QUESTIONS

Explain what you understand by Doppler shift. Of what interest are the Doppler methods in clinical ultrasonic. Sketch a diagram showing the basic element of the continuous ultrasonic Doppler shift detector.

Write short notes on: Pulsed wave system Continuous wave system. Directionally sensitive system. Range gated system. Two dimensional scanning. ANSWERS The Doppler shift is the difference between the incident frequency and reflected frequency. Ultrasound wave is generated in a continuous manner from the transmitting transducer at a particular frequency known as the incident frequency.

 Sound reflected to the receiver transducer from stationary sources is of equal frequency to the incident beam but reflected sound from moving structures is altered or shifted according to the velocity and direction of the moving structure. Returning echo originate from the cellular elements of the blood, particularly the red blood cells. The change of frequency is proportional to the velocity of the interface. The higher the transducer frequency or the faster the interface moves, the greater the doppler frequency shift

 It is greatest when the beam strikes a vessel at small angle. The smaller the angle between the sonic beam and the flow direction, the greater the vector of motion towards transducer and the greater the Doppler shift. Motion at right angle to the transducer shows no Doppler effect. The difference, the Doppler shift usually falls within the frequency range detectable by human ears and after amplification, this Doppler shift is the audio signal. The Doppler shift equation is as follows

DOPPLER EQUATION 1 shift)

(Doppler

2 f0v cos fD c

fd is Doppler frequency (shift) 0 = frequency of source v = speed of reflector c = speed of sound in medium

 A great deal can be learnt about the status of the circulatory system with a Doppler device. It can be used to detect blood flow or its absence in both arteries and veins. It can be used to identify vascular constriction with their associated edgy currents and venturi jets. Useful in detecting fetal heart motion earlier than any other method.`

PULSED WAVE SYSTEM

Pulsed Doppler is similar to a conventional pulse echo instrument in that bursts of uss are emitted repetitively at a precisely controlled rate into the tissues. A new pulse is not transmitted until echoes from the previous pulse has been detected. The depth at which a returning signal originated can be determined by knowing the time of transmission of the signal and the time of its return i.e. the time of flight to an interface and its subsequent return. Short burst of uss about 0.5 to 1.0 micro secs can yield good axial resolution with separation of interfaces to within about 1mm. Pulsed Doppler instrument provide both velocity and position information simultaneously.

 Determining the Doppler shift of an echo at a specific depth requires that the ultrasonic transducer produce very short duration burst at a precise rate of repetition. After transmission of this short burst of uss, the receiving transducer may be turned on(gating on) for a short period at a specific time therefore, only signals arriving from a specific tissue depth are available for detection. The same transducer is usually used for transmitting and receiving. The depth from which the signal originates is controlled by the length of time after pulse transmission before the transducer is allowed to receive returning signals (the time at which the gate is turned on)

 The axial length over which the signal originates is determined by the length of time the gate is turned on. A high Pulse Repetition Frequency limits the depth at which a pulsed Doppler transducer can receive echoes. PRF also determines the maximum Doppler shift frequency that can be detected. With short pulses used in imaging it is not possible to get accurate Doppler flow information.

DIRECTIONALLY SENSITIVE SYSTEM

COLOUR FLOW IMAGING This is a directionally sensitive system which provides a 2D visual display of moving blood in the vasculature superimposed upon the conventional grey scale image. Velocity and direction are determined for multiple position within a subarea of the image and then color encoded. Shades of red for blood moving towards the transducer and shades of blue for blood moving away from the transducer. Turbulence i.e. variation in flow direction show green or yellow Two dimensional color flow system does not use the full Doppler shift information because of lack of time and or lack of parallel channels necessary for real time imaging. The depth of each color depends on the velocity of flow stationary tissue appear grey. Compared with normal B scan imaging, the Doppler pulse is longer, being a compromise between accurate depth information requiring a short pulse and accurate velocity information requiring a longer pulse.

CONTINUOUS WAVE SYSTEM

This is the simplest and the least expensive device for measuring blood velocity. Two transducer are required, with one transmitting the incident uss and the other detecting the resultant continuous echoes both are contained in a single head and are slightly angled. They are chosen as regards operating frequency in the range 2 to 10MHz according to the depth of the vessel.

 The transmitter is energized continuously with a radiofrequency alternating voltage of frequency f. The receiver R listens continuously to the back scattered waves of frequency f coming from the cross over area or sensitive volume. A Doppler signal having the difference frequency (f- f) is extracted electronically. Frequency analyzer is used to produce a spectrum of Doppler frequencies that can be displayed on the screen. The Doppler signal can be heard through a loud speaker or head phone as a rushing sound. The higher the pitch the greater the velocity, the harsher the sound the greater the turbulence. With a continuous wave it is not possible to locate the moving reflector or to distinguish between the flow in two overlapping vessels at different depth in the beam.

RANGE GATED SYSTEM

This is also known as Duplex scanning. Doppler measurement is combined with a real time B scan image. Most of the time is spent in the Doppler mode, the B scan image is updated once a second. The imaging frequency is chosen to optimize resolution. A real time B mode image is produced , and with its help a line of sight is chosen for the Doppler beam. Along its cursors are set to identify the sampling volume, which is positioned over the vessel in which blood flow is to be measured. If the vessel is clearly defined, the angle theta can be read off to allow measured frequency shift to be converted into blood flow velocities. The diameter of the lumen of the vessel can also be estimated to allow volume flow rate to be calculated.

 The normal short imaging pulses are interspersed with burst of Doppler uss, each some 10 cycles long. A range gate is set to accept only those echoes that arrive within a short interval at a specific time, so that they can have come only from the selected sampling volume. The depth of the tissue so interrogated depends on the time at which the gate is opened and its thickness on the time for which it is open. The width of the sampling volume (or gated Doppler acquisition area), which in practice is pear shaped, is the width of the Doppler beam.

 The interval between pulses must be long enough for the successive Doppler signals not to overlap. A high PRF is chosen for superficial vessels and a lower one for deeper vessels. AS the range setting is increased, the PRF is reduced and the TGC automatically increased. The Doppler signals can be analyzed and displayed as a time velocity spectrum or sonogram.

TWO DIMENSIONAL SCANING

This is achieved by sweeping a pulsed ultrasound beam over the volume of interest and displaying echo signals using the brightness modulated dot on a displayed screen. In general, the brightness of the dot is proportional to the echo signal amplitude. Echo position Is based on the delay time between the pulse initiation and the reception of the echo, using the speed of sound in soft tissue(1540m/sec). The 2D image is progressively built up or continuously updated as the beam is swept through the object.