(IVUS) For intravascular ultrasound a small IVUS catheter with a probe is introduced into the artery. The transducer transmits and receives acoustic energy through this catheter. The reflected acoustic energy is used to build a picture of the inside of the vessel. A IVUS image consists of three layers around the lumen, the intima, media and adventitia.
In addition, elastography or palpography could be used to evaluate the local mechanical properties of tissues (e.g. lipid pools in high-risk vulnerable atherosclerotic plaques). These techniques use the deformation caused by the intraluminal pressure generated by the probe.
A high strain region at the lumen vessel wall boundary has 88% sensitivity and 89% specificity for identifying vulnerable plaques. There are high strain values of 1% in soft plaques with increased strain up to 2% at the shoulders of the plaque, while calcified material shows low strain values (0-0.2%). The radial strain in the tissue is obtained by cross-correlation techniques on the radio frequency signal. The strain is color-coded and plotted as a complimentary image to the intravascular ultrasound echogram.

See also Interventional Ultrasound, Vascular Ultrasound.

(TRUS) Transrectal sonography (also called transrectal ultrasonography, transrectal echography (TRE), endorectal ultrasound (ERUS or EUS)) is an ultrasound procedure used to examine the prostate gland, the rectum or bladder.
A small, lubricated transducer placed into the rectum releases sound waves, which create echoes as they enter the region of interest. A computer creates a picture called a sonogram.
TRUS is commonly used for guidance during a prostate needle biopsy and may be used to deliver brachytherapy and monitor cancer treatment. Transrectal ultrasonography detects enlargement, tumors and other abnormalities of the prostate, rectal polyps, rectal cancer, perianal infection, and sphincter muscle injuries. TRUS is also performed on male patients with infertility to view the prostate and surrounding structures and on patients with suspected bladder conditions or disease to view the bladder.

See also Transurethral Sonography, Endoscopic Ultrasound, Pelvic Ultrasound, Rectal Probe, Biplane Probe, Endocavitary Echography and High Intensity Focused Ultrasound.

As far as ultrasound is concerned, 4D ultrasound (also referred to as live 3D ultrasound or 4B-mode) is the latest ultrasound technology - the fourth dimension means length, width, and depth over time. 4D Ultrasound takes 3D ultrasound images and adds the element of time to the progress so that a moving three-dimensional image is seen on the monitor. A 4D scan takes the same amounts of time as a 2D or 3D scan; the difference is the ultrasound equipment being used. One advantage of a 4D fetal ultrasound to a 2D-mode is that parents can see how their baby will generally look like. However, there are different opinions over the medical advantages.
To scan a 3D ultrasound image, the probe is swept over the maternal abdomen. A computer takes multiple images and renders the 3D picture. With 4D imaging, the computer takes the images as multiple pictures while the probe is hold still and a 3D image is simultaneously rendered in real time on a monitor.
In most cases, the standard 2D ultrasound is taken, and then the 3D/4D scan capability is added if an abnormality is detected or suspected. The 3D/4D sonogram is then focused on a specific area, to provide the details needed to assess and diagnose a suspected problem. A quick 4D scan of the face of the fetus may be performed at the end of a routine exam, providing the parents with a photo.
See also Obstetric and Gynecologic Ultrasound, Pregnancy Ultrasound, Fetal Ultrasound and Abdominal Ultrasound.

As far as ultrasound is concerned, 4D ultrasound (also referred to as live 3D ultrasound or 4B-mode) is the latest ultrasound technology - the fourth dimension means length, width, and depth over time. 4D Ultrasound takes 3D ultrasound images and adds the element of time to the progress so that a moving three-dimensional image is seen on the monitor. A 4D scan takes the same amounts of time as a 2D or 3D scan; the difference is the ultrasound equipment being used. One advantage of a 4D fetal ultrasound to a 2D-mode is that parents can see how their baby will generally look like. However, there are different opinions over the medical advantages.
To scan a 3D ultrasound image, the probe is swept over the maternal abdomen. A computer takes multiple images and renders the 3D picture. With 4D imaging, the computer takes the images as multiple pictures while the probe is hold still and a 3D image is simultaneously rendered in real time on a monitor.
In most cases, the standard 2D ultrasound is taken, and then the 3D/4D scan capability is added if an abnormality is detected or suspected. The 3D/4D sonogram is then focused on a specific area, to provide the details needed to assess and diagnose a suspected problem. A quick 4D scan of the face of the fetus may be performed at the end of a routine exam, providing the parents with a photo.

Gray scale [also grayscale, grey scale = brit.] produces basically black and white images with series of shades of gray. Solid areas appear white and fluid areas appear black, varying from black at the weakest intensity to white at the strongest. Gray scale resolves artifacts as small as 1 mm. The display is made by transmitting bursts of energy and analyzing the returning signal. Gray scale pictures are limited to the gray scale tones; color pictures display more information because the color is added to the gray scale.
Most ultrasound contrast agents also improve gray scale visualization of the flowing blood to such a degree that the tissue echogenicity increases. Gray scale enhancement of flow in an organ promises to improve lesion detection, along with the ability to differentiate between normal and abnormal areas, using many of the criteria already routinely used in CT and MRI.

See also Compress, Densitometry, Triplex Exam and QB-Mode.