4. THE ACOUSTICS OF THE BODY 4.1. THE NATURE AND CHARACTERISTICS OF SOUND “Although humans make sounds with their mouths and occasionally look at each other, there is no solid evidence that they actually communicate with each other.”For the human being sound is one of the most important ways to communicate by: « expressing himself through speech © obtaining information through listening © obtaining stimulation (music) Sound allows more complex information transfer than, for example, visual impressions. Tools of information exchange through sound are: e throat - mouth tract for producing and modulating speech sounds ¢ car for listening and analyzing sounds Sound can be used as a diagnostical tool: * body as resonator => stethoscope « transmission and reflection of sound => ultrasound imaging Review of general principles of acoustics is necessary to appreciate the sensitivity of the human sound system. It is also important for understanding acoustical diagnostics. 153‘Transmission of sound requires matter (air, liquids, solids) as transmitting medium, unlike light (e.m. waves) which can travel through matter free space! Sound represents a longitudinal wave of wavelength \ and frequency f which is transmitted by pressure (density) changes with the speed of sound v in transmitting medium. Vibrating | diap! Je Sadie co yang (a) : f Uoludapeaker Pe ao 2 PR-A— 5 ) g ° -_p Distance (m) wave behaviour can be described by wave equation: . (2nt 2: A= Ag: sin (2 — 252) — Ap. sinaas (t- 2) A is displacement of molecules in transmitting medium at position ¢ and time t, Ap is maximum displacement of molecules.Well known relation between speed of sound v, frequency of sound f, and wavelength vad-f speed of sound is a material constant (depends on molecular structure, temperature, and density of material), therefore product of wavelength and frequency is constant. Values of p, v and Z for Various Substances p (kg/m) v (m/s) Z (kg/m? s) Air 1.29 3.31 x 102 430 Water ‘1.00 x 10 14.8 x 102 1.48 x 108 Fat 0.92 x 103 14.5 x 102 1.33 x 108 Muscle 1.04 x 103 15.8 x 102 1.64 x 106 Human sound system operates within a certain frequency range: © range of human voice: 64 Hz (male bass) to 2050 Hz (2.05 kHz) (female soprano) © range of human ear: 20 Hz to 20000 Hz (20 kHz) © frequencies below audible range: infrasound frequencies above audible range: ultrasoundEXAMPLE wavelengths of soprano and bass sound: 344 m/s 64 Hz 344 m/s 3050 Hz > 0.168 m ease = = 5.38 m Asoprano = The capability of hearing does not only depend on the frequency of sound but also on the intensity! whisper - scream The intensity of sound J is correlated to energy B [J] per time t [s] and area [m2]: E J Ww trarea [eemel ~ Ural The mechanical energy of a sound wave with frequency f and speed v necessary to move a single molecule by a maximum distance Ay is: E=1/2-m-v [J] + E=2n'mA3f? [J] The total intensity can be expressed in terms of density p 50 A? (On AP [W/m 156The product of density and speed of sound is a material constant and is called the acoustic impedance Z. 15-2 (Aw)? [W/m with w = 2m f as angular frequency. The intensity can be expressed in terms of change of pressure P in transmitting medium: Audible sound intensities at +1000Hz range from 10~!? [W/m?] (quiet) to 1 [W/m?] (loud)! Audible range covers twelve orders of magnitude: unsurpassed in sensitivity!!! EXAMPLE What is the displacement range for air molecules corresponding to the audible intensity range at an average frequency f = 1000 Hz? 12-1)? 1 [aed =oo(=) =seya=li-10% Atoua mlz) 280 \ 430 ° displacement corresponds to size of a cell! 1 (2-1)? _ 1 ‘(2-10-12 =i boa = 525 (HF) = §280\ 430 110 displacement corresponds to the size of the atom! 10 [um] = 10 [pm] 157What is the displacement range for the ear drum diaphragm corresponding to the audible intensity range? Z=p-v=1.64-10° [kg/(m?