Unit I Ch. 1 PPS

INTRODCUCTION & HISTORY OF SONOGRAPHY Unit I Ch.
Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.
History of Acoustics -The Beginning

Middle Ages
Pythagoras (550 BC)
Observed relationship between pitch and frequency. Invented the sonometer to study musical sounds.
Archytas of Tarentum (428-347 BC)

Observed that pitch is related to movement of vibrating air.
Aristotle (384- 322 BC)

Developed the theory that sound is carried to the ears by the movement of air.
Boethius (480-524 AD)

1st to compare sound waves with waves produced by dropping a pebble into water.
Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc. 3
History of Acoustics -15 to 1600s

15th & 16th Centuries
Leonardo Da Vinci in 1500
Determined that sound travels in waves. Wrote Book on The Theory of sound. Discovered that the angle of reflection is = to the angle of incidence. Determined that the frequency of sound determines the pitch.
Galileo in 1638 Robert Boyle in 1660
Popularized the theory of the elasticity of air Provided evidence that air is necessary for either the production or transmission of sound
History of Acoustics -15 to 1600s

15th & 16th Centuries
Sir Isaac Newton in 1668
Experimented with demonstrating the speed of sound. Velocity Theory: sound-pressure pulses transmitted through fluid experimented with speed of sound.
Christiaan Huygens in 1687

Argued Newton's theory that light consists of waves. Huygens's Principle explained that miniature wavelets combined to form a wave front. Derived the laws of reflection and refraction.
History of Acoustics 17 to 1800s

18th Century
Lazzaro Spallanzani in 1793
1st Experiment with Ultrasound on the activity with bats Observed that bats function efficiently in the dark, and theorized that they could hear something he could not.
Augustin Fresnel 1818

Established the theory of wave diffraction: That light waves had the same frequency as the original wave known as the Huygens-Fresnel Principle.
Christian Doppler in 1842

Investigated the effect of motion on the pitch of sounds Formulated the principal known as the Doppler Effect
Lord Rayleigh (1842-1919)

Published The Theory of Sound: The mechanics of a vibrating medium that produces sound (volume 1) & acoustic wave propagation (volume 2)
The Nature of Ultrasound What is Ultrasound/Sonography?

Ultrasound Is a range of
sound where sound waves vibrate at a frequency of greater than 20,000 Hertz (Hz) or 20 kHz. Above or beyond the range of normal hearing (Human). It is Non-Audible. Ultra = Above
Sonography
The mechanical application of ultrasound energy (sound waves) specific to medical imaging. The source of energy production is the transducer. Applications can be diagnostic or therapeutic. Ultrasound is commonly used to describe the modality but the preferred word is Sonography
The Nature of Ultrasound What is Ultrasound/Sonography?

Ultrasonography
Is The process of using high frequency low intensity (energy) sound waves to image and visualize body structures for the use of diagnostic purposes. Focused high-energy ultrasound waves are used for therapeutic ultrasound to remove unwanted tissue. or Sonographer You guessed right. Its you the professional doing the exam.
Ultrasonographer
Echocardiographer
A sonographer who is skilled in doing cardiac ultrasound exams.
Nature of Ultrasound 17 to 1800s

1880-1883 Jacque and Pierre Curie
Piezoelectric Effect: where crystals expand and contract in an alternating electrical field. (Brothers)
Reverse Piezoelectricity: The same crystal creates an electric potential to be a receiver and the source of sound waves. Their accomplishments ultimately led to the development of modern day ultrasound transducers.
Pierre Curie (1859-1906), Nobel Prize in Physics, 1903
Jacques Curie (1856-1941)

http://www.wcume.org/wp-content/uploads/2011/05/Tsung.pdf Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.
Nature of Ultrasound In The 19th Century

35 years later
1917 Langevin & Chilowsky
Both used the property of echoing sound waves to detect underwater objects (hydrophone) Discovered the harmful effects of ultrasound known as biological effects. Used Piezoelectricity. Sonar detection was born.
http://www.wcume.org/wp-content/uploads/2011/05/Tsung.pdf
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Medical Applications of Ultrasound In The 19th Century

Ultrasound was being used for:
Industrial Applications
To detect flaws in metals.
Medical Applications 20s & 30s

Began in the early 1920s & 30s For Physical Therapy, Sterilization of vaccines and Cancer therapy.
Medical Applications 1940s

Dussik in 1942 Developed A-Mode imaging of the brain
Was the 1st Physician to use diagnostic medical ultrasound.
Ludwig in 1947 Use of ultrasound diagnose gallstones. Wild Was 1st to use ultrasound to detect tissue thickness.

