Alzaiem Al-azhari University Faculty of Graduate Studies & Faculty of Radiologic Sciences Medical Imaging Medical Diagnostic Ultrasound(Ms.

c) Batch(9)- Semester (1) seminar about: compound ,panoramic, and tissue harmonic imaging.
Presented by:
Gofran Hassan Osman Ali Nosiba Abdelbagi Dafaalla Mohammed Enas Adel Mohammed Alhashmey

Supervisor: D. ahmed abdalraheim

6.3.2013:

Compound imaging
Presented by: Gofran Hassan Osman Ali

Panoramic imaging Presented by: Nosiba Abdelbagi Dafaalla Mohammed

Panoramic photography
(often called a pano ) sometimes known as wide format photography is a technique of photography , using specialized equipment or software, that captures images with elongated fields of view .panoramic images are quite similar to the way we see the world (2-1)

Fig(2-1)Shows Panoramic photography)2-1(

Panoramic radiography
Panoramic X-ray images provide an overview of both jaws, show missing The panoramic radiograph continues to offer todays. dentist a unique patient view; covering the entire dentition and surrounding structures, the facial bones and condoyles, and parts of the maxillary and nasal complexes.sinus (2-3)

Figure (2-2) shows Normal Panoramic Radiograph)2-2(

Panoramic imaging ultrasound

Panoramic ultrasound is a technical modification of conventional ultrasound that produces images with a large anatomic field of view. (2-3)

Panoramic imaging ultrasound cont

Panoramic Imaging allows you to examine extended scans as a single image by automatically displaying an extended fieldof view. Panoramic Imaging also supports angular scanning from convex and linear probe data acquisition (2-3).

Panoramic imaging ultrasound cont

Since the near-field image width is limited by the width of the transducer, it is difficult to obtain a wide view of shallow structures. Panoramic imaging allows the transducer to be moved along the patient's anatomy, blending multiple images together to form one long image with an extremely wide field of view. (2-3)

Panoramic imaging ultrasound cont

This extended field-of-view technique has been upgraded to support color-flow and power-mode imaging and can be used to measure larger structures in the panoramic image evaluated panoramic imagings ability to measure anatomic dimensions of structures, such as human legs, and found that it underestimates linear distances by 1.7% (52.2%), which is similar to the spatial error range of normal B-mode imaging. )2-3(

How it works?
PanoView allows recording of image sequences in order to build a larger ultrasound overview image by combining (gluing) the series of single images. The user starts a patient study as usual, e.g. by optimizing the image using TGC, Gain, and other settings. Once the user wants to get panoramic scan of the interesting anatomy. (2-5)

How it works? Cont

We just pushes the PanoView button and move the transducer smoothly and continually with more or less constant speed along the desired direction A progress bar shows the current state during acquisition. Recording can be stopped by pressing any button on keyboard or mouse/touchpad. Once the acquisition is completed, a panoramic image is automatically created and displayed immediately by processing of frame sequence)2-5(

Applications:
1-Abdominal 2-OB/GYN 3-Musculoskeletal 4-Color Seascape panoramic imaging is available as an enhancement to B/W Seascape imaging (2-5)

The 2D B-mode and color-flow images have a limited field of view, allowing the visualization of only portions of larger organs [e.g. the renal transplant in Figure (2-5-a)to be seen at a time. To extend the field of view to see larger organs and their surroundings [e.g. the renal transplant, liver, and distal fluid collection in Figure(2-5-b) )2-6(

L][] j

fig(2-3-a)Standard field of view of kidney renal transplant(2-6).

(2-3-b) Panoramic image displaying the renal transplant, liver, and distal fluid collection. )2-6(

Panoramic imaging projection

The system may be used to generate a panoramic image of any body structure and, indeed, as is explained further below, may also be combined with known techniques for generating flow information so as to create a panoramic image on which color flow data is superimposed. (2-7)

Fig(2-4-a )Narrow Angle of View (2-7)

Fig( 2-4-b ) Wider Angle of View

Panoramic Ultrasound of the Thyroid

Images obtained with this technique display both lobes of the thyroid gland on a single image, and provide an accurate imaging representation of a variety of thyroid disorders. This report describes the use of panoramic ultrasound and presents examples of panoramic ultrasound of the thyroid. (2-8)

