1. Medical Ultrasonography PLAN BONNARD Maud – ESIL - Biomedical Department - Promotion 2008 I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND

2. I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND

3. ULTRASOUNDS = high frequency sound waves MEDICAL ULTRASONOGRAPHY – Definition PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Medical ultrasonography = ultrasound-based diagnostic imaging technique. High frequency sound waves and their echoes Muscles and internal organs ( size, structures, pathologies or lesions). VISUALIZE

4. MEDICAL ULTRASONOGRAPHY – Historic PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND 1940 Sonar extensively developed and used to detect submarines. 1953 First successful measurement of heart activity. 1964 It became possible to study pregnancy from start to finish and diagnose complications. 1975 Invention of 2D and real time ultrasound. 1994 Invention of the 3D ultrasound … Starts in the mid 19 century by measuring distance under water using sound waves.

5. 5. Dynamic images MEDICAL ULTRASONOGRAPHY – How are ultrasound performed ? PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasound s performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND 4. Calculations by a computer 1.Gel smeared on the area of the body to undergo the ultrasound 2. High frequency sound waves sent 3. Their echoes are received

6. PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasound s performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND At a given temperature, the sound velocity is constant in a given material, but it varies if the materials are different. Solid structures (bones, muscles) reflect sound waves.  show up as white in an ultrasound image. Soft or hollow areas (tissues, chambers of the heart) don’t reflect sound waves.  appear as black. Like many organs, the tennis ball is solid on the outside and hollow on the inside. MEDICAL ULTRASONOGRAPHY – How are ultrasound performed ?

7. MEDICAL ULTRASONOGRAPHY – The Equipment PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Console Transducers CPU : central processing unit

8. MEDICAL ULTRASONOGRAPHY – Different types of ultrasound PLAN 3D Ultrasound Imaging Doppler Ultrasound I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Power Doppler ultrasound of the kidney. 3D ultrasound images

9. MEDICAL ULTRASONOGRAPHY – Benefits vs Risks PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Benefits Risks  No confirmed adverse biological effects caused by exposures to ultrasound  No ionizing radiation X- RAYS  Non invasive and painless  Easy-to-use  Less expensive than other imaging methods  Provides real-time imaging

10. Ultrasound waves do not pass through air or gas, can be reflected evaluation of the stomach, small intestine and large intestine limited Ultrasound has difficulty penetrating bone only see the outer surface of bony structures but not within. MEDICAL ULTRASONOGRAPHY – Limitations PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND

11. DIAGNOSTIC APPLICATIONS PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND  Echocardiogram : heart and its valves, heart's pumping ability  Obstetrical ultrasound : follow development of the fetus  Abdominal ultrasound : detect abnormalities in abdominal organs (kidneys, liver, pancreas, gallbladder…)  Renal ultrasound : examine the kidneys and urinary tract.  Vascular ultrasound : see the vascular system and its function, detection of blood clots.  … MANY !!!!

12. PLAN DIAGNOSTIC APPLICATIONS – Cardiology What is an echocardiogram ? I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Ultrasound of the heart  2D pictures of cardiovascular system  Assess velocity of blood (doppler ultrasound)  Size, shape of the heart, pumping strength.  Any cardiac valve disfonction (leak, regurgitation of blood)  Detect abnormalities linked to deseases (coronary artery ) Advantages : noninvasive, no side effects

13. PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND DIAGNOSTIC APPLICATIONS – Cardiology  Transthoracic echocardiogram (TTE) Views of the heart obtained by moving the transducer to different locations on the chest or abdominal wall.  Stress echocardiogram An echocardiogram is done both before and after the heart is stressed by having the patient exercise or by injecting a medicine.  To detect coronary artery diseases  Doppler echocardiogram  To look how blood flows through the heart chambers, heart valves, and blood vessels.  Measures the direction and speed of blood through blood vessels.  Transesophageal echocardiogram (TEE ) Shows clearer pictures of the heart. (The probe is closer to the heart and the lungs  bones of the chest wall do not block the sound waves)

14. I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND DIAGNOSTIC APPLICATIONS – Cardiology PLAN No risks from a transthoracic or doppler echocardiogram. Stress echocardiogram : dizziness, low blood pressure, shortness of breath, nausea, irregular heartbeats, and heart attack. Transesophageal echocardiogram : sometimes nausea, mouth and throat discomfort, minor bleeding, trouble breathing, slow or abnormal heartbeats. No risks due to ultrasounds itselves

15. I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND DIAGNOSTIC APPLICATIONS – Obstetric Ultrasound is commonly used to: Measure the size of the fetus to determine the due date Determine the position of the fetus See the number of fetuses in the uterus Check the fetus' growth rate See tumors of the ovary and breast … PLAN

16. DIAGNOSTIC APPLICATIONS – Obstetric I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND PLAN -Assess fetal heart beat (doppler ultrasound ) and malformations in the fetus. -Make measurements (gestational age, size and growth in the fetus). Information recomposed into a dynamic picture (sonogram) on the monitor screen. Color Doppler clearly depict the blood flow in fetal blood vessels in a realtime scan. (different colors = different directions) Used : - in diagnosis of fetal cardiac and blood vessels defects - in the assessment of the hemodynamic responses to fetal hypoxia and anemia.

17. DIAGNOSTIC APPLICATIONS – Obstetric I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND PLAN  Placing the transducer (that emits high frequency sound waves) on the maternal abdomen.  Moving it to "look at" (likened to a light shined from a torch) any particular content of the uterus. The procedure is done by : Repetitive arrays of ultrasound beams scan the fetus in thin slices and are reflected back onto the same transducer.

18. DIAGNOSTIC APPLICATIONS – Obstetric I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND PLAN  Development of heat: Tissues or water absorb the ultrasound energy which increases their temperature locally.  Formation of bubbles (cavitation): When dissolved gases come out of solution due to local heat caused by ultrasound. Major dangers with ultrasound : No substantiated ill-effects of ultrasound documented in studies in either humans or animals. BUT :

19. PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND DIAGNOSTIC APPLICATIONS – Obstetric Obstetric ultrasound cannot identify all fetal abnormalities Amniocentesis (Evaluation of fluid taken from the sac surrounding the baby) If suspicions for a possible abnormality OTHER TESTS !

20. PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND THE FUTURE OF ULTRASOUNDS  Improve the ultrasound machines technology  Improve the imaging techniques. Ultrasonography can still be improved ! - Faster, smaller - Better storage capacity - Transducers  smaller  more insertable - Develop 3D ultrasound - Develop ultrasound imaging + virtual reality-type displays  help for amniocentesis, biopsy.

21. CONCLUSION PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Very used and useful technic for diagnostic applications in medecine. Various forms  allow to see many things Benefits and limitations but no risk known. Can still be improved to help even better preventing deseases or curing people. HOWEVER : ULTRASONOGRAPHY :

22. PLAN I/ MEDICAL ULTRASONOGRAPHY 1/ Definition 2/ Historic 3/ How are ultrasounds performed? 4/ The Equipment 5/ Different types of Ultrasound 6/ Benefits-Risks 7/ Limitations II/ DIAGNOSTIC APPLICATIONS 1/ Cardiology - What is an echocardiogram? - Different types of echocardiogram - Risks 2/ Obstetric - What is Obstetric Ultrasound Imaging? - The procedure - Dangers of ultrasound - Limitations III/ THE FUTURE OF ULTRASOUND Thank you for your attention ! Some DJs start learning their craft at an early age...