DMS-2350: SONOGRAPHIC INSTRUMENT/PHYSICS

Transcription

1 DMS-2350: Sonographic Instrument/Physics 1 DMS-2350: SONOGRAPHIC INSTRUMENT/PHYSICS Cuyahoga Community College Viewing:DMS-2350 : Sonographic Instrument/Physics Board of Trustees: Academic Term: Subject Code DMS - Diagnostic Medical Sonography Course Number: 2350 Title: Sonographic Instrument/Physics Catalog Description: Physics and related mathematics as applied to ultrasound including the study of acoustical principles, sound transmission, signal processing, transducer construction, ultrasound instrumentation, quality assurance, and bioeffects of diagnostic ultrasound on soft tissue. Study of resolution, display modes, hemodynamics, Doppler principles and related instrumentation as it relates to ultrasound. Modular courses DMS-235A and DMS-235B will also meet the requirements for this course. Credit Hour(s): 3 Lecture Hour(s): 3 Requisites Prerequisite and Corequisite DMS-1071 Concepts of Physics in Diagnostic Sonography and ENG-0990 Language Fundamentals II, or appropriate score on English Placement Test. I. ACADEMIC CREDIT Academic Credit According to the Ohio Department of Higher Education, one (1) semester hour of college credit will be awarded for each lecture hour. Students will be expected to work on out-of-class assignments on a regular basis which, over the length of the course, would normally average two hours of out-of-class study for each hour of formal class activity. For laboratory hours, one (1) credit shall be awarded for a minimum of three laboratory hours in a standard week for which little or no out-of-class study is required since three hours will be in the lab (i.e. Laboratory 03 hours). Whereas, one (1) credit shall be awarded for a minimum of two laboratory hours in a standard week, if supplemented by out-of-class assignments which would normally average one hour of out-of class study preparing for or following up the laboratory experience (i.e. Laboratory 02 hours). Credit is also awarded for other hours such as directed practice, practicum, cooperative work experience, and field experience. The number of hours required to receive credit is listed under Other Hours on the syllabus. The number of credit hours for lecture, lab and other hours are listed at the beginning of the syllabus. Make sure you can prioritize your time accordingly. Proper planning, prioritization and dedication will enhance your success in this course. The standard expectation for an online course is that you will spend 3 hours per week for each credit hour. II. ACCESSIBILITY STATEMENT If you need any special course adaptations or accommodations because of a documented disability, please notify your instructor within a reasonable length of time, preferably the first week of the term with formal notice of that need (i.e. an official letter from the Student Accessibility Services (SAS) office). Accommodations will not be made retroactively. For specific information pertaining to ADA accommodation, please contact your campus SAS office or visit online athttp:// Blackboard accessibility information is available athttp://access.blackboard.com. Eastern (216) Voice Metropolitan (216) Voice

