Quality Control of Ultrasound
Lecture 4
Ultrasound Imaging
Medical Ultrasound
Introduction
SOUND
Sound is the perception of vibrations stimulating
the ear .
ULTRASOUND
Ultrasound is a non-ionizing waves which uses
sound waves of frequencies over 20,000 Hz,
which is about the upper limit of human hearing(
20-20,000Hz).
Introduction
ULTRASONOGRAPHY
Medical imaging technique that uses high ultrasound
pulses and their echoes to delineate objects or areas
of different density in the body.
Ultrasound is an oscillating sound pressure wave with a
frequency greater than the upper limit of the human
hearing range.
Diagnostic sonography (ultrasonography) is an ultrasound-
based diagnostic imaging technique used for visualizing
internal body structures including tendons, muscles, joints,
vessels and internal organs for possible pathology or lesions.
The practice of examining pregnant women using ultrasound
is called obstetric sonography, and is widely used.
Compared to other prominent methods of medical
imaging, ultrasonography has several advantages:
It provides images in real-time (rather than after an
acquisition or processing delay)
It is portable and can be brought to a sick patient's
bedside
It is substantially lower in cost
It does not use harmful ionizing radiation.
Drawbacks of ultrasonography include:
difficulty imaging structures behind bone and air
Its relative dependence on a skilled operator.
Typical diagnostic sonographic scanners operate in
the frequency range of 1 to 18 megahertz, though
frequencies up to 50–100 megahertz
The choice of frequency is a trade-off between
spatial resolution of the image and imaging depth:
lower frequencies produce less resolution but
image deeper into the body.
Higher frequency sound waves increase image
resolution but limited depth of penetration of the
sound wave into the body
Production of Sound Wave
A sound wave is typically produced by a piezoelectric
transducer encased in a plastic housing. Strong, short
electrical pulses from the ultrasound machine drive
the transducer at the desired frequency.
Newer technology transducers use phased array
techniques to enable the ultrasound machine to
change the direction and depth of focus.
The sound is focused either by the shape of the
transducer, a lens in front of the transducer, or a
complex set of control pulses from the ultrasound
scanner (Beamforming).
Receiving the Echo
• The return of the sound wave to the transducer
results in the same process that it took to send
the sound wave, except in reverse.
• The return sound wave vibrates the transducer,
the transducer turns the vibrations into
electrical pulses that travel to the ultrasonic
scanner where they are processed and
transformed into a digital image.
Forming the Image
To make an image, the ultrasound scanner must
determine two things from each received echo:
How long it took the echo to be received from
when the sound was transmitted.
How strong the echo was.
Once the ultrasonic scanner determines these
two things, it can locate which pixel in the
image to light up and to what intensity.
Ultrasound transducers
Ultrasound transducers are probes containing
the collection of piezoelectric elements used for
ultrasound transmission .
It generates and receives sound waves using a
principle called the piezoelectric (pressure
electricity) effect.
The crystal transducer head convert electrical
energy into strong vibratory sound waves.
Electronic Transducer
Ultrasound - Working Principle
The ultrasound machine transmits sound pulses into your body
using a probe.
The sound waves travel in and hit a boundary between tissues .
Some of the sound waves get reflected back to the probe, while
some travel on further until they reach another boundary and
get reflected.
The reflected waves are picked up by the probe and relayed to
the machine.
The machine calculates the distance from the probe to the tissue
or organ using the speed of sound in tissue and the time of the
each echo's return.
The machine displays the distances and intensities of the echoes
on the screen, forming a image.
US imaging modes
Several modes of ultrasound are used in medical imaging:
A-mode: A-mode (amplitude mode) is the simplest type of
ultrasound. A single transducer scans a line through the body
with the echoes plotted on screen as a function of depth.
B-mode or 2D mode: In B-mode (brightness mode)
ultrasound, a linear array of transducers
simultaneously scans a plane through the body that
can be viewed as a two-dimensional image on screen.
C-mode: A C-mode image is formed in a plane normal to a B-
mode image. A gate that selects data from a specific depth from
an A-mode line is used; then the transducer is moved in the 2D
plane to sample the entire region at this fixed depth. When the
transducer traverses the area in a spiral, an area of 100 cm2 can
be scanned in around 10 seconds.