-s)] for I= 1 [W/m] 1 2-1\¥? =f Agquiet = oF FF) =18-10 for I=10-? [W/m] molecular structure of diaphragm allows less displacement. Correlation of sensitivity range of human ear with respect to frequency and intensity of sound waves! -10 40 60 100 200 400 600 1000 2000 4000 10,000 20.00 (Hz) 158UNITS OF SOUND INTENSITIES FOR AUDITORY SYSTEMS It is difficult to assign absolute intensity units for auditory systems because absolute values always depend on medium and pressure conditions. In air they also depend on atmospheric pressure which changes with height and weather conditions. Therefore relative intensity units have been established which depend on intensity ratios. Typically intensity is normalized to lowest audible intensity Ip = 10- [W/m?| International standard unit corresponding to an intensity ratio of 10: In/I=10 corresponds to 1 bel (in honor of Graham Bell) I, 1 bel] = login q The bel unit represents a rather crude scale, therefore the introduction of decibels: 1db = 0.1 bel 1db = 10 logy? qh As shown before, sound intensity is directly related to pressure change: Ia P? 2 1db = 10- log? = 10- logio (2) =20- logyoe? q PA Py Ifa sound wave causes a pressure difference of two: 20 log2 = 6 db if sound wave causes a pressure difference of ten: 20 log10 = 20 db 159Audible intensities are referenced to lowest audible intensity Ig = 10°? [W/m] Py = VIp- 2 Z = 3-107 [Pa] the most intense sound which can be heard without inflicting pain or damage is this corresponds to intensity in decibels: 1 1=1(W/m}; 12 10 Logig x? = 120 [at] 1 120 [db] = 20- Logie = Pai + P=30 [Pa] % Py Approximate intensities of day-to-day sounds humans are exposed to! Approximate Intensities of Various Sounds Intensity Level (W/m?) (dB) Sound that is barely perceptible 1072 0 Whisper 1010 20 Average dwelling 109 30 Business office 107 50 Speech at 1m 106 60 Busy street 105 70 Subway or automobile 103 90 Sound that produces pain 109 120 Jet aircraft 10! 130 Rocket on launch pad 105 170 160EXAMPLE Intensity levels of 160 db can cause damage of the ear drum diaphragm. What is the displacement of the diaphragm at such an intensity adopting an average frequency of f = 1000 Hz? A= 1 it ize 6 2 nF with Z=1.64-10° [kg/m?s] 10 tog = 160 db logh = 16 J = 107-10 = 104 [W/m] 0 0 A = 0.018 [mm] ~ 2m 1000 Hz” 1614. THE ACOUSTICS OF THE BODY 4.4. THE PRODUCTION OF SPEECH 163Speech sounds are produced by modulation of outward flow of air exhaled from the lung, through the trachea, and oral mouth cavities. => Speech can only be produced while exhaling! Nasal cavity Hard Soft Palate Palate (Velum) Cricoid cartilage Esophagus Vocal cords exhaled air passes through glottis (vocal chords). muscle controlled contraction of glottis triggers modulation process: origin of pressure variations in the exhaled air. mouth cavities function as resonator to give sound the characteristic modulation of voice.Sound modulations are produced by changing volume of resonating cavities. a, e, i, 0, u, + voiced sounds rely on changing resonator volume only! Non-voiced sounds require supporting movement of tongue and/or lips! s, f, th, ch, : frictive sounds rely on increase of friction for exhaled air through tongue and/or lips! p, t, k, q, : explosive sounds rely on build-up and sudden release of pressure in the oral cavities! 165PHYSIOLOGY OF VOCAL SYSTEM Simple model of speech production. Muscle Force 1. Glottis closed by muscle force: trachea, Ptrachea “600 - 2000 [Pa] Nose Output Nasal = Pr Tube Trachea and Bronchi + increase of air pressure inside 2, pressure opens glottis: + decrease of air pressure inside trachea mc ‘ence 1663. originates airflow through opening according to Bernoulli’s law Prrachea + 1/2+ P+ Virachea Patcttis + 1/2+ p+ Vitouis = constant 4. associated decrease of pressure causes closure of glottis 5. pressure modulation in exhaled air, fine modulation by vibrations in vocal chords Vocal tract modification t Glottal wave $ Radiated wave 2 Za 6. articulation in resonating mouth and nose cavities ssa Periode einer kHz Stimmbandschwingung > 6 : ok bad rh sj Time — fal lef fil lol tut DAS LEH ROU GH DERBY SIOLOG Ie a om — 7 ‘summa Voice characteristics is determined by volume and design of oral cavities. 