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