Minggu, 25 Juli 2010

Ultrasound


Ultrasound


Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Although this limit varies from person to person, it is approximately 20 kilohertz (20,000 hertz) in healthy, young adults and thus, 20 kHz serves as a useful lower limit in describing ultrasound. The production of ultrasound is used in many different fields, typically to penetrate a medium and measure the reflection signature or supply focused energy. The reflection signature can reveal details about the inner structure of the medium, a property also used by animals such as bats for hunting. The most well known application of ultrasound is its use in sonography to produce pictures of fetuses in the human womb. There are a vast number of other applications as well.[1]
Approximate frequency ranges corresponding to ultrasound, with rough guide of some applications
A fetus in its mother's womb, viewed in a sonogram (brightness scan)
An ultrasound examination in East Germany, 1990

Contents

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[edit]Ability to hear ultrasound

The upper frequency limit in humans (approximately 20 kHz) is due to limitations of the middle ear, which acts as a low-pass filterUltrasonic hearing can occur if ultrasound is fed directly into the skull bone and reaches the cochlea throughbone conduction without passing through the middle ear.
It is a fact in psychoacoustics that children can hear some high-pitched sounds that older adults cannot hear, because in humans the upper limit pitch of hearing tends to become lower with age.[2] A cell phone company has used this to create ring signals supposedly only able to be heard by younger humans;[3] but many older people claim to be able to hear it, which is likely given the considerable variation of age-related deterioration in the upper hearing threshold.
Some animals — such as dogscatsdolphinsbats, and mice — have an upper frequency limit that is greater than that of the human ear and thus can hear ultrasound, which is how a dog whistle works.

[edit]Diagnostic sonography

Sonogram of a fetus at 14 weeks (profile)
Head of a fetus, aged 29 weeks, in a "3D ultrasound"
Medical sonography(ultrasonography) is an ultrasound-based diagnostic medical imagingtechnique used to visualize muscles, tendons, and many internal organs, to capture their size, structure and any pathological lesions with real time tomographic images. Ultrasound has been used by radiologists andsonographers to image the human body for at least 50 years and has become one of the most widely used diagnostic tools in modern medicine. The technology is relatively inexpensive and portable, especially when compared with other techniques, such as magnetic resonance imaging (MRI) andcomputed tomography (CT). Ultrasound is also used to visualize fetuses during routine and emergency prenatal care. Such diagnostic applications used during pregnancy are referred to as obstetric sonography.
As currently applied in the medical field, properly performed ultrasound poses no known risks to the patient.[4] Sonography is generally described as a "safe test" because it does not use mutagenic ionizing radiation, which can pose hazards such as chromosome breakage and cancer development. However, ultrasonic energy has two potential physiological effects: it enhances inflammatory response; and it can heat soft tissue. Ultrasound energy produces a mechanical pressure wave through soft tissue. This pressure wave may cause microscopic bubbles in living tissues and distortion of the cell membrane, influencing ion fluxes and intracellular activity. When ultrasound enters the body, it causes molecular friction and heats the tissues slightly. This effect is typically very minor as normal tissue perfusion dissipates most of the heat, but with high intensity, it can also cause small pockets of gas in body fluids or tissues to expand and contract/collapse in a phenomenon called cavitation; however this is not known to occur at diagnostic power levels used by modern diagnostic ultrasound units.[citation needed]
In 2008, the AIUM published a 130-page report titled "American Institute of Ultrasound in Medicine Consensus Report on Potential Bioeffects of Diagnostic Ultrasound"[5] stating that there are indeed some potential risks to administering ultrasound tests, which include "postnatal thermal effects, fetal thermal effects, postnatal mechanical effects, fetal mechanical effects, and bioeffects considerations for ultrasound contrast agents."[6] The long-term effects of tissue heating and cavitation have shown decreases in the size of red blood cells in cattle when exposed to intensities higher than diagnostic levels.[7] However, long term effects due to ultrasound exposure at diagnostic intensity is still unknown.[8]
There are several studies that indicate the harmful side effects on animal fetuses associated with the use of sonography on pregnant mammals. A Yale study in 2006 suggested exposure to ultrasound affects fetal brain development in mice. A typical fetal scan, including evaluation for fetal malformations, typically takes 10–30 minutes.[9] The study showed that rodent brain cells failed to migrate to their proper positions and remained scattered in incorrect parts of the brain. This misplacement of brain cells during their development is linked to disorders ranging from "mental retardation and childhood epilepsy to developmental dyslexia, autism spectrum disorders and schizophrenia." However, this effect was only detectable after 30 minutes of continuous scanning. No link has yet been made between the test results on animals such as mice and the possible effects on humans. Although the possibility exists that biological effects on humans may be identified in the future, currently most doctors feel that based on available information the benefits to patients outweigh the risks.[10] Also the ALARA (As Low As Reasonably Achievable) principle has been advocated for an ultrasound examination; that is keeping the scanning time and power settings as low as possible but consistent with diagnostic imaging; and that is the principle by which non-medical uses which by definition are not necessary are actively discouraged.
Obstetric ultrasound can be used to identify many conditions that would be harmful to the mother and the baby. Many health care professionals consider the risk of leaving these conditions undiagnosed to be much greater than the very small risk, if any, associated with undergoing an ultrasound scan. According to Cochrane Review, routine ultrasound in early pregnancy (less than 24 weeks) appears to enable better gestational age assessment, earlier detection of multiple pregnancies and earlier detection of clinically unsuspected fetal malformation at a time when termination of pregnancy is possible.[11]
Sonography is used routinely in obstetric appointments during pregnancy, but the FDA discourages its use for non-medical purposes such as fetal keepsake videos and photos, even though it is the same technology used in hospitals.[12]
Obstetric ultrasound is primarily used to:
  • Date the pregnancy (gestational age)
  • Confirm fetal viability
  • Determine location of fetus, intrauterine vs ectopic
  • Check the location of the placenta in relation to the cervix
  • Check for the number of fetuses (multiple pregnancy)
  • Check for major physical abnormalities.
  • Assess fetal growth (for evidence of intrauterine growth restriction (IUGR))
  • Check for fetal movement and heartbeat.
  • Determine the sex of the baby
Unfortunately, results are occasionally wrong,[citation needed] producing a false positive (the Cochrane Collaboration is a relevant effort to improve the reliability of health care trials). False detection may result in patients being warned of birth defects when no such defect exists. Sex determination is only accurate after 12 weeks gestation. When balancing risk and reward, there are recommendations to avoid the use of routine ultrasound for low risk pregnancies. In many countries ultrasound is used routinely in the management of all pregnancies.
According to the European Committee of Medical Ultrasound Safety (ECMUS) "Ultrasonic examinations should only be performed by competent personnel who are trained and updated in safety matters. Ultrasound produces heating, pressure changes and mechanical disturbances in tissue. Diagnostic levels of ultrasound can produce temperature rises that are hazardous to sensitive organs and the embryo/fetus. Biological effects of non-thermal origin have been reported in animals but, to date, no such effects have been demonstrated in humans, except when a microbubble contrast agent is present."[13] Nonetheless, care should be taken to use low power settings and avoid pulsed wave scanning of the fetal brain unless specifically indicated in high risk pregnancies.
It should be noted that obstetrics is not the only use of ultrasound. Soft tissue imaging of many other parts of the body is conducted with ultrasound. Other scans routinely conducted are cardiac, renal, liver and gallbladder (hepatic). Other common applications include musculo-skeletal imaging of muscles, ligaments and tendons, ophthalmic ultrasound (eye) scans and superficial structures such as testiclethyroidsalivary glands and lymph nodes. Because of the real time nature of ultrasound, it is often used to guide interventional procedures such as fine needle aspiration FNA or biopsy of masses for cytologyor histology testing in the breast, thyroid, liver, kidney, lymph nodes, muscles and joints.
Ultrasound scanners have different Doppler-techniques to visualize arteries and veins. The most common is colour doppler or power doppler, but also other techniques like b-flow are used to show bloodflow in an organ. By using pulsed wave doppler or continuous wave doppler bloodflow velocities can be calculated.
Figures released for the period 2005-2006 by UK Government (Department of Health) show that non-obstetric ultrasound examinations constituted more than 65% of the total number of ultrasound scans conducted.
Ultrasound is also increasingly being used in trauma and first aid cases, withemergency ultrasound becoming a staple of most EMT response teams.