167EXAMPLE How much acoustical energy is required to teach for 75 minutes? Average frequency of speech is * 1000 Hz (for bass) -+ corresponds to frequency of vibrating vocal chords! power in vibrating vocal chords ~ 15 - 25 pW Talking for 75 minutes requires a total energy of: E = (15 — 25)[u¥]- 4500 [s] = 0.068 — 0.113 [J] required acoustical energy is small! 1684, THE ACOUSTICS OF THE BODY 4.3. THE PHYSICS OF THE EAR gore Sng, Middle ear 6 Foot, 59P* es Lar Middle eor cavity 170‘The ear is the body’s main receiver system for acoustic wave information. The main objective of the ear is to receive, the acoustic waves, to amplify the intensity, to analyze the frequency and intensity structure of the wave, and to reject random background noise. Gerdusch The auditory system of the body is structured into a: Mechanical system, to catch and to amplify acoustical information (ear); « Sensory (electrical) system which converts mechanical pulses into electrical signals which are passed on by the auditory nerves to the brain; « Auditory system, to decode and analyse the electrical nerve signals in the auditory cortex (brain). ‘The following section will be mainly concerned with the mechanical aspects of the hearing process, the physics of the ear. The electrical aspects of information transfer will be discussed in section 6. wm‘The ear itself can be structured into three sections with the purpose to receive acoustical signals and to amplify these signals: Semicireular Canals Vestibular Nerve UsUtricle SwSaccule « OUTER EAR, ~ 2.5 cm long ear canal terminated by the eardrum. « MIDDLE EAR, cavity section containing by three small bones (ossi- cles with connecting tube to the mouth cavity (Eustachian tube). * INNER EAR, spiral-shaped, fluid-filled tube system (chochlea) with internal organ of Corti. the three parts are separated by membrane windows, eardrum (between outer and middle ear), oval window and round window (between middle ear and inner ear). The cochlea is separated by the basilar membrane. 172THE OUTER EAR The visible part of the outer ear (pinna) is nearly negligible for the hearing process. Removement would lead only to insignificant consequences as far as the auditory sensibility is concerned. The critical part of the outer ear is the auditary canal which is © 2.5 cm long. The canal is closed by the eardrum membrane. It represents a tube closed on one side. Therefore incoming acoustic waves of certain frequency can resonante. auditory canal ear The natural frequency for an air-filled tube of length L with one end closed is: 0 : fa = neg (with n=1,3,5,7,..) — 330 m/s] _ f= F005 [mr] ~ ie = 2. 330 [m/s] _ fa = 2 Tgp py = 0000 He ‘This enhances the sensitivity of ear in the higher frequency range * 2000 - 8000 Hz. 173The sensitivity of the ear changes with frequency and can be described in terms of the loudness. Constant loudness (isophon) varies with intensity and frequency. The unit for the loudness is the phon which is normalized to the intensity at the fixed frequency of f=1000 Hz. 1 [phon] = 1 [db] at f = 1000 [Hz SSE 120 t ae 10 f 100 100 90 90. 2B 0 a © 4 0 2 6 60. 50 40 a 30 x0 20 a 10 7 ° 10 . 