2 2 DMS-2350: Sonographic Instrument/Physics Western (216) Voice Westshore (216) Voice Brunswick (216) Voice Off-Site (216) Voice III. ATTENDANCE TRACKING Regular class attendance is expected. Tri-C is required by law to verify the enrollment of students who participate in federal Title IV student aid programs and/or who receive educational benefits through other funding sources. Eligibility for federal student financial aid is, in part, based on your enrollment status. Students who do not attend classes for the entire term are required to withdraw from the course(s). Additionally, students who withdraw from a course or stop attending class without officially withdrawing may be required to return all or a portion of the financial aid based on the date of last attendance. Students who do not attend the full session are responsible for withdrawing from the course(s). Tri-C is responsible for identifying students who have not attended a course, before financial aid funds can be applied to students accounts. Therefore, attendance will be recorded in the following ways: For in-person courses, students are required to attend the course by the 15th day of the semester, or equivalent for terms shorter than 5-weeks, to be considered attending. Students who have not met all attendance requirements for an in-person course, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. For blended-learning courses, students are required to attend the course by the 15th day of the semester, or equivalent for terms shorter than 5-weeks, or submit an assignment, to be considered attending. Students who have not met all attendance requirements for a blended-learning courses, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. For online courses, students are required to login in at least two (2) times per week and submit one (1) assignment per week for the first two (2) weeks of the semester, or equivalent to the 15th day of the term. Students who have not met all attendance requirements for an online course, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. At the conclusion of the first two weeks of a semester, or equivalent, instructors report any registered students who have Never Attended a course. Those students will be administratively withdrawn from that course. However, after the time period in the previous paragraphs, if a student stops attending a class, wants or needs to withdraw, for any reason, it is the student's responsibility to take action to withdraw from the course. Students must complete and submit the appropriate Tri-C form by the established withdrawal deadline. Tri-C is required to ensure that students receive financial aid only for courses that they attend and complete. Students reported for not attending at least one of their registered courses will have all financial aid funds held until confirmation of attendance in registered courses has been verified. Students who fail to complete at least one course may be required to repay all or a portion of their federal financial aid funds and may be ineligible to receive future federal financial aid awards. Students who withdraw from classes prior to completing more than 60 percent of their enrolled class time may be subject to the required federal refund policy. If illness or emergency should necessitate a brief absence from class, students should confer with instructors upon their return. Students having problems with class work because of a prolonged absence should confer with the instructor or a counselor. IV. CONCEALED CARRY STATEMENT College policy prohibits the possession of weapons on college property by students, faculty and staff, unless specifically approved in advance as a job-related requirement (i.e., Tri-C campus police officers) or, in accordance with Ohio law, secured in a parked vehicle in a designated parking area only by an individual in possession of a valid conceal carry permit. As a Tri-C student, your behavior on campus must comply with the student code of conduct which is available on page 29 within the Tri-C student handbook, available athttp:// must also comply with the College s Zero Tolerance for Violence on College Property available athttp:// documents/ zero-tolerance-for-violence-policy.pdf Outcomes Course Outcome(s): Apply knowledge of physical concepts of sound as it relates to ultrasound when performing sonographic scans. Objective(s): Describe the physical properties of sound Differentiate between an analog and digital signal describing advantages and disadvantages Describe the advantages of multi-crystal transducers configurations Describe the anatomy of an ultrasound beam and the factors that affect it Categorize the methods used to focus and steer the sound beam Define the piezoelectric and reverse piezoelectric effect Relate the various parts of the transducer construction to their purpose.

3 DMS-2350: Sonographic Instrument/Physics Explain the principles of pulsed ultrasound creation, the parameters that define a pulse and the factors that influence those parameters Describe the purpose of the various components that modify the returning echo Differentiate between an analog and digital signal describing advantages and disadvantages Describe the advantages of multi-crystal transducers configurations. Course Outcome(s): Applying knowledge of the various methods behind signal processing in the ultrasound system to the sonographic procedure. Objective(s): Identify the types of artifacts encountered in diagnostic ultrasound and state their probable causes Describe the various devices used to perform quality assurance on ultrasound equipment Explain the importance behind current research that describes how ultrasound produces bioeffects Explain the various types of ultrasound mode display forms Differentiate between the various types of resolution and indicate how to compensate for a decline in resolution. Course Outcome(s): Relate the laws of fluid dynamics to its effects on the circulatory system. Objective(s): Distinguish how fluid, pressure, and resistance are interrelated Identify the various kinds of flow encountered in circulation Explain how stenosis affects blood flow. Course Outcome(s): Distinguish and differentiate between a normal and abnormal Doppler display. Objective(s): Explain the Doppler Effect and describe the interrelationships between the Doppler equation variables Evaluate Doppler images to provide a determination of the Doppler Effect Identify the various Doppler artifacts encountered in diagnostic ultrasound and explain probable causes Differentiate between the various methods of Doppler signal analysis Describe the basic principles of color flow Doppler Identify the instrumentation involved in color flow Determine whether color flow imaging, power Doppler imaging or duplex Doppler imaging is more appropriate in a given situation. Methods of Evaluation: 1. Weekly quizzes 2. Weekly written assignments 3. Comprehensive mid term examination 4. QA project 5. Comprehensive final examination Course Content Outline: 1. Concepts a. Critical thinking b. Sound properties c. Sound beam d. Transducers e. Digital devices f. Instrumentation g. Artifacts h. Bioeffects i. Display modes j. Resolution k. Doppler