Fig(2-5) Panoramic imaging of the Thyroid (2-8)

Fig(2-6) showsPanoramic view of a simple cyst within the glandular layer of .)2-8(breast breast tissue

Fig(2-7) shows Panoramic ultrasound from the lumbar to the coccygeal region showing the lower spinal cord, (90 rotation of ultrasound picture). the (2-8)

Panoramic Prenatal Ultrasound

A recent advancement in the field of ultrasound is the ability to scan a panoramic view of the fetus. As the transducer is moved along a part of the body, the image continues to grow, showing the entire scanned area (instead of just showing the area currently being scanned by the transducer). This view gives the display both fine detail and big picture (2-9)

Fig(2-8) shows Panoramic ultrasound image of triplet gestation at 11 weeks.(2-8)

Benefits
1-Larger organs and vessels can be viewed in their entirety for improved diagnostic confidence. 2-CINE function provides high resolution image and anatomical reference in split screen.

Fig(2-9) shows panorama of the liver and right kidney.)2-8(

Fig(2-10) shows Leg panorama scan(2-8)

3) Features
1-Intuitive and easy to use; 2-No additional external devices (trackers etc.) are needed. 3-Tracker-free scanning, no change of the familiar examination procedure. 4-Panorama images possible also along curved lines, e.g. by following the path of a vessel.

5-Length measurements with Ruler and Poly line too. 6-Contrast, brightness and gamma correction of the panoramic image Colorizing of the image for better contrast resolution. 7-Ultrasound frame window shows selected individual frame together with its position within the panoramic view.

8-Patient data and resulting images can be stored or .into the integrated database, in a separate file printed. 9-Colorizing of the image for better contrast resolution. 10-Movie clips can be stored as an uncompressed file for further processing or presentations.)2-5(

Tissue harmonic imaging Presented by: Enas Adel Mohammed Alhashmey

TISSUE HARMONIC IMAGING

Definition of Harmonics:Frequencies that are even and odd multiples Of the original frequency called fundamental or operating frequency.)1(

Figure(3-1)Frequency spectrum of the transmitted and received waves. )3 (

How are harmonic signals generated?

Harmonics are generated by the passage of the ultrasound scanner beam as it passes through tissue. The peaks and troughs of the transmit pulse cause the tissue to alternatively expand and contract distorting its shape; Because tissue is not linearly elastic it contracts less than it expands.(2)

harmonic generation(cont..)
During tissue contraction, tissue density increases, causing the peak of the sound wave to travel slightly faster than the trough. The result of this process called non-linear propagation, is that the wave becomes progressively more asymmetrical; This distortion results in harmonics.(2) asymmetrical

Figure (3-2) generation of harmonic frequencies)3)

harmonic generation(cont..)
Although the amount of harmonics that tissue generates at any given instant is small, the harmonics build as the pulse propagates through tissue as the ultrasound scanner wave travels through more tissue, more harmonics are generated )2(

harmonic generation(cont..)
Although the amount of harmonics that tissue generates at any given instant is small, the harmonics build as the pulse propagates through tissue as the ultrasound scanner wave travels through more tissue, more harmonics are generated )2(

harmonic generation(cont..)
The region of maximal production of harmonics is at the focal zone, because beam intensity is highest at that location. Little or no harmonics are produced by weak waves such as at the edges of the main ultrasound scanner beam.(2)

harmonic generation(cont..)
Once the fundamental frequencies are eliminated only the harmonic frequencies are left for image formation ,Indeed the quality of the harmonic image is primarily dependent on the complete elimination of all echoes derived from the transmitted frequencies.(2)

Image Formation in Tissue Harmonics

Tissue harmonic imaging in ultrasound scanner operates by transmitting a fundamental beam that has a lower frequency ; This fundamental pulse as it propagates through tissue inside the body ,generates the higher frequency harmonic sound(2).