Dussik in 1942 Developed A-Mode imaging of the brain.
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Ludwig in 1947 Use of ultrasound diagnose for gallstones.
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Medical Applications of Ultrasound The 19th Century Bi-Stable Years

Howry in 1947-49
Developed B-Mode Beginning of Bi-Stable Imaging 1st Bi-Stable (B-Mode) Scanner - Somascope Water-Path B-Mode Scanner Cattle Tank
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Somascope 1st Bi-Stable (B-Mode) Scanner
http://www.ob-ultrasound.net/posakony_notes.html
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Cattle Tank Bi-Stable (B-Mode) Water Path Scanner
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Medical Applications of Ultrasound In The 1950s Bi-Stable Years
Wolf D. Kiedel
Was the first to use ultrasound on the heart.
Recorded first moving pictures of the heart. Employed A & B-Mode techniques, added a moving display = M-Mode Considered the Fathers of Echocardiography Recognized and confirmed M-Mode pattern of anterior leaflet of the mitral valve while using 2D.
Inge Edler and Hellmuth Hertz in 1953
Joyner, Reid, Howry & Holmes Howry
Collaborated on building echocardiography equipment

1953 - B-29 Gun Turret Water-Path (B-Mode) Scanner 1957- Water Bath (B-Mode) Pan Scanner
Early M-Mode of the Mitral Valve

Left, Normal mitral valve patterns. Right, An abnormal, flat-topped stenotic mitral valve pattern.
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B-29 Gun Turret Bi-Stable 1953 (B-Mode) Water Bath Scanner
http://www.ob-ultrasound.net/posakony_notes.html
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Water Bath B-Mode 1957 Pan Scanner
http://www.ob-ultrasound.net/posakony_notes.html Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.
20
Bi-Stable Imaging Years -1960s

The most important pioneering contributions In B-Mode Imaging was in 1962
Howry Developed the Compound Contact Scanner Holmes and Wright Developed the Porta-Arm Scanner The 1st commercial portable ultrasound system Considered most seminal pioneering contribution in B-Mode imaging and contact scanning Precursor to imaging systems used today
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Bi-Stable 2-D (B-Mode) Pulsed Echo First Compound Contact Scanner
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Bi-Stable Porta-Arm Scanner
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Bi-Stable Imaging Years 1960s

Scientists studied Bi-Stable imaging to enhance clinical diagnosis and to change limitations of Bi-Stable Imaging

Cumbersome equipment assembly. Failure to demonstrate subtle soft tissue differences Use of water submerging patients for testing
Areas studied: adult polycystic kidney disease, liver transplantation, visualization of the placenta, diagnosis of fetal death in utero, midline brain shifts in workers exposed to industrial toxins, and A-mode investigations of the heart.
William Fry High-intensity ultrasonic, noninvasive surgical

techniques Francis Fry developed a computer-based low-intensity unit for soft-tissue visualization to study the use of ultrasound in the detection of breast cancer
Bi-Stable Years -1960s Early Research on US Safety

Extensive experiments were conducted on human cells and rats. English & Japanese investigators report no ill effects at low-intensity levels in humans
First guidelines on biological safety were published from the AIUM.
25
Grayscale Revolution 1970s

Kossoff & Garrett
2D Echo Grayscale Imaging was introduced. On-screen measuring calipers were added. Analog scan converter systems were used. 1975 - Octoson multi-transducer scanner was one of the first machines made with the new technology Digital converters replaced analog converters capable of producing 64 shades of gray
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Octoson - Gray-Scale Imager