4 4 DMS-2350: Sonographic Instrument/Physics l. Hemodynamics m. Quality assurance 2. Skills a. Interpreting Doppler signals b. Interpreting hemodynamic changes c. Manipulating machine adjustments for quality images d. Maintaining safe machine operation e. Developing risk verse benefit machine adjustments f. Evaluating the performance of an ultrasound system with a phantom. 3. Issues a. Benefits b. Limitations c. Operator dependent d. Quality assurance e. Safety f. Interpretation results g. Atypical studies h. Accuracy Topical Outline 1. Review of basic mathematics 2. Review sound properties a. Longitudinal mechanical waves b. Pulsed Wave c. Pulse production d. Ultrasound transmission 3. Sound Beam a. Formation - Near Field and Far Field (Fresnel and Fraunhofer Zones) b. Interference phenomena i. Huygen''s principle ii. Diffraction (divergence) iii. Bandwidth c. Length of near field (focal distance) d. Shape of near field and far field i. Beam width ii. Natural focus e. Dependence on frequency and crystal or aperture size f. Beam steering i. Transmission time delays ii. Reception time delays g. Beam focusing i. Time delays ii. Dynamic reception focus iii. Multiple transmission foci iv. Apodization v. Subdicing vi. Dynamic aperture h. Clinical usage i. On screen display j. Identifying failure 4. Transducer Construction and Characteristics a. Thickness resonance of crystal b. Operating (resonance) frequency i. Crystal thickness ii. Speed of sound in crystal material c. Frequency characteristics (spectrum) i. Bandwidth 1. Quality factor 2. Effect of damping

5 ii. Multi-Hertz iii. Harmonics d. Damping e. Matching layer-numerical example 5. Scanning Speed Limitations a. Applications of range equation and relationship to pulsing characteristics b. Real-time systems-relationships between i. Pulsing characteristics ii. Frame rate and time required to generate one frame iii. Number of lines per frame iv. Number of focal regions v. Field of view (e.g., sector angle) vi. Image depth (penetration) 6. Digital Devices a. Binary system i. Terminology (bits, bytes, pixels) ii. Discrete nature of binary numbers b. Steps in processing echo information i. Analog-to-digital converter ii. Digital memory 1. Spatial resolution a. Pixels b. Matrix c. Field of view 2. Contrast resolution iii. Digital-to-analog converter iv. Display devices 7. Instrumentation a. Signal types i. Analog ii. Digital iii. Scan conversion b. Transmitter (Output) i. Effect of transmitter voltage on penetration ii. Effect of transmitter voltage on intensity and on patient exposure c. Receiver i. Amplification 1. Output power 2. Receiver gain ii. Compensation-time gain control (TGC) iii. Compression and dynamic range d. Demodulation i. Rectification ii. Smoothing (enveloping) e. Rejection f. Pre and post processing i. Definition ii. Preprocessing functions 1. Time (depth) gain compensation 2. Logarithmic compression 3. Write magnification iii. Postprocessing function 1. Freeze frame 2. Black/white inversion 3. Read magnification 4. Contrast variation iv. Preprocessing or postprocessing functions (equipment manufacturer''s discretion) 1. Persistence 2. Frame averaging DMS-2350: Sonographic Instrument/Physics 5

