. Muscle appears relatively hypoechoic to tendon fibers, also articular hyaline cartilage appears hypoechoic. •
Sonography [aka: ultrasonography] is a term that encompasses the entire process of performing ultrasound examinations and interpreting the obtained images. Sonography involves the skilled application of ultrasound technology by trained professionals known as sonographers or ultrasound technologists. These specialists operate the ultrasound equipment, manipulate the transducer, and acquire the necessary pictures for diagnostic imaging purposes. Sonography requires in-depth knowledge of anatomy, physiology, and pathology to accurately interpret the ultrasound images and provide valuable information to the treating physician. Sonography uses equipment that generates high frequency sound waves to produce images from muscles, soft tissues, fluid collections, and vascular structures of the human body. Obstetric sonography is commonly used during pregnancy. Sonography visualizes anatomy, function, and pathology of for example gallbladder, kidneys, pancreas, spleen, liver, uterus, ovaries, urinary bladder, eye, thyroid, breast, aorta, veins and arteries in the extremities, carotid arteries in the neck, as well as the heart. A typical medical ultrasound machine, usually a real-time scanner, operates in the frequency range of 2 to 13 megahertz. See also Musculoskeletal and Joint Ultrasound, Pediatric Ultrasound, Cerebrovascular Ultrasonography and Contrast Enhanced Ultrasound.  Further Reading: Basics:
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Targeted ultrasound contrast agents provide advantages compared with usual microbubble blood pool agents. The goal of targeted ultrasound contrast agents is to significantly and selectively enhance the detection of a targeted vascular site. Tissue-specific ultrasound contrast agents improve the image contrast resolution through differential uptake. Targeted drug delivery via contrast microbubbles is another contrast media concept and provides the potential for earlier detection and characterization of disease. Targeted contrast imaging provides a higher sensitivity and specificity than obtained with a nontargeted contrast agent. The detection of disease-indicative molecular signatures may allow early assessment of pathology on a molecular level. Molecular imaging should be an efficient and less invasive technique to obtain three-dimensional localization of pathology. Ultrasound agents typically remain within the vascular space, and therefore possible targets include molecular markers on thrombus, endothelial cells, and leukocytes. Targeted contrast agents permit noninvasive detection of thrombus, cancer, inflammation, or other sites where specific integrins or other adhesion molecules are expressed. Adhesion molecules such as monoclonal antibodies, peptides, asialoglycoproteins, or polysaccharides are incorporated into the shell of the microbubble or liposome. After injection into the bloodstream, the targeted agent accumulates via adhesion receptors at the affected site, enhancing detection with an ultrasound system. See also Acoustically Active Lipospheres, and Tissue-Specific Ultrasound Contrast Agent. Further Reading: News & More:
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