40 60 100 200 400 600 1000 2000 4000 10,000 20,00 (He) The solid lines indicate the isophones, curves of constant loudness as a function of intensity and frequency. All sounds along the isophone appear equally loud to the listener. The lowest isophone represents the hearing threshold. The dips in the isophones at frequencies around 3000 Hz and 8000 Hz signalize that lower intensities correspond to higher loudness, this results from the increased sensitivity of the ear due to the resonance effect in the outer ear canal.The Eardrum ‘The eardrum is a 0.5 mm thick membran with an area of © 65 mm?. It separates the outer ear canal from the middle ear cavity. The main purpose of the membrane is to absorb and transmit the pressure variations caused by acoustical waves in the outer ear canal. Because the thinness of the membrane large pressure variations due to intense noise, 160 db (see example) or large pressure differences between outer and middle ear cavities (AP ~ 8-103 Pa) can cause its rupture. To avoid rapid development of pressure gradients (for example by rapid change of atmospheric pressure, Eustachian tube connects middle ear and mouth cavity for pressure equilibrization. Eustachian tube is normally closed, but opens when swallowing. A pressure gradient develops during the start and landing of aircraft, in rapidly moving elevators, swallowing avoids ear-popping! EXAMPLE An small aircraft drops rapidly from its initial height Ay to height ha, the rapid change in atmospheric pressure causes rupture of the pilot’s eardrum. Calculate the height difference. AP = p-g-(hi—/h») AP 8- 10° [Pa] (i —he) = 57> = 729 [kg/mi] 9.81 ey 28 The free fall takes 11 s (see Mechanics of the Body, section 1.3), rapid swallowing should prevent rupture of the eardrum. usReflection and Transmission at the Eardrum The acoustical signal travels along the ear canal and hits the eardrum. This causes partial reflection and transmission of the signal. To optimize the hearing sensitivity reflection should be minimized and transmission maximized. Sound waves in different material moves with different speed. The density of the material and the speed of sound determine the impedance for the sound transmission in the material: Z = p-v If sound waves traveling through material with impedance Z; hit the surface of a material with different impedance Z only part of the sound wave transmits into the material, most of the sound wave is reflected at the surface. Considering the amplitudes of the incident wave Ajn, the reflected wave A,ey and the transmitted wave Atrans, We get the relation: Arp _ Z2=F | Atrans 2+ a An +h? An — 2+2Z2 teeny The ear receives and processes the intensity of the acoustical signal: I « A’. 176To investigate the transmission of the acoustical signal inside the ear it is necessary to consider the intensity ratios rather than the amplitude ratios. Trep (254) Tin 24+ 2, Lerans Buf 2-2 y Tn 2p \%i +2 If the material show large impedance differences, most of the signal is reflected, only a small portion of the intensity is transmitted into the higher impedance material: impedance mismatch. ‘This yields for the intensity ratios for reflected and transmitted acoustical waves at the eardrum! Zain =430 kg/m? - 8, Zmuscte=1.48-108 kg/m? s 2 Tet = (#4) = 0.9988 Tin 2+ 2, Terans _ 21 ( 2-2 y Ferans _ Za = 0.0012 In 2 \A+2e om Most of the incoming wave intensity is reflected and therefore lost for the hearing process. = 10-Logi90.0012 = —29 db Better conditions for transmission between water and muscle: impedance matching (Zwater=1.64-10° kg/m? +8, Zmuscte=1-48-10° kg/m? - s) Treg _ . Ztrans _ 7 = 0.0026 ; 7. = 0.9974 in lin Good impedance matching is necessary for good signal transmission! 177THE MIDDLE EAR The middle ear is an air filled cavity which is connected by the Eustachian tube with the mouth cavity. Dominant feature of the middle ear are three small bones, the ossicles, malleus (hammer), incus (anvil), and stapes (stirrup). Purpose of the bones is to serve as mechanical impedance matching and amplifying system for the transmission of the eardrum vibrations towards the inner ear. ‘Ligaments (control moti ion of bones) Inner ear Oval Window LN Tympanic muscle Eardrum Q Stapedius muscle \ Stirrup (stapes) ‘The malleus is attched directly to the eardrum membrane to absorb the vibrations, the incus couples the malleus with the stapes which in turn is attached to the oval window membrane which separates the middle ear cavity from the inner ear. The ossicles act as a lever system causing a substantial amplification of the eardrum membrane vibrations. 