Basic Ultrasound Physics

29 – Image optimisation: Focal zone markers

The focal zone marker is ideally adjusted to a position just below the target structure under study.

The more sophisticated ultrasound systems provide the possibility to select two or more focal zone markers.

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The image shows an ultrasound scan of the internal jugular vein and the common carotid artery. The two green arrows are pointing at two focal zone markers positioned to maximize the image quality of the target vessels.

30 – Image optimisation: Focal zone markers continued

Some simpler ultrasound systems do not allow adjustment of the exact position of the focal zone. Instead it is possible to select among a few steps.

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In this ultrasound system it is possible to select one of three steps that control image optimisation based on selected depth, ultrasound program and probe frequencies.

26 – Depth: Aligning the target structure to the center of the monitor

The size of the displayed image can be adjusted using the depth controls.

When the depth of the field-of-view (FOV) is increased, it becomes possible to see deeper structures.

When the depth is decreased, the FOV is narrowed around structures closer to the probe, thereby omitting the deeper structures.

Reduction of the depth means that the time from emitted to received signal is reduced. This allows a higher frame rate. Higher frame rate can be used to increase the spatial or temporal resolution or the sector width.

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Different depth settings depending on the position of the target vessel.

25 – Depth: Keep all relevant details in the image

The goal of depth adjustment is to align the target structure to the center of the monitor and to visualise the entire target structure inside the visual field.

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This illustration shows an ultrasound image of the heart with different depth settings. The top image is too shallow, the depth of the middle image is appropriate, and the depth of the bottom image is too large.

20 – Gain: Undergain & overgain

Undergain:

If the user sets the gain control too low, the result is that the amplification of the electrical signals becomes too small and the 2D greyscale image on the screen becomes too dark. That is called “undergain”.

Overgain:

If the user sets the gain control too high, the result is overamplified electrical signals including artefactual noise and the 2D greyscale image becomes too bright (white) with loss of resolution.

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The image on the right shows an ultrasound image of the heart with different gain settings. The top image is undergained, the middle image has optimised gain, and the bottom image is overgained.

19 – Image optimisation: Gain

The gain user control is similar to the brightness control of a television set.

Some of the emitted echo signal is reflected back to the probe when the emitted beam hits a reflective interface in the tissue.

The echo signal returning to the probe from the tissue is converted to an electronic signal by the probe. The electronic signal is very weak and has to be amplified before it is processed to a grey scale dot to be displayed on the screen.

The signal amplification is called “gain”.

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The yellow arrow points at the “overall” gain control. It adjusts the gain in the entire visual field. The red arrow points at the “far field” gain control, and the green arrow points at the “near field” gain control. These buttons only adjust the gain in the near and far field zones of the visual field respectively.

22 – Time Gain Compensation (TGC)

TGC is a user controlled selective amplification of signals reflected from particular depths in the tissue. TGC compensates for the depth dependent attenuation of the ultrasound wave.

A typical user control panel is illustrated in the image.

By fine-tuning TGC, optimal image quality can be achieved at all depths of the image.

Some low-range ultrasound systems do not have built-in TGC.

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The picture shows what happens when the TGC is adjusted at different depths. In the top image, TGC is increased in the upper bands resulting in increased (more white) gain in the superficial part of the image. In the bottom image, TGC is increased in the lower bands resulting in increased gain in the deeper parts of the image. The middle image has appropriate TGC.

21 – Autogain

A lot of modern ultrasound systems have a user control called “Autogain”. When you press it, the ultrasound system optimises the gain based on the selected probe, ultrasound program and image depth.

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The Autogain user control.

24 – The depth scale

The depth is adjusted with the depth control buttons. The depth scale is typically visible along the right side of the ultrasound image.

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The blue arrow points at the depth scale (the 2 cm mark). The red arrow points at the deepest border of the image. The green arrow points at the surface (skin) of the image.

23 – Image optimisation: Depth

The size of the displayed image can be adjusted using the depth controls.

When the depth of the field-of-view (FOV) is increased, it becomes possible to see deeper structures.

When the depth is decreased, the FOV is narrowed around structures closer to the probe, thereby omitting the deeper structures.

Reduction of the depth means that the time from emitted to received signal is reduced. This allows a higher frame rate. Higher frame rate can be used to increase the spatial or temporal resolution or the sector width.

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The depth control buttons.