Ausonics UI Octoson, the first commercially available gray-scale imager.
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Early Gray-Scale Scan

Early Octoson gray-scale scan of a breast cyst.
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Comparison Bi-Stable (B-Mode) Images to Early Gray-Scale Images

A, Bi-stable, compound-contact B-scan pregnant abdomen made with the Diasonograph, circa 1960s. B, Gray-scale scan of the fetal trunk and placenta circa early 1980s.
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The Doppler Revolution

Baker & Watkins -1970

developed the first pulsed Doppler unit.
Baker, Rushmer, & Franklin 1974

designed 1st pulsed wave scanner capable of combining 2-D Grayscale with Doppler now able to visualize placement of Doppler for acquisition
1975 - updates to provide color-coded velocity

waveforms and flow images superimposed on M-Mode and 2D Grayscale images
Strandnessdeveloped noninvasive measuring of the peripheral vascular system; his 1967 publication assigned particular waveforms to specific disease conditions.
1st Pulsed-Doppler System
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The Real-Time Revolution 1970s

Krause & Soldner
Real-Time Imaging was born - Moving ultrasound images with the Fast B-Scanner Vidoson the Vidoson had a rotating transducer, produced 15 images/sec with 120 lines of site = good image resolution in a basic gray format.
Martin Wilcox -1973 Compact linear array real-time
scanner - Perfected transducer focusing -set the standard for subsequent designs. Griffith & Henry produced a mechanical oscillating real-time scanner advanced the development of echocardiography. 1975 Newer units used focusing techniques. Invasive procedures such as amniocentesis, and peracentisis gained acceptance with the use of real-time.
Real-time - Images produced by automated scanners with

sufficient speed to visualize and record moving structures.
Linear-Array Real-Time Ultrasound System
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Era of Transducer Technology 1980s

1980s Real-time scanners Were more sophisticated offered curvilinear (convex) transducers, with high-speed digital electronics
Transducer crystal technology yielded broadband capabilities, increased arrays, faster computation times, increased # of focal zones, and automatic time-gain controls. Replaced larger linear arrays - mass conversion from static to real-time was in place by 1985. Improved resolution allowed use of ultrasound in other medical specialties - biggest impact was in OB imaging. Vascular Sonography became standard diagnostic tool due to CW ultrasound provided rapid imaging of the peripheral vasculature 1987
IVUS- Intravascular used ultrasound to investigate coronary artery atherosclerosis.

Early Doppler Studies Using Diasonics 400

An ulcerated carotid plaque obtained using a 7.5-MHz mechanical sector scanner.
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Early Doppler Studies Using the Diasonics 400

Normal Doppler analysis of the carotid artery.
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Early Doppler Studies Using the Diasonics 400

Aliased Doppler spectrum.
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Tissue Harmonic Imaging 1990s

1990s Doppler instrumentation was incorporated into most US systems Harmonic imaging is a quantitative method of distinguishing different types of tissue. Provides additional information about the soft tissue structures being insonated.
Harmonic Doppler ultrasound used to: Improve detection of flow in small vessels by enhancing the Doppler signal from blood - suppressing the echoes from surrounding tissue. Mass differentiation
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Harmonic Imaging
Acoustic emission effect after IV injection of contrast material.
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Sonograhpy - The 21st Century
Three-dimensional (3D) & four-dimensional (4D) US
Musculoskeletal ultrasound (MSUS) imaging used for

examining superficial soft-tissue pathology.
Hand-carried units (HCU) are compact ultrasound systems weighing less than 10 pounds.
Focused Assessment by Sonography in Trauma (FAST)time-sensitive diagnosis of potentially lifethreatening bleeding Transcranial Doppler (TCD)evaluates blood as it flows through the brain. Interventional Ultrasound Applications for the treatment of fluid collections, inflammatory diseases, benign/malignant tumors Interventional echocardiography Interventional pain management: Tumor biopsies
3D Ultrasound Imaging
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3D Ultrasound Imaging
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MSUS Imaging
A, Intramuscular hematoma. B, Comparison of normal and injured tendon.
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MSUS Imaging
C, Tenosynovitis of the extensor tendons of the hand. D, Halo effect.
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MSUS Imaging
EFOV image of the Achilles tendon.
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Hand-Carried Units
The SonoSite M-Turbo
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Hand-Carried Units
General Electrics V-scan
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Sonography The 21st Century