6 6 DMS-2350: Sonographic Instrument/Physics 3. Edge enhancement 4. Smoothing 5. Fill-in interpolation 8. Storage devices a. Video format i. Display (monitors) ii. TV monitors 1. High resolution monitors a. Lines and spatial resolution b. Brightness c. Contrast d. Frame rate iii. Single or multi-image cameras and laser imagers 1. Photographic film 2. Emulsion film iv. Recorders 1. Fiber-optic 2. Videotape cassette v. Printer 1. Thermal 2. Laser b. Digital format i. Magneto-optical disc (digital still recorder) ii. PACS (Picture Archiving and Communication System) c. Contrast and brightness control adjustments 9. Artifacts a. Definition b. Artifact Recognition in Performing and Interpreting Examinations i. Echoes not representing actual interfaces ii. Missing echoes iii. Misrepresented interface location iv. Misrepresented interface amplitude c. Artifacts Associated with Resolution and Propagation (Axial Resolution, Lateral Resolution, Section Thickness, Acoustic Speckle) i. Definitions ii. Mechanisms of Production iii. Appearance d. Artifacts Associated with Propagation (Reverberation, Comet-tail, Ring-down, Mirror Image, Multipath, Side Lobes, Grating Lobes, Refraction, Speed Error; and Range Ambiguity) i. Definitions ii. Mechanisms of Production iii. Appearance e. Artifacts Associated with Attenuation (Shadowing, Enhancement, and Focal Enhancement or Focal Banding) i. Definitions ii. Mechanisms of Production iii. Appearance f. Other (Electronic Noise, Equipment Malfunction) i. Definitions ii. Mechanisms of Production iii. Appearance g. Artifact Effects on Measurements (velocity or speed error and range ambiguity) 10. Quality Assurance of Ultrasound Instruments a. Need for and Nature of a Quality Assurance Program b. Methods for Evaluating Instrument Performance i. Test objects ii. Phantoms (tissue, Doppler, flow) c. Parameters to Be Evaluated i. Test object 1. Dead zone 2. Axial resolution and lateral resolution (beam width)

7 3. Depth calibration accuracy 4. TGC characteristics 5. Uniformity 6. System sensitivity ii. Tissue equivalent (mimicking) phantom 1. Dead zone 2. Depth calibration accuracy 3. Lateral (horizontal) distance measurement accuracy 4. Axial, lateral, and section thickness (elevational) resolution 5. TGC characteristics 6. System sensitivity 7. Dynamic range 8. Contrast resolution 9. Lesion detection iii. Doppler flow, string, or belt phantoms 1. Maximum depth 2. Pulsed Doppler sample volume alignment (gate position accuracy) 3. Velocity accuracy 4. Color flow penetration 5. Image congruency test d. Preventive Equipment Maintenance i. Cleaning ii. Disinfecting iii. Sterilization e. Record Keeping f. Statistical Indices i. Sensitivity/specificity ii. Negative/positive predictive value iii. Accuracy 11. Bioeffects and Safety a. Acoustic Output Quantities i. Pressure 1. Units 2. Peak pressures 3. Methods of determining pressure (miniature hydrophone) ii. Power 1. Units (mw) 2. Methods of determining power (radiation force, hydrophone) iii. Intensity 1. Units (mw/cm2, W/cm2) 2. Spatial and temporal considerations 3. Average and peak intensities 4. Methods of determining intensity (hydrophones) 5. Common intensities a. SATA - spatial average temporal average b. SPTA -spatial peak temporal average c. SPPA - spatial peak pulse average d. SPTP - spatial peak temporal peak 6. Intensity and power values for different operating modes b. Acoustic Output Labeling Standard i. Thermal index 1. TIS soft tissue thermal index 2. TIB - bone thermal index 3. TIC - cranial bone thermal index ii. Mechanical index c. Acoustic Exposure i. Definition and concepts of prudent use (ALARA) ii. Methods of reducing acoustic exposure d. Primary Mechanisms of Biologic Effect Production DMS-2350: Sonographic Instrument/Physics 7