[edit]Animal research ultrasonography

[edit]Biomedical ultrasonic applications

Ultrasound also has therapeutic applications, which can be highly beneficial when used with dosage precautions:[14]
  • According to RadiologyInfo,[15] ultrasounds are useful in the detection ofpelvic abnormalities and can involve techniques known as abdominal(transabdominal) ultrasound, vaginal (transvaginal or endovaginal) ultrasound in women, and also rectal (transrectal) ultrasound in men.
  • Focused high-energy ultrasound pulses can be used to break calculi such as kidney stones and gallstones into fragments small enough to be passed from the body without undue difficulty, a process known as lithotripsy.
  • Treating benign and malignant tumors and other disorders via a process known as high intensity focused ultrasound (HIFU), also called focused ultrasound surgery (FUS). In this procedure, a generally lower frequencies than medical diagnostic ultrasound is used (250–2000 kHz), but significantly higher time-averaged intensities. The treatment is often guided by magnetic resonance imaging (MRI)—this is called Magnetic resonance-guided focused ultrasound (MRgFUS). Delivering chemotherapy to brain cancer cells and various drugs to other tissues is called acoustic targeted drug delivery(ATDD).[16] These procedures generally use high frequency ultrasound (1-10 MHz) and a range of intensities (0-20 watts/cm2). The acoustic energy is focused on the tissue of interest to agitate its matrix and make it more permeable for therapeutic drugs.[17][18]
    Enhanced drug uptake using acoustic targeted drug delivery (ATDD).
  • Therapeutic ultrasound, a technique that uses more powerful ultrasound sources to generate cellular effects in soft tissue has fallen out of favor as research has shown a lack of efficacy[19] and a lack of scientific basis for proposed biophysical effects.[20]Ultrasound has been used incancer treatment.
  • Cleaning teeth in dental hygiene.
  • Focused ultrasound sources may be used for cataract treatment byphacoemulsification.
  • Additional physiological effects of low-intensity ultrasound have recently been discovered, e.g. the ability to stimulate bone-growth and its potential to disrupt the blood-brain barrier for drug delivery.
  • Ultrasound is essential to the procedures of ultrasound-guided sclerotherapyand endovenous laser treatment for the non-surgical treatment of varicose veins.
  • Ultrasound-assisted lipectomy is lipectomy assisted by ultrasound.Liposuction can also be assisted by ultrasound.
  • Doppler ultrasound is being tested for use in aiding tissue plasminogen activator treatment in stroke sufferers in the procedure called ultrasound-enhanced systemic thrombolysis.
  • Low intensity pulsed ultrasound is used for therapeutic tooth and bone regeneration.
  • Ultrasound can also be used for elastography. This can be useful in medical diagnoses, as elasticity can discern healthy from unhealthy tissue for specific organs/growths. In some cases unhealthy tissue may have a lower system Q, meaning that the system acts more like a large heavy spring as compared to higher values of system Q (healthy tissue) that respond to higher forcing frequencies. Ultrasonic elastography is different from conventional ultrasound, as a transceiver (pair) and a transmitter are used instead of only a transceiver. One transducer acts as both the transmitter and receiver to image the region of interest over time. The extra transmitter is a very low frequency transmitter, and perturbs the system so the unhealthy tissue oscillates at a low frequency and the healthy tissue does not. The transceiver, which operates at a high frequency (typically MHz) then measures the displacement of the unhealthy tissue (oscillating at a much lower frequency). The movement of the slowly oscillating tissue is used to determine the elasticity of the material, which can then be used to distinguish healthy tissue from the unhealthy tissue.
  • Ultrasound has been shown to act synergistically with antibiotics in bacterial cell killing.[21]
  • Ultrasound has been postulated to allow thicker eukaryotic cell tissue cultures by promoting nutrient penetration.[22]
  • Ultrasound in the low MHz range in the form of standing waves is an emerging tool for contactless separation, concentration and manipulation of microparticles and biological cells, a method referred to as acoustophoresis. The basis is the acoustic radiation force, a non-linear effect which causes particles to be attracted to either the nodes or anti-nodes of the standing wave depending on the acoustic contrast factor, which is a function of thesound velocities and densities of the particle and of the medium in which the particle is immersed.