Contrast-Enhanced Ultrasound
Molecular imaging achieved by increasing the reflection of ultrasonic echoes and improving the signal-to-noise ratio. Contrast agents consist of gas microbubble solutions or solid particles suspended in solutions or emulsions within a thin shell. Contrast can be administered before ultrasound-guided ablation procedures. Post-treatment contrast-enhanced scans can reveal any areas missed during the ablation or sites where the tumor is regrowing. High-Intensity Focused Ultrasound (HIFU) Acoustic Radiation Force Impulse (ARFI) Elastography detects tumors dense, fibrous tissue that grows around malignant tumors.
A, Mass (arrows) in the right posterior lobe of the liver having mixed echogenicity. B, Hepatic artery and portal veins filled with contrast (arrowheads).
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C, On delayed imaging the lesion was hypoechoic compared with the surrounding liver tissue.
Elastography
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The Future of Ultrasound

Ergonomics Patient-focused care Merging ultrasound probes with smart phones
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Homework Assignment
Read Ch. 2 & 3 pgs. 31-64

Review for Unit I Quiz - Tuesday June 12th
53

Unit I Ch. 1 PPS

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INTRODCUCTION & HISTORY OF SONOGRAPHY Unit I Ch.

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

History of Acoustics -The Beginning

Archytas of Tarentum (428-347 BC)

Aristotle (384- 322 BC)

Boethius (480-524 AD)

History of Acoustics -15 to 1600s

Galileo in 1638 Robert Boyle in 1660

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

History of Acoustics -15 to 1600s

Christiaan Huygens in 1687

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

History of Acoustics 17 to 1800s

Augustin Fresnel 1818

Christian Doppler in 1842

Lord Rayleigh (1842-1919)

The Nature of Ultrasound What is Ultrasound/Sonography?

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

The Nature of Ultrasound What is Ultrasound/Sonography?

A sonographer who is skilled in doing cardiac ultrasound exams.

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Nature of Ultrasound 17 to 1800s

Pierre Curie (1859-1906), Nobel Prize in Physics, 1903

Jacques Curie (1856-1941)

Nature of Ultrasound In The 19th Century

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Medical Applications of Ultrasound In The 19th Century

Medical Applications 20s & 30s

Medical Applications 1940s

Medical Applications of Ultrasound In The 19th Century

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Medical Applications of Ultrasound In The 19th Century

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Medical Applications of Ultrasound The 19th Century Bi-Stable Years

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Somascope 1st Bi-Stable (B-Mode) Scanner

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Cattle Tank Bi-Stable (B-Mode) Water Path Scanner

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Medical Applications of Ultrasound In The 1950s Bi-Stable Years

Inge Edler and Hellmuth Hertz in 1953

Joyner, Reid, Howry & Holmes Howry

Collaborated on building echocardiography equipment

Early M-Mode of the Mitral Valve

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

B-29 Gun Turret Bi-Stable 1953 (B-Mode) Water Bath Scanner

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Water Bath B-Mode 1957 Pan Scanner

http://www.ob-ultrasound.net/posakony_notes.html Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Bi-Stable Imaging Years -1960s

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Bi-Stable 2-D (B-Mode) Pulsed Echo First Compound Contact Scanner

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Bi-Stable Porta-Arm Scanner

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Bi-Stable Imaging Years 1960s

William Fry High-intensity ultrasonic, noninvasive surgical

Bi-Stable Years -1960s Early Research on US Safety

First guidelines on biological safety were published from the AIUM.

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Grayscale Revolution 1970s

Copyright 2013, 2006, 1993 by Saunders, an imprint of Elsevier Inc.

Octoson - Gray-Scale Imager