8 8 DMS-2350: Sonographic Instrument/Physics i. Cavitation mechanisms: relevant acoustic parameters ii. Thermal mechanisms: relevant acoustic parameters e. Experimental Biological Effect Studies i. Animal studies ii. In vitro studies iii. Epidemiologic studies f. Guidelines and Regulations i. American Institute of Ultrasound in Medicine (AIUM) Statementse.g., mammalian, epidemiology, in vitro) ii. National Electrical Manufacturers Association (NEMA) iii. Food and Drug Administration (FDA) g. Electrical and Mechanical Hazards i. Patient susceptibility to electrical hazard ii. Equipment components which could present a hazard 12. Modes of display a. Principal Display Modes (A-mode, B-mode, M-mode) i. Definition of each mode ii. Information displayed on each mode iii. Advantages and disadvantages of each mode b. Principles of Real-time Image Formation i. Relationship between echo amplitude and B-mode display ii. Positioning of echoes iii. Harmonics iv. 3-D and 4-D 13. Resolution a. Axial Resolution i. Dependence on spatial pulse length/ pulse duration ii. Numerical example iii. Effect of damping iv. Transducer frequency spectrum-relation to pulse duration v. Bandwidth b. Lateral Resolution i. Dependence on beam width ii. Frequency iii. Transducer size and focal characteristics iv. Range c. Slice Thickness Resolution (Elevational Resolution) i. Dependence on beam width ii. Transducer array and focal characteristics iii. Frequency iv. Lateral and axial resolution relationship d. Temporal i. Lines ii. Frame iii. Sector size iv. Depth v. Foci vi. Pulse repetition frequency 14. Hemodynamics a. Energy gradient b. Effects of viscosity, friction, inertia c. Pressure/volume/flow relationships d. Velocity e. Steady flow i. Laminar ii. Parabolic iii. Disturbed iv. Turbulence 1. Eddies 2. Reynold''s number

9 DMS-2350: Sonographic Instrument/Physics 9 f. Pulsatile flow g. Stenosis i. Continuity Rule ii. Bernoulli Effect h. Venous resistance i. Hydrostatic pressure j. Effects of respiration (phasicity) 15. Doppler Physical Principles a. Doppler Effect i. Principle as related to sampling red blood cell movement ii. Doppler equation 1. Transmitted versus received 2. Effect of source frequency on shift 3. Effect of the angle on shift 4. Effect of reflector velocity b. Factors influencing the magnitude of the Doppler shift frequency i. Range of the Doppler shift frequency ii. Effects of beam angle, transmitted frequency, flow velocity, and flow direction 16. Doppler Instruments a. Pulsed wave Doppler i. Transducer construction ii. Benefits iii. Limitations iv. Nyquist limit v. Range ambiguity b. Continuous wave Doppler i. Transducer construction ii. Benefits iii. Limitations iv. Uni- and bi- directional units c. Instrumentation i. Receiver ii. Demodulater iii. Wall filter for clutter rejection iv. Directional devices d. Duplex instruments-definition and basic principles e. Spectral analysis i. Purpose 1. Direction 2. Velocity 3. Duration 4. Character 5. Magnitude ii. Fast Fourier transform (FFT) iii. Diagnostic measurements (indices-i.e. pulsatility, resistive) 17. Color Flow Imaging a. Basic Principles i. Sampling methods ii. Display of Doppler information 1. Reflector direction 2. Average velocity 3. Velocity variance iii. Advantages and limitations b. Resources Edelman, Sidney K.Understanding Ultrasound Physics.4th ed. Dallas, TX: ESP, 2012.

10 10 DMS-2350: Sonographic Instrument/Physics Hedrick, Wayne R.Technology for Diagnostic Sonography.1st ed. St. Louis, MO: Elsevier Science, Kremkau, Frederick.Diagnostic Ultrasound Principles and Instruments.9th ed. St. Louis: Saunders, Miele, Frank R.Ultrasound Physics Instrumentation Volumes 1 2.5th ed. Forney, TX: Pegasus Lectures, Hughes, Sheila.National Certification Examination Review: Sonography Principles Instrumentation (SPI).4th ed. Dallas,TX: Society of Diagnostic Medical Sonography, Top of page Key: 1466