[edit]Industrial ultrasound

Non-destructive testing of a swing shaft showing spline cracking
Ultrasonic testing is a type ofnondestructive testing commonly used to find flaws in materials and to measure the thickness of objects. Frequencies of 2 to 10 MHz are common but for special purposes other frequencies are used. Inspection may be manual or automated and is an essential part of modern manufacturing processes. Most metals can be inspected as well as plastics and aerospace composites. Lower frequency ultrasound (50–500 kHz) can also be used to inspect less dense materials such as wood,concrete and cement.
Ultrasound can also be used for heat transfer in liquids. Researchers recently employed ultrasound in dry corn milling plant to enhance ethanol production.[23]

[edit]Ultrasonic manipulation and characterization of particles

A researcher at the Industrial Materials Research Institute, Alessandro Malutta, devised an experiment that demonstrated the trapping action of ultrasonic standing waves on wood pulp fibers diluted in water and their parallel orienting into the equidistant pressure planes.[24] The time to orient the fibers in equidistant planes is measured with a laser and an electro-optical sensor. This could provide the paper industry a quick on-line fiber size measurement system. A somewhat different implementation was demonstrated at Penn State University using a microchip which generated a pair of perpendicular standing surface acoustic waves allowing to position particles equidistant to each other on a grid. This experiment, called "acoustic tweezers", can be used for applications in material sciences, biology, physics, chemistry and nanotechnology.

[edit]Ultrasonic cleaning

Ultrasonic cleaners, sometimes mistakenly called supersonic cleaners, are used at frequencies from 20 to 40 kHz for jewellerylenses and other optical parts, watchesdental instrumentssurgical instrumentsdiving regulators andindustrial parts. An ultrasonic cleaner works mostly by energy released from the collapse of millions of microscopic cavitations near the dirty surface. The bubbles made by cavitation collapse forming tiny jets directed at the surface.

[edit]Ultrasonic disintegration

Similar to ultrasonic cleaning, biological cells including bacteria can be disintegrated. High power ultrasound produces cavitation that facilitates particle disintegration or reactions. This has uses in biological science for analytical or chemical purposes (Sonication and Sonoporation) and in killing bacteria insewage. Dr. Samir Khanal of Iowa State University employed high power ultrasound to disintegrate corn slurry to enhance liquefaction and saccharification for higher ethanol yield in dry corn milling plants.[25][26] Similar to these findings was Dr. Oleg Kozyuk able to improve ethanol yield with hydrodynamic cavitation.[27] [28]

[edit]Ultrasonic humidifier

The ultrasonic humidifier, one type of nebulizer (a device that creates a very fine spray), is a popular type of humidifier. It works by vibrating a metal plate at ultrasonic frequencies to nebulize (sometimes incorrectly called "atomize") the water. Because the water is not heated for evaporation, it produces a cool mist. The ultrasonic pressure waves nebulize not only the water but also materials in the water including calcium, other minerals, viruses, fungi, bacteria,[29] and other impurities. Illness caused by impurities that reside in a humidifier's reservoir fall under the heading of "Humidifier Fever".

[edit]Ultrasound Identification (USID)

Ultrasound Identification (USID) is a Real Time Locating System (RTLS) orIndoor Positioning System (IPS) technology used to automatically track and identify the location of objects in real time using simple, inexpensive nodes (badges/tags) attached to or embedded in objects and devices, which then transmit an ultrasound signal to communicate their location to microphone sensors.

[edit]Ultrasonic welding

In ultrasonic welding of plastics, high frequency (15 kHz to 40 kHz ) low amplitude vibration is used to create heat by way of friction between the materials to be joined. The interface of the two parts is specially designed to concentrate the energy for the maximum weld strength.