178‘The pressure variation Pn induce a force Fy = Pn + Am at the eardrum with area Aj, which causes a torque 7 at the incus. This torque in turn transmits a force F, and pressure P, onto the oval window with area Ay. > Ay Tm = Fn Lm = Fo* Lo =. ae R Pm+ Am * Lm = Po* Ao’ Lo Ro = Po _ Am tm = Pr Ay Ly Eardrum ‘This pressure ratio for the vibrations on eardrum and oval window represents a significant amplification of the initial acoustical system: For Lm/Lo © 1.3 and Am/Ay #15 = Po/Pn * 19.5! This represents an increase in decibels of: 20- loge = 20-logy19.5 = 26 db Ossicle lever system in the middle ear provides efficient coupling between the vibrating eardrum membrane and the oval window membrane without intensity losses. The coupling (impedance matching) is most efficient in the frequency range from 400 Hz to 4000 Hz. For higher and lower frequencies, stiffness and mass of the ossicle system limit the impedance match. 179THE INNER EAR The inner ear is well protected within the skull. ‘The inner ear consists of a spiral shaped system of three parallel tubes, the cochlea, filled with an anionic liquid. The two outer tubes (tympanic chamber and vestibular chamber) are connected at the tip of the cochlea. The inner tube (cochlear duct) is separated by the basilar membrane from the outer tubes. The stapes is attached to the oval window which separates the vestibular chamber from the middle ear. The round window separates the tympanic chamber from the middle ear. Vibrations of the oval window transmit pressure variations to the fluid in the closed vestibular and tympanic chambers of the cochlea. 180The movement of the liquid causes a wave-like vibration in the basilar membrane of the cochlear duct moving toward the tip of the cochlea. Due to the decreasing stiffness of the basilar membrane tones of certain intensity and frequency cause local maximum of wave amplitude along the basilar membrane. DISTANCE FROM STAPES (APPROX mm) ‘The basilar membrane carries the organ of Corti, covered by fine hair sensors which gets locally excited at the amplitude maximum of the vibration of the basilar membrane, This position dependent excitation of sensors causes frequency dispersion. 1814. THE ACOUSTICS OF THE BODY 4.4. DIAGNOSTICS WITH SOUND AND ULTRASOUND Display Sa Pulser timing and spatial position Control panel Transmitter- Receiver Tec processing ADC 183,THE STETHOSCOPE The stethoscope is the standard instrument to amplify and analyze characteristic body sounds like heart beat and blood flow (see section 3). (For a history of the stethoscope see Cameron, Skofronick and Grant, ’Physics of the Body’.) ‘The use of the stethoscope is based on the principle of sound transmission through a tube with both ends closed. Earpieces diaphram bell The bell is attached to the body to pick up sounds. The open bell relies on the skin as vibrating diaphragm. The closed bell has its own diaphragm. ‘The bell serves as impedance matcher between body matter and the air in the tube. This requires that the frequency of the sounds must resonate in the bell membrane. The natural resonant frequency fres of the bell depends on bell diameter d and tension T' of the diaphragm with the area density o [kg/m], 1 {fF fre © SGNG P Pipa Ayers = 5-2 m8 with @ as vibrational parameter f ~0.76. 184To selectiveley pick up certain frequency ranges (low frequency heart murmur, high frequency lung sounds) the appropriate bell size and diaphragm tension must be choosen. For the open bell the tension is modified by changing the pressure of the bell against the skin. With increasing tension the sensitivity for high frequency sounds improves. To select a low frequency range a large diameter bell must be used. For open