Ultrasound and Doppler
Basics
Dr. Aarathy Appukuttan
Final year resident
Radiodiagnosis
•
Ultrasound imaging, also called
sonography, involves exposing part
of the body to high- frequency
sound waves to produce images of
the inside of the body.
• Ultrasound
examinations do not
use ionizing radiation (as used in
x-rays).
• Because
ultrasound images are captured in realtime, they can show the structure and movement
of the bodys internal organs, as well as blood
flowing through blood vessels.
•
Ultrasound is the most widely used imaging
technology worldwide
•
Popular due to availability, speed, low cost,
patient-friendliness (no radiation)
•
Applied in obstetrics, cardiology, inner medicine,
urology
• Can
help to diagnose a variety of conditions and
to assess organ damage following illness.
• Is
used to help physicians evaluate symptoms
such as:
•
pain
•
swelling
•
infection
•
hematuria
• heart
and blood vessels
• Liver
• Gallbladder
•
unborn child (fetus) in
pregnant patients
•
Eyes
•
Thyroid and parathyroid
glands• Scrotum
•
brain in infants• hips in
infants
• Spleen
•
Pancreas
•
Kidneys
• Bladder
•
Uterus and ovaries,
• guide
procedures such as needle biopsies, in
which needles are used to extract sample cells
from an abnormal area for laboratory testing.
•
image the breasts and to guide biopsy of breast
cancer
•
diagnose a variety of heart conditions and to
assess damage after a heart attack or diagnose
for valvular heart disease.
Doppler ultrasound images can help the
physician to see and evaluate:
• blockages
to blood flow (such as clots).
•
narrowing of vessels (which may be caused
by plaque).
•
tumors and congenital vascular
malformation
• With
knowledge about the speed and
volume of blood flow gained from a Doppler
ultrasound image, the physician can often
determine whether a patient is a good
candidate for a procedure like angioplasty.
Applications in Obstetrics
• Follow
•
•
fetal development
Detect pathologies
Two-dimensional B-mode Ultrasound image and
3D image of a fetus
Applications in Cardiology
• Blood
flow in vessels
• Contraction,
Rhythm
• Blood
flow in the heart (defects on wall muscle,
valve defects
• Assessment
of cardiac perfusion Prenatal
diagnostic of the Fallot-Tetralogy
Applications in Musculoskeletal System
•
•
Visualisation of tendons, ligaments
Investigations under movement is possible
– simplifies the detection of ruptures,
obstructions
Applications of Ultrasound Elastography
• US
Elastography is often used to classify
tumours.
• Malignant
tumours are 10 to 100 times stiffer
than the normal soft tissue around Elastogram
(of a breast) indication a mass with a high
probability of being malignant tumour
Equipment
•
Ultrasound scanners consist of a
console containing a computer and
electronics, a video display screen
and a transducer that is used to do
the scanning.
• The
transducer is a small hand-held
device that resembles a microphone,
attached to the scanner by a cord.
• The
transducer sends out inaudible high frequency
sound waves into the body and then listens for the
returning echoes from the tissues in the body.
•
The principles are similar to sonar used by boats and
submarines.
• Properties
•
of Ultrasound
The frequencies of medical Ultrasound waves
are several magnitudes higher than theupper
limit of → human hearing.
• The
ultrasound image is immediately visible on a
video display screen that looks like a computer or
television monitor.
•
The image is created based on the amplitude
(strength), frequency and time it takes for the
sound signal to return from the area of the
patient being examined to the transducer and the
type of body structure the sound travels through.
• How
•
•
is the procedure performed?
For most ultrasound exams, the patient is
positioned lying face-up on an examination table
that can be tilted or moved.
A clear water-based gel is applied to the
area of the body being studied
•
To help the transducer make secure
contact with the body and eliminate air
pockets between the transducer and
• The
skin that can block the sound waves
from passing into your body.
• The
sonographer (ultrasound technologist) or
radiologist then presses the transducer firmly
against the skin in various locations, sweeping
over the area of interest or angling the sound
beam from a farther location to better see an
area of concern.
Doppler
• Doppler
ultrasound, a special application of
ultrasound, measures the direction and speed of blood
cells as they move through vessels.
•
The movement of blood cells causes a change in pitch
of the reflected sound waves (called the Doppler
effect).
•A
computer collects and processes the sounds and
creates graphs or color pictures that represent the
flow of blood through the blood vessels.
• the
Doppler effect is used to measure blood flow
velocity.
• Ultrasound
reflected from red blood cells will
change in frequency according to the blood flow
velocity.
•
When direction of blood flow is towards the
transducer, the echoes from blood reflected back
to the transducer will have a higher frequency
than the one emitted from the transducer.
• When
the direction is away from the transducer,
the echoes will have a lower frequency than those
emitted.
• The
difference in frequency between transmitted
and received echoes is called the Doppler
frequency shift, and this shift in frequency is
proportional to the blood flow velocity.
•
DOPPLER FREQUENCY SHIFT
•
The Doppler shift is the difference between the incident
frequency and reflected frequency.
•
When the reflector is moving directly away from or
toward the source of sound, the Doppler frequency shift
(fd) is calculated as where fI is the frequency of the sound
incident on the reflector and fr is the frequency of the
reflected sound.
•
Thus, the Doppler shift is proportional to the velocity of
the blood cells.
• TYPES
• 1.
•
OF DOPPLER OPERATION
Continuous wave Doppler
2. Pulsed wave doppler
• 3.
Duplex scanning
• 4.
Color flow doppler imaging
•
5. Power dopple
What are the benefits ?
•
•
Most ultrasound scanning is noninvasive (no
needles or injections) and is usually painless.
widely available, easy-to-use and less
expensive than other imaging methods.
• does
•
not use any ionizing radiation.
• Gives
a clear picture of soft tissues that do not
show up well on x-ray images.
•
The preferred imaging modality for the
diagnosis and monitoring of pregnant women and
their unborn babies.
•
Provides real-time imaging, making it a good
tool for guiding minimally invasive procedures
such as needle biopsies and needle aspiration
Limitations
•
Ultrasound waves are disrupted by air or gas;
•
Therefore ultrasound is not an ideal imaging
technique for air-filled bowel or organs obscured by
the bowel.
•
In most cases, barium exams, CT scanning, and MRI
are the methods of choice in this setting.
•
• Large
patients are more difficult to image by usg
because greater amounts of tissue attenuates
(weakens) the sound waves as they pass deeper
into the body.
•
Usg has difficulty penetrating bone and,
therefore, can only see the outer surface of bony
structures and not what lies within (except in
infants).
• For
visualizing internal structure of bones or
certain joints, other imaging modalities such as
MRI are typically used.
THANK YOU