[edit]Ultrasound and animals

[edit]Bats

Bats use ultrasounds to move in the darkness.
Bats use a variety of ultrasonic ranging (echolocation) techniques to detect their prey. They can detect frequencies as high as 100 kHz, although there is some disagreement on the upper limit.[30]

[edit]Rodents/insects

There is evidence that ultrasound in the range emitted by bats causes flyingmoths to make evasive manoeuvres because bats eat moths. Ultrasonic frequencies trigger a reflex action in the noctuid moth that cause it to drop a few inches in its flight to evade attack.[31]
Tiger moths also emit clicks which jam bats' echolocation.[32][33]
Ultrasound generator/speaker systems are sold with claims that they frighten away rodents and insects, but there is no scientific evidence that the devices work.[citation needed]

[edit]Dogs

Dogs can hear sound at higher frequencies than humans can. A dog whistleexploits this by emitting a high frequency sound to call to a dog. Many dog whistles emit sound in the upper audible range of humans, but some, such as the silent whistle, emit ultrasound at a frequency in the range 18–22 kHz.

[edit]Dolphins and whales

It is well known that some whales can hear ultrasound and have their own natural sonar system. Some whales use the ultrasound as a hunting tool (for both detection of prey and as an attack).[34]

[edit]Fish

Several types of fish can detect ultrasound. In the order Clupeiformes, members of the subfamily Alosinae (shad), have been shown to be able to detect sounds up to 180 kHz, while the other subfamilies (e.g. herrings) can hear only up to 4 kHz.[35]

[edit]Horses

Diagnostic ultrasound is used externally in the equine for evaluation of soft tissue and tendon injuries, and internally in particular for reproductive work - evaluation of the reproductive tract of the mare and pregnancy detection[36]. It may also be used in an external manner in stallions for evaluation of testicular condition and diameter as well as internally for reproductive evaluation (deferent duct etc.).[37]

[edit]Cattle

Starting at the turn of the century, ultrasound technology began to be used by the beef cattle industry to improve animal health and the yield of cattle operations.[38] Ultrasound is used to evaluate fat thickness, rib eye area, and intramuscular fat in living animals.[39] It is also used to evaluate the health and characteristics of unborn calves.
Ultrasound technology provides a means for cattle producers to obtain information that can be used to improve the breeding and husbandry of cattle. The technology can be expensive, and it requires a substantial time commitment for continuous data collection and operator training.[39]Nevertheless, this technology has proven useful in managing and running a cattle breeding operation.[38]

[edit]Sonochemistry

Power ultrasound in the 20–100 kHz range is used in chemistry. The ultrasound does not interact directly with molecules to induce the chemical change, as its typical wavelength (in the millimeter range) is too long compared to the molecules. Instead:
  • It causes cavitation which causes local extremes of temperature and pressure in the liquid where the reaction happens.
  • It breaks up solids and removes passivating layers of inert material to give a larger surface area for the reaction to occur over.
Both of these make the reaction faster.
  • It is used in extraction, using different frequencies.

[edit]Ultrasonic range finding

Principle of an active sonar
A common use of ultrasound is in range finding; this use is also called SONAR, (sound navigation and ranging). This works similarly to RADAR (radio detection and ranging): An ultrasonic pulse is generated in a particular direction. If there is an object in the path of this pulse, part or all of the pulse will be reflected back to the transmitter as an echo and can be detected through the receiver path. By measuring the difference in time between the pulse being transmitted and the echo being received, it is possible to determine how far away the object is.
The measured travel time of SONAR pulses in water is strongly dependent on the temperature and the salinity of the water. Ultrasonic ranging is also applied for measurement in air and for short distances. Such method is capable for easily and rapidly measuring the layout of rooms.
Although range finding underwater is performed at both sub-audible and audible frequencies for great distances (1 to several kilometers), ultrasonic range finding is used when distances are shorter and the accuracy of the distance measurement is desired to be finer. Ultrasonic measurements may be limited through barrier layers with large salinity, temperature or vortex differentials. Ranging in water varies from about hundreds to thousands of meters, but can be performed with centimeters to meters accuracy.

[edit]Other uses

Ultrasound when applied in specific configurations can produce short bursts of light in an exotic phenomenon known as sonoluminescence. This phenomenon is being investigated partly because of the possibility of bubble fusion (a nuclear fusion reaction hypothesized to occur during sonoluminescence).
Researchers have successfully used ultrasound to regenerate dental material[40].
Ultrasound is used when characterizing particulates through the technique ofultrasound attenuation spectroscopy or by observing electroacoustic phenomena.
In rheology, an acoustic rheometer relies on the principle of ultrasound. In fluid mechanics, fluid flow can be measured using an ultrasound flow meter.
Ultrasound also plays a role in Sonic weaponry.
High and ultra high ultrasound waves are used in Acoustic microscopy
Audio can be propagated by modulated ultrasound.

[edit]Nonlinear propagation effects

Because of their high amplitude to wavelength ratio, ultrasonic waves commonly display nonlinear propagation.

[edit]Safety

Occupational exposure to ultrasound in excess of 120 dB may lead to hearing loss. Exposure in excess of 155 dB may produce heating effects that are harmful to the human body, and it has been calculated that exposures above 180 dB may lead to death.[41]

[edit]See also

[edit]References

  1. ^ Novelline, Robert (1997). Squire's Fundamentals of Radiology (5th ed.). Harvard University Press. pp. 34–35. ISBN 0674833392.
  2. ^ Takeda, S.; Morioka, I.; Miyashita, K.; Okumura, A.; Yoshida, Y.; Matsumoto, K. (1992). "Age variation in the upper limit of hearing"European Journal of Applied Physiology 65 (5): 403–408. doi:10.1007/BF00243505. Retrieved 2008-11-17. edit
  3. ^ "A Ring Tone Meant to Fall on Deaf Ears" (New York Times article)
  4. ^ Hangiandreou, N. J. (2003). "Physics Tutorial for Residents: Topics in US: B-mode US: Basic Concepts and New Technology - Hangiandreou".Radiographics 23 (4): 1019. doi:10.1148/rg.234035034.
  5. ^ Bioeffects Committee of the American Institute of Ultrasound in Medicine (2008-04-01). "American Institute of Ultrasound in Medicine Consensus Report on Potential Bioeffects of Diagnostic Ultrasound: Executive Summary"Journal of Ultrasound in Medicine (American Institute of Ultrasound in Medicine) 27 (4): 503–515. PMID 18359906.
  6. ^ AIUM Consensus report (2008)
  7. ^ Soetanto, Kawan; Kobayashi, Masahiro; Okujima, Motoyoshi (1998)."Fundamental Examination of Cattle Red Blood Cells Damage with Ultrasound Exposure Microscopic System (UEMS)"Japanese Journal of Applied Physics 37: 3070. doi:10.1143/JJAP.37.3070.
  8. ^ FDA Radiological Health - Ultrasound Imaging
  9. ^ "Ultrasonographic Screening for Fetal Malformations"
  10. ^ Patient Information - Ultrasound Safety
  11. ^ "Ultrasound for fetal assessment in early pregnancy".
  12. ^ [1]
  13. ^ Clinical Safety Statements
  14. ^ Essentials of Medical Ultrasound: A Practical Introduction to the Principles, Techniques and Biomedical Applications, edited by M. H. Rapacholi, Humana Press 1982
  15. ^ "Ultrasound - Pelvis".
  16. ^ Lewis Jr., George K.; Olbricht, Willam L.; Lewis, George (2008). Acoustic enhanced Evans blue dye perfusion in neurological tissues2. pp. 020001.doi:10.1121/1.2890703.
  17. ^ Lewis, George K.; Olbricht, William (2007). A phantom feasibility study of acoustic enhanced drug delivery to neurological tissue. pp. 67.doi:10.1109/LSSA.2007.4400886.
  18. ^ "Acoustics and brain cancer".
  19. ^ Valma J Robertson, Kerry G Baker (2001). "A Review of Therapeutic Ultrasound: Effectiveness Studies"Physical Therapy 81 (7): 1339.PMID 11444997.
  20. ^ Kerry G Baker, et al (2001). "A Review of Therapeutic Ultrasound: Biophysical Effects". Physical Therapy 81 (7): 1351. PMID 11444998.
  21. ^ Carmen, JC; Roeder, BL; Nelson, JL; Beckstead, BL; Runyan, CM; Schaalje, GB; Robison, RA; Pitt, WG (2004). "Ultrasonically enhanced vancomycin activity against Staphylococcus epidermidis biofilms in vivo."Journal of biomaterials applications 18 (4): 237–45. doi:10.1177/0885328204040540.PMID 15070512.
  22. ^ Pitt WG, Ross SA (2003). "Ultrasound increases the rate of bacterial cell growth"Biotechnol Prog. 19 (3): 1038–44. doi:10.1021/bp0340685.PMID 12790676.
  23. ^ Using Infrared To See If You're Lit
  24. ^ Dion, J. L.; Malutta, A.; Cielo, P., "Ultrasonic inspection of fiber suspensions", The Journal of the Acoustical Society of America, Volume 72, Issue 5, November 1982, pp.1524–1526.
  25. ^ (Hans) Van Leeuwen, J; Akin, Beril; Khanal, Samir Kumar; Sung, Shihwu; Grewell, David; (Hans) Van Leeuwen, J (2006). "Ultrasound pre-treatment of waste activated sludge"Water Science & Technology: Water Supply 6: 35.doi:10.2166/ws.2006.962.
  26. ^ U Neis, K Nickel and A Tiehm (2000). "Enhancement of anaerobic sludge digestion by ultrasonic disintegration"Water Science & Technology 42 (9): 73.
  27. ^ Ethanol Producer Magazine; Tiny Bubbles to Make You Happy
  28. ^ Oleg Kozyuk;Arisdyne Systems Inc.; US patent US 7,667,082 B2; Apparatus and Method for Increasing Alcohol Yield from Grain
  29. ^ Oie, S; Masumoto, N; Hironaga, K; Koshiro, A; Kamiya, A (1992). "Microbial contamination by ultrasonic humidifier". Microbios 72 (292-293): 161–6.PMID 1488018.
  30. ^ Cancel, Juan (1998). "Frequency of Bat Sonar"The Physics Factbook.
  31. ^ Jones, G; D A Waters (2000). "Moth hearing in response to bat echolocation calls manipulated independently in time and frequency."Proceedings of the Royal Society B Biological Sciences 267 (1453): 1627.doi:10.1098/rspb.2000.1188PMID 11467425.
  32. ^ Matt Kaplan (July 17, 2009). "Moths Jam Bat Sonar, Throw the Predators Off Course". National Geographic News.
  33. ^ Some Moths Escape Bats By Jamming Sonar (video)
  34. ^ Voices in the Sea
  35. ^ Mann DA, et al. (2001). "Ultrasound detection by clupeiform fishes". JASA109 (6): 3048–3054. doi:10.1121/1.1368406.
  36. ^ Ultrasound Characteristics of the Uterus in the Cycling Mare and their Correlation with Steroid Hormones and Timing of Ovulation
  37. ^ McKinnon and Voss "Equine Reproduction" (Lea & Febiger; 1993)
  38. a b Bennett, David (May 19, 2005). "Subiaco Abbey’s Angus herd"Delta Farm Press. Archived from the original on February 27, 2010. Retrieved February 27, 2010.
  39. a b Wagner, Wayne. "Extension Effort in Beef Cattle Breeding & Selection".West Virginia University Extension Service. Archived from the original on February 27, 2010. Retrieved February 27, 2010.
  40. ^ Toothsome research may hold key to repairing dental disasters - ExpressNews - University of Alberta
  41. ^ Part II, industrial and commercial applications (1991). Guidelines for the Safe Use of Ultrasound Part II - Industrial & Commercial Applications - Safety Code 24. Health Canada. ISBN 0-660-13741-0.

[edit]Further reading

Radiology


Radiology is the branch or specialty of medicine that utilizes imaging technologies like x-rays, CT scans, and MRIs to diagnose and treat diseases.
Radiologists are physicians that utilize an array of imaging technologies (such as ultrasound,computed tomography (CT), nuclear medicinepositron emission tomography (PET) and magnetic resonance imaging (MRI)) to diagnose or treat diseases.Interventional radiology is the performance of (usually minimally invasive) medical procedures with the guidance of imaging technologies. The acquisition of medical imaging is usually carried out by the radiographer or radiologic technologist.

Acquisition of radiological images

The following imaging modalities are used in the field of diagnostic radiology:

[edit]Projection (plain) radiography

Madura Foot X-Ray
Radiographs (or roentgenographs, named after the discoverer of x-rays,Wilhelm Conrad Röntgen) are produced by the transmission of x-rays through a patient to a capture device then converted into an image for diagnosis. The original and still common imaging produces silver impregnated films. In Film-Screen radiography an x-ray tube generates a beam of x-rays which is aimed at the patient. The x-rays which pass through the patient are filtered to reduce scatter and noise and then strike an undeveloped film, held tight to a screen of light emitting phosphors in a light-tight cassette. The film is then developed chemically and an image appears on the film. Now replacing Film-Screen radiography is Digital Radiography, DR, in which x-rays strike a plate of sensors which then converts the signals generated into digital information and an image on computer screen. Plain radiography was the only imaging modality available during the first 50 years of radiology. It is still the first study ordered in evaluation of the lungs, heart and skeleton because of its wide availability, speed and relative low cost. New developments in radiography include the virtual x-ray system (virtX), invented by a team of computer scientists, trauma surgeons, and radiologists. VirtX allows trainees to make C-arm adjustments for different surgical procedures by using a simulation-based practice environment without x-ray exposure but with visual feedback through a digitally reconstructed radiograph (or DRR).[1] The announcement of the first-place RSNA congress award for the new system was made in February 2010.[1]

[edit]Fluoroscopy

Fluoroscopy and angiography are special applications of X-ray imaging, in which a fluorescent screen and image intensifier tube is connected to a closed-circuit television system.[2]:26 This allows real-time imaging of structures in motion or augmented with a radiocontrast agent. Radiocontrast agents are administered, often swallowed or injected into the body of the patient, to delineate anatomy and functioning of the blood vessels, the genitourinary system or thegastrointestinal tract. Two radiocontrasts are presently in use. Barium (as BaSO4) may be given orally or rectally for evaluation of the GI tract. Iodine, in multiple proprietary forms, may be given by oral, rectal, intraarterial or intravenous routes. These radiocontrast agents strongly absorb or scatter X-ray radiation, and in conjunction with the real-time imaging allows demonstration of dynamic processes, such as peristalsis in the digestive tract or blood flow in arteries and veins. Iodine contrast may also be concentrated in abnormal areas more or less than in normal tissues and make abnormalities (tumors, cysts, inflammation) more conspicuous. Additionally, in specific circumstances air can be used as a contrast agent for the gastrointestinal system and carbon dioxide can be used as a contrast agent in the venous system; in these cases, the contrast agent attenuates the X-ray radiation less than the surrounding tissues.

[edit]Interventional radiology

Interventional radiology (abbreviated IR or sometimes VIR for vascular and interventional radiology, also known as Image-Guided Surgery) is a subspecialty of radiology in which minimally invasive procedures are performed using image guidance. Some of these procedures are done for purely diagnostic purposes (e.g., angiogram), while others are done for treatment purposes (e.g., angioplasty).
The basic concept behind interventional radiology is to diagnose or treat pathology with the most minimally invasive technique possible. Interventional radiologists diagnose and treat several disorders including peripheral vascular diseaserenal artery stenosisinferior vena cava filter placement, gastrostomytube placements, biliary stents and hepatic interventions. Images are used for guidance and the primary instruments used during the procedure are needles and tiny tubes called catheters. The images provide road maps that allow the interventional radiologist to guide these instruments through the body to the areas containing disease. By minimizing the physical trauma to the patient, peripheral interventions can reduce infection rates and recovery time as well as shorten hospital stays. To be a trained interventionalist in the United States, an individual typically requires fifteen years of post-high school training, of which seven years is spent in residency.[3]

[edit]CT scanning

Brain CT Scan image slice
CT imaging uses X-rays in conjunction with computingalgorithms to image the body.[4] In CT, an X-ray generating tube opposite an X-ray detector (or detectors) in a ring shaped apparatus rotate around a patient producing a computer generated cross-sectional image (tomogram). CT is acquired in theaxial plane, while coronal and sagittal images can be rendered by computer reconstruction. Radiocontrast agents are often used with CT for enhanced delineation of anatomy. Although radiographs provide higher spatial resolution, CT can detect more subtle variations in attenuation of X-rays. CT exposes the patient to more ionizing radiation than a radiograph. Spiral Multi-detector CT utilizes 8, 16, 64 or more detectors during continuous motion of the patient through the radiation beam to obtain much finer detail images in a shorter exam time. With rapid administration of IV contrast during the CT scan these fine detail images can be reconstructed into 3D images of carotid, cerebral and coronary arteries, CTA, CT angiography. CT scanning has become the test of choice in diagnosing some urgent and emergent conditions such as cerebral hemorrhage, pulmonary embolism (clots in the arteries of the lungs), aortic dissection (tearing of the aortic wall), appendicitis, diverticulitis, and obstructing kidney stones. Continuing improvements in CT technology including faster scanning times and improved resolution have dramatically increased the accuracy and usefulness of CT scanning and consequently increased utilization in medical diagnosis.
The first commercially viable CT scanner was invented by Sir Godfrey Hounsfieldat EMI Central Research Labs, Great Britain in 1972. EMI owned the distribution rights to The Beatles music and it was their profits which funded the research.[5]Sir Hounsfield and Alan McLeod McCormick shared the Nobel Prize for Medicine in 1979 for the invention of CT scanning. The first CT scanner in North America was installed at the Mayo Clinic in Rochester, MN in 1972.

[edit]Ultrasound

Medical ultrasonography uses ultrasound (high-frequency sound waves) to visualize soft tissue structures in the body in real time. No ionizing radiation is involved, but the quality of the images obtained using ultrasound is highly dependent on the skill of the person (ultrasonographer) performing the exam. Ultrasound is also limited by its inability to image through air (lungs, bowel loops) or bone. The use of ultrasound in medical imaging has developed mostly within the last 30 years. The first ultrasound images were static and two dimensional (2D), but with modern-day ultrasonography 3D reconstructions can be observed in real-time; effectively becoming 4D.
Because ultrasound does not utilize ionizing radiation, unlike radiography, CT scans, and nuclear medicine imaging techniques, it is generally considered safer. For this reason, this modality plays a vital role in obstetrical imaging. Fetal anatomic development can be thoroughly evaluated allowing early diagnosis of many fetal anomalies. Growth can be assessed over time, important in patients with chronic disease or gestation-induced disease, and in multiple gestations (twins, triplets etc.). Color-Flow Doppler Ultrasound measures the severity of peripheral vascular disease and is used by Cardiology for dynamic evaluation of the heart, heart valves and major vessels. Stenosis of the carotid arteries can presage cerebral infarcts (strokes). DVT in the legs can be found via ultrasound before it dislodges and travels to the lungs (pulmonary embolism), which can be fatal if left untreated. Ultrasound is useful for image-guided interventions like biopsies and drainages such as thoracentesis). Small portable ultrasound devices now replace peritoneal lavage in the triage of traumavictims by directly assessing for the presence of hemorrhage in the peritoneumand the integrity of the major viscera including the liverspleen and kidneys. Extensive hemoperitoneum (bleeding inside the body cavity) or injury to the major organs may require emergent surgical exploration and repair.

[edit]MRI (Magnetic Resonance Imaging)

MRI image of human knee with a displaced patella
MRI uses strong magnetic fields to align atomic nuclei (usually hydrogenprotons) within body tissues, then uses a radio signal to disturb the axis of rotation of these nuclei and observes the radio frequency signal generated as the nuclei return to their baseline states plus all surrounding areas. The radio signals are collected by small antennae, called coils, placed near the area of interest. An advantage of MRI is its ability to produce images in axialcoronal,sagittal and multiple oblique planes with equal ease. MRI scans give the best soft tissue contrast of all the imaging modalities. With advances in scanning speed and spatial resolution, and improvements in computer 3D algorithms and hardware, MRI has become a tool in musculoskeletal radiology and neuroradiology.
One disadvantage is that the patient has to hold still for long periods of time in a noisy, cramped space while the imaging is performed. Claustrophobia severe enough to terminate the MRI exam is reported in up to 5% of patients. Recent improvements in magnet design including stronger magnetic fields (3 teslas), shortening exam times, wider, shorter magnet bores and more open magnet designs, have brought some relief for claustrophobic patients. However, in magnets of equal field strength there is often a trade-off between image quality and open design. MRI has great benefit in imaging the brain, spine, and musculoskeletal system. The modality is currently contraindicated for patients with pacemakers, cochlear implants, some indwelling medication pumps, certain types of cerebral aneurysm clips, metal fragments in the eyes and some metallic hardware due to the powerful magnetic fields and strong fluctuating radio signals the body is exposed to. Areas of potential advancement include functional imaging, cardiovascular MRI, as well as MR image guided therapy.

[edit]Nuclear Medicine

Nuclear medicine imaging involves the administration into the patient of radiopharmaceuticals consisting of substances with affinity for certain body tissues labeled with radioactive tracer. The most commonly used tracers are Technetium-99m, Iodine-123, Iodine-131, Gallium-67 and Thallium-201. Theheartlungsthyroidlivergallbladder, and bones are commonly evaluated for particular conditions using these techniques. While anatomical detail is limited in these studies, nuclear medicine is useful in displaying physiological function. The excretory function of the kidneys, iodine concentrating ability of the thyroid, blood flow to heart muscle, etc. can be measured. The principal imaging device is the gamma camera which detects the radiation emitted by the tracer in the body and displays it as an image. With computer processing, the information can be displayed as axial, coronal and sagittal images (SPECT images, single-photon emission computed tomography). In the most modern devices Nuclear Medicine images can be fused with a CT scan taken quasi-simultaneously so that the physiological information can be overlaid or co-registered with the anatomical structures to improve diagnostic accuracy.
Positron emission tomography (PET), scanning also falls under "nuclear medicine." In PET scanning, a radioactive, biologically active substance, most often Fludeoxyglucose (18F), is injected into a patient and the radiation emitted by the patient is detected to produce multi-planar images of the body. Metabolically more active tissues, such as cancer, concentrate the active substance more than normal tissues. PET images can be combined (or "fused") with an anatomic imaging study (currently generally CT images), to more accurately localize PET findings and thereby improve diagnostic accuracy.
The applications of nuclear medicine can include bone scanning which traditionally has had a strong role in the work-up/staging of cancers. [[[index.php?title=Single_photon_emission_computed_tomography Single photon emission computed tomography]|Myocardial perfusion]] imaging is a sensitive and specific screening exam for reversible [[[index.php?title=Ischaemic_heart_disease Ischaemic heart disease]|myocardial ischemia]].Molecular imaging is the new and exciting frontier in this field.

[edit]Teleradiology

Teleradiology is the transmission of radiographic images from one location to another for interpretation by a radiologist. It is most often used to allow rapid interpretation of emergency room, ICU and other emergent examinations after hours of usual operation, at night and on weekends. In these cases the images are often sent across time zones (i.e. to Spain, Australia, India) with the receiving radiologist working his normal daylight hours. Teleradiology can also be utilized to obtain consultation with an expert or sub-specialist about a complicated or puzzling case.
Teleradiology requires a sending station, high speed Internet connection and high quality receiving station. At the transmission station, plain radiographs are passed through a digitizing machine before transmission, while CT scans, MRIs, Ultrasounds and Nuclear Medicine scans can be sent directly as they are already a stream of digital data. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. The interpreting radiologist then faxes or e-mails the radiology report to the requesting physician.
The major advantage of teleradiology is the ability to utilize different time zones to provide real-time emergency radiology services around-the-clock. The disadvantages include higher costs , limited contact between the ordering physician and the radiologist, and the inability to cover for procedures requiring an onsite radiologist. Laws and regulations concerning the use of teleradiology vary among the states, with some states requiring a license to practice medicine in the state sending the radiologic exam. Some states require the teleradiology report to be preliminary with the official report issued by a hospital staff radiologist.

[edit]Radiologist training

[edit]United States

Radiology is a competitive field in medicine and successful applicants are often near the top of their medical school class, with high board scores. The field is rapidly expanding due to advances in computer technology, which is closely linked to modern imaging. Diagnostic radiologists must complete at least 13 years of post-high school education, including 4 years of prerequisite undergraduate training, 4 years of medical school, and 5 years of post-graduate training. The first postgraduate year is usually a transitional year of various rotations, but is sometimes a preliminary internship in medicine or surgery. A four-year diagnostic radiology residency follows. The Radiology resident must pass a medical physics board exam covering the science and technology of ultrasound, CTs, x-rays, nuclear medicine and MRI. Core knowledge of the radiologist includes radiobiology, which is the study of the effects of ionizing radiation on living tissue. Near the completion of residency, the radiologist in training is eligible to take the written and oral board examinations administered by the American Board of Radiology (ABR). Starting in 2010, the ABR's board examination structure will be changed to include two computer-based exams, one given after the third year of residency training, and the second given 18 months after the first.
The Wayne State University School of Medicine and the University of South Carolina School of Medicine both offer an integrated radiology curriculum during their respective MD Programs in collaboration with GE Medical led by investigators of the Advanced Diagnostic Ultrasound in Microgravity study.[6][7][8]
Following completion of residency training, radiologists either begin their practice or enter into sub-speciality training programs known as fellowships. Examples of sub-speciality training in radiology include abdominal imaging, thoracic imaging, CT/Ultrasound, MRImusculoskeletal imaging, interventional radiologyneuroradiologyinterventional neuroradiologypaediatric radiology, mammography and women's imaging. Fellowship training programs in radiology are usually 1 or 2 years in length. [9]
Radiographic exams are usually performed by radiologic technologists, (also known as diagnostic radiographers) who in the United States have a 2-year Associates Degree and the UK a 3 year Honours Degree.
Veterinary radiologists are veterinarians that specialize in the use of X-rays, ultrasound, MRI and nuclear medicine for diagnostic imaging or treatment of disease in animals. They are certified in either diagnostic radiology or radiation oncology by the American College of Veterinary Radiology.

[edit]Germany

After obtaining medical licensure, German radiologists complete a 5-year residency, culminating with a board examination (known as Facharztausbildung).

[edit]Italy

Until 2008, a Radiology training program had a duration of four years. At present, a radiology training program lasts five years. Further training is required for specialization in radiotherapy or nuclear medicine.

[edit]Bangladesh

In Bangladesh the only medical university, BSMMU, arranges a yearly seminar and monthly conferences,of which the Bangladesh Society of Radiology & Imaging takes part in the management.