ULTRASOUND in MEDICINE

Human ears respond to sound in the

frequency range of about 20 to 20000 Hz,
medical engineers developed techniques for
using ultrasound for diagnosis. Basically, an
ultrasound source sends a beam of pulses
of 1 to 5 MHz sound into the body. The time
required for the sound pulses to be
reflected gives information on the distances
to the various structures or organs in the
path of the ultrasound beam.
 There are several methods of
generating ultrasound. The most
important for medical applications
involves the piezoelectric effect. Many
crystals can be cut so that on oscillating
voltage across the crystals will produce
a similar vibration of the crystal, thus
generating a sound wave.
A device that converts electrical energy to
mechanical energy or vice versa is called
transducer. Each transducer has a natural
resonant frequency of vibration. The thinner
the crystal, the higher the frequency at
which it will oscillate. For a quartz crystal
cut long a certain axis ( X – cut), a thickness
of 2.85 mm gives a resonant frequency of
about 1 MHz. Typical frequencies for
medical work are in the 1 to 5 MHz range.
Pulses of ultrasound are transmitted into
the body by placing the vibrating crystal in
close contact with the skin, using water or a
jelly past to element the air. This gives a
good coupling at the skin and greatly
increases the transmission of the ultrasound
into the body and of the echoes back to the
detector. The vibration of the crystal
produced by the echoes generate a voltage
across it – the signals are displayed on an
oscilloscope.
. Many of applications of ultrasound in medicine
are based on the principles of sonar. In sonar a
sound wave pulse is sent out and is reflected
from an object, from the time required to receive
the echo and the known velocity of sound in
water, the distance to the object can be
determined. This procedure is called the A-scan
method of ultrasound diagnosis; pulses for A-
scan work are typically a few microseconds long.
They are usually emitted at 400 to 1000 pulse/s.
In( Fig a). a transducer T sends a pulse of
ultrasound through a beaker of water of diameter
d. The sound is reflected from the other side of the
beaker and returns to the transducer, which also
acts as a receiver. The detected echo is converted
to an electrical signal and is displayed as the
vertical deflection R on the cathode ray tube (CRT)
of an oscilloscope, fig a´ since the echo has been
attenuated by the water, R is smaller in amplitude
than the initial pulse shown in the oscilloscope at
O.
In object in the beaker can be located with
ultrasound. In ( Fig b) a surface S at a
distance d1 produces an additional echo.
Which displayed on the oscilloscope as S at
the position d1 (Fig b´). Note that the echo
R is now smaller. When the surface vibrates
(Fig c), the position of the echo on the
oscilloscope also moves Fig c´
 It is also possible to have multiple reflections between surfaces. A
pulse emitted at the transducer T is reflected from the far side and
returns to the transducer, where apart is converted to a signal and
apart is again reflected to the far side: this part returns to the
transducer again and appears as a signal. Such a multiple echo
appears in (Fig b) as an object at a distance d and a second object
at 2d.
Another problem is the lack of resolution. Or the
ability of the equipment to detect separate echoes
from two objects close together. In general,
structure smaller than the wavelength λ can not be
resolved.
Since : λ=V/f
Where V is the velocity of sound and f is the
frequency, the high frequency sound has shorter
wavelengths and allows better resolution than low
frequency sound. Since the absorption increases as
the frequency increases.
One scan procedure echo encephalography, has been used in the
detection of brain tumors. Pluses of ultrasound are sent into thin
region of the skull slightly above the ear and echo from the
different structures with in the head are displayed on an
oscilloscope. The usual procedure is to compare the echoes from
the left side of the head to those from the right side and to look for
a shift in the midline structure.
An ultrasound transducer
T transmits sound
through water into eye,
and the reflected sound is
displayed on an
oscilloscope. It is possible
to measure distance in
the eye such as lens
thickness, depth from
cornea to the lens the
distance to the retina.
The B scan method is used to obtain two-dimensional views
of parts of the body. The principles are the same as for A scan
except that the transducer is moved as result each echo
produces a dot on the oscilloscope at a position
corresponding to the location of the reflection surface
 B scan provide information about
the internal structure of the body.
They have been used in diagnostic
studies of the eye, liver, breast, heart
and fetus. They can detect pregnancy
as early as the fifth week.
 ULTRASOUND TO MEASURE MOTION

• Two methods are used to obtain information about motion in the

body with ultrasound: the M scan, which used to study motion as
that of the heart and the heart valves, and the Doppler technique,
which is used to measure blood flow.

• The M scan combines certain features of A scan and B scan.

The transducer is held stationary as in the A scan and the
echoes appear as dotes in the B scan.
• M scan are used to obtain diagnostic information
about the heart. The rate of closing for a normal
valve is indicated by the slope.
•
 The frequency change is called the Doppler shift. When the sound source is
moving toward the listener or when he is moving toward the source, the
sound waves are pushed together and he hears a frequency higher than fo.
When the source is moving away from the listener or when he is moving
away from the source, he hears a frequency lower than fo.
 The Doppler Effect can be used to measure the speed of moving objects or fluids
within the body, such as the blood.
When the blood is moving at an angle 𝜽 from the direction of the sound waves, the
frequency change fd is
𝟐𝒇ₒ 𝑽
fd = 𝒄𝒐 𝒔 𝜽
𝜸
Where fo is the frequency of initial ultrasound wave
V is the velocity of blood
𝜸 is the velocity of sound
𝜽 is the angle between V and 𝜸
The Doppler Effect is also used to detect motion of the fetal heart,
when a continuous sound wave of frequency fo is incident upon the
fetal heart, the reflected sound is shifted to frequencies slightly higher
than fo when the fetal heart is moving toward the source of sound and
slightly lower than fo when the fetal heart is moving away from it.
Variations in the frequency give the fetal rate.
 The most common use of the Doppler effect in obstetrics is
in locating the point of entry of the umbilical cord (artery)
into placenta.
PHYSIOLOGICAL EFFECTS OF ULTRASOUND IN THERAPY

Various physical and chemical effects

occur when ultrasonic pass through the
body, and they can cause physiological
effects. The magnitude of the
physiological effects depends on the
frequency and amplitude of the sound.
The primary physical effects produced by
ultrasound are temperature increase and
pressure variations. The primary effect
used for therapy is the temperature rise to
the absorption of a acoustic energy in the
tissue.
 Ultrasound waves differ completely from
electromagnetic waves, they interact with tissue
primarily by microscopic motion of the tissue
particles. As a sound wave moves through tissue,
the region of compression and rarefaction cause
pressure differences in adjacent region of tissue.
Stretching occurs in these regions. If the
stretching exceeds the elastic limit of the tissue,
tearing results. This is why an eardrum can be
ruptured by a very intense sound.
In physical therapy the typical intensity is about 1
to 10 W/cm2 and the frequency about 1 MHz
𝟏
Using equation I = Z (A W)2
𝟐
We find that amplitude of displacement A at 10
W/cm2 in tissue is about 10-6 cm. The maximum
pressure amplitude Po
𝑷ₒ𝟐
Equation I=
𝟐𝒁
Is approximately 5 atm