M-mode: In M-mode (motion mode) ultrasound, pulses are emitted in
quick succession – each time, either an A-mode or B-mode image is
taken. Over time, this is analogous to recording a video in ultrasound. As
the organ boundaries that produce reflections move relative to the
probe, this can be used to determine the velocity of specific organ
structures.
• Doppler mode: This mode makes use of the
Doppler effect in measuring and visualizing
blood flow
4D Ultrasound •
Ultrasound Machine - Components
Central Processing Unit
Transducer Pulse Control
Display
Keyboard
Disk Storage
Quality Control of Ultrasound
equipment
Types of QC tests
Acceptance testing
Routine performance evaluations
Error correction tests
Acceptance testing
Is performed on new equipment to demonstrate
that it is performed within the manufactures’
specifications and criteria.
Acceptance testing consists of measuring
electromechanical performance, analyzing image
performance and evaluating the system component
Acceptance testing
The results obtained during acceptance testing
are also used to establish the baseline
performance of the equipment that is used as a
reference point in future QC testing.
Routine performance evaluations
Are specific tests performed on the equipment in
use after a certain time has elapsed. These
evaluations can verify that equipment is
performing within previously accepted standards
and can be used to diagnose any changes in
performance before becoming apparent.
Error correction tests
Evaluate equipment that is malfunctioning or
not performing at specification and are also
used to verify the correct causes of the
malfunction so that the proper repair can be
made.
Phantoms used in ultrasound equipment
Tissue-Mimicking Phantom
Is a device that mimics soft tissues in its ultrasound
waves transmission characteristics (speed,
attenuation etc..)
The tissue mimicking material consist of a water-
based gelatin mixed with microscopic graphite
particles. to measure the distance
Phantoms used in ultrasound equipment
Phantoms have targets in known positions for image to
measure the distance.
1. Water-based gels loose water and air might enter
thus rendering it ineffective therefore, keep in a
humid air-tight container
2. Rubber-based phantom solve the problem partially
Can be stored in an open environment
Rubber-based tissue mimicking phantom
Quality Control Tests
1. Transducer choice
2. System sensitivity
3. Photography and gray-scale hard copy
4. Routine image checks
5. Scan uniformity
6. Distance measurement
7. spatial resolution
8. Doppler testing
9. Doppler flow phantom
10. Documentation
Transducer choice
Standardized transducer is selected record its
identifications future tests must be done with
the same transducer
System sensitivity
It refers to echo signal level that can be detected
Achieved by controls that vary output and
amplify the received signals (gain)
The maximum sensitivity is limited by electrical
noise (e.g. from computer terminals)
Variations may be due to transducer damaged
cables or electronic drift
Commonly used in measuring maximum depth of
visualization
Results should be within 1 cm
Maximum depth of visualization
A- max. depth is 15.2 cm (4MHz)
B- max. depth is 16.8 cm (3.5 MHz)
C- max. depth cannot be determined
because it is good all the )MHz 2.5(
way down to the bottom of the
phantom
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Routine image check
Should be performed weekly
To ascertain that the brightness variations are
recorded
The gray bar pattern should appear on the edge
Verify with the image taken recently
Scan Image Uniformity
If the unit gain settings are adjusted properly
the image should be uniform
Deviation may be due to:-
1. Bad probe elements
2. Inadequate compensation
3. Inadequate blending of pixel data
Image uniformity tests
. .
Good uniformity
Problematic transducer
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Distance measurement
Done periodically
Distance indicator include 1-cm depth marker
Two measurements are executed:-
1. Vertical
2. Horizontal
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Vertical distance
Steps:
Ensure that the reflectors are clearly imaged
Use the caliper to measure the distance
between each two reflectors
Accuracy must be within 1 mm
Vertical distance measurement. The caliper
reading 9.9 mm compare to 10 mm
Horizontal Distance
Similar to the vertical accuracy
Should agree with the manufacturers i.e.
within 3 mm
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Horizontal distance measurements. The caliper reading is
30.5 mm compare to the actual 30 mm