Image Formation in)cont(

Tissue harmonic imaging in ultrasound scanner operates by transmitting a fundamental beam that has a lower frequency ; This fundamental pulse as it propagates through tissue inside the body ,generates the higher frequency harmonic sound(2).

technique Tissue harmonic imaging

Tissue harmonic imaging in ultrasound scanner is a new grayscale imaging technique. Tissue harmonics uses various techniques to eliminate the echoes arising from the main transmitted ultrasound scanner beam (the fundamental frequencies) from which conventional images are made.)2(

Filtration
is the technique to remove the fundamental frequency , currently used most commonly to produce tissue harmonic images. uses sophisticated transmit beam formers to produce a narrower bandwidth and signal processing techniques to filter out the spectrum of frequencies that are likely to arise from the fundamental beam. (2)

Filtration)cont.(
the information from both the fundamental signal and the harmonic signal overlaps. With narrow bandwidth beams(less overlap), filtration can provide a much cleaner separation of the harmonic related information from the fundamental signal (2).

Single Line Pulse Inversion (PI)

Pulse inversion is a technique that adds the echoes from two opposite polarity pulses to cancel the fundamental echoes leaving only the harmonic information. An initial pulse is sent into the body and the returning echoes are recorded)2(

Single Line Pulse Inversion (PI)

This first pulse-echo cycle results in both fundamental and harmonic frequencies returning from the tissue and the data received are stored. (2)

Single Line Pulse Inversion (PI)

Fundamental and harmonic frequencies of the second cycle are received and added to the data received from the first cycle assuming no patient motion adding the data will then cancel the linear fundamental echoes.(2)

Single Line Pulse (cont..)

The non-linear harmonic information remains, resulting in an unfiltered harmonic signal over the entire frequency bandwidth of the transducer.)2(

Fig(3-3)Schematic diagram of phase inversion harmonic sono graphy.(4)

Side-by-side Phase Cancellation

Side-by-side phase cancellation is similar to pulse inversion , Instead of two firings of opposite phase ultrasound scanner beams along the same line this method sends both signals together at the same time with opposite phases These adjacent lines are then added. (2)

Side-by-side Phase)cont(
The resulting cancellation of the fundamental opposite phase lines leaves the harmonics from which images can be made This technique is a spatial cancellation technique while pulse inversion is a temporal cancellation technique.)2(

Pulse Encoding
Pulse encoding of the transmitted ultrasound scanner beam is another technique to cancel the fundamental echoes and enhance harmonic detection ,Transmit pulse encoding uses relatively complex waveform sequences to give each a unique recognizable signature or code.(2)

Pulse Encoding)cont..(
This complex coded pulse is sent into the body The unique code is then recognized in the return waveform by a special decoder that is part of the equipment;Because the linear fundamental echoes have a specific code they can be identified and canceled.(2)

Pulse Encoding)cont(
The remaining nonlinear harmonic signal is then processed to form the image ,This technique has proved especially useful in the near field.(2)

Comparison Between conventional us and THI US

Harmonic waves are generated within the tissue and build up with depth to a point of maximal intensity before they decrease because of attenuation , In comparison conventional ultrasound waves are generated at the surface of the transducer and progressively decrease in intensity as they traverse the body )3(

Comparison(cont..)
Harmonic imaging improved signal-to-noise ratio by reducing noise from side lobe artifact in the near field and echo detection from multiple scattering events , This reduced noise was responsible for the superiority of (HI ) over conventional US in the visualization of cystic lesions and in the improved confidence of diagnosis for most cystic lesions.)3(

Comparison(cont..)
Tissue harmonic imaging especially effective in renal imaging, probably because of the considerable distortion related to the body wall in that area. Better definition of the posterior acoustic shadows in calcifications and lesions containing air also contributed to improved lesion visibility. )3(

Figure(3-4)liver and hepatic vein improvement cystic clearing in this vessels with harmonic image)5(

Advantages of Tissue harmonic imaging

1-improved axial resolution due to shorter wavelength. 2-better lateral resolution due to improved focusing with higher frequencies. 3-Reduced artifact due to the relatively small amplitude which reduces detection of echoes from multiple scattering events. )2(

Advantages of Tissue harm(cont..)

Tissue harmonic imaging in ultrasound scanner reduces artifact in several ways, which are:1- Decreased Effects of the Body Wall 2- Reduced Artifacts from Weak Echoes 3- Decreased Body Wall Reverberations)2)

Advantages of Tissue harm(cont..)

4-tissue harmonic imaging in ultrasound scanner has the potential to decrease the time required to scan some patients 5-reduced slice thickness and signal-to-noise ratio(2). .

Advantages of Tissue harm(cont..)

5-harmonic beams are produced beyond the body wall, thereby reducing the defocusing effect of the body wall. This is a theoretic advantage in imaging of obese patients. (2)

Advantages of Tissue harm(cont..)

Harmonic imaging was especially helpful in obese patients because of reduction in the This increased intensity was one of the factors that improved lesion visibility in obese patients ; whose body walls typically contain proportion a high of fat. (2)

Advantages of Tissue harm(cont..)

6-improves the image quality by primary way (improving lateral resolution, grating lobe artifacts are eliminated()1(

Figure(3-5)liver and portal vein improvement in penetration harmonic image)5(and contrast resolution with

Second harmonic imaging

Second harmonic imaging was originally developed as a technique to increase the sensitivity of detection of ultrasound contrast agent, particularly when evaluating organ perfusion or to delineate cardiac chambers Ultrasound contrast agents usually consist of very small gas microspheres. )6(

Second harmonic)cont(
They are strong reflectors of ultrasound and resonate when placed in an ultrasound field, As they resonate they generate harmonics and these harmonic echoes are larger in amplitude than those from tissue, This makes it easier to detect and image the contrast agent within the cardiac chambers and tissues.)6(

Harmonic Doppler imaging

Harmonic Doppler imaging has been found to be well suited to a number of diagnostic applications. (e.g echocardiography( Doppler processed harmonic signals exhibit greater resolution than their fundamental frequency counterparts due to the higher frequencies involved)7(

Harmonic Doppler)cont..(
The harmonic echo signals are Doppler processed and displayed, The harmonic Doppler signals may be displayed alone or in combination with a fundamental frequency or harmonic grayscale image. )7(

Limitations
H I was better for demonstrating most abdominal lesions, but at times it did not have any additional benefit over conventional US for demonstrating a lesion, improving diagnostic confidence or altering clinical management patients with diffuse fatty infiltration in the liver penetration of the US beam was better on conventional US images.(2)

References
(2-1 )www.bhphoto video.com, http \\indepth \sites \default \files . Panorama ,tool and technique of panoramic photography , Friday-22feb- 10:00 am (2-2)www.acrobat.com Successful panoramic radiography page 10-11 Sunday 24feb10.30 pm (2-3)www0medical ultrasound system.com, http: \\ssfs.royalsociecty puplishing .org \content \477 \f23 expantion.html.Panoramic ultrasound imagidng Friday22 feb11:03 am.

(2-4)hwww. Telemed.com http : \ \www. Telemed. \pano view-enlt- htm Pano view Saturday-2 march -12:00 pmm (2-5)www.wikipedia.org . http : \ \en . wikipedia .org \wiki \ Panoramic- photography Sunday 24-feb-9:15 am (2-6)www.healthcare.siemens.com, http : \ \healthcare siemens.com \ultrasound \option andupgrades \clinical-application \panoramic imaging, Panoramic imaging Sat 21feb -6:16 pm

(2-7)www.google.com http: \\wwwgoogle.com \images? Panoramic ultrasound imaging Friday 1-3 9:25 am (2-8)www sciencedirect.com http: \\www sciencedirect.com \. Science \article \pii sat 2 march 12:00am

- 1-Frederick w . kremkau , Diagnostic U/S(principles and instruments(7edition-by elsevier inc Saunders , United State Of America:2006(page22-105) 2-www.wikipedia.com,http://www. nova.medical.com (27-2-2013,4:21pm) 3- www.wikipedia.com,http://www. Radiographics /rsna.org. (27-2-2013,4:45) 4- www.wikipedia.com,http://www.ajronline.org. (27-2-2013,4:21) 5-www.wikipedia.com,http://www .ge health care.com.)2-3-2013,11:00)

6-www.wikipedia.com,http://www .ncbi. mnih/gov/published.)28-2-2013,5:30pm) 7-www.wikipedia.com,http://www. devileye.net. (2-3-2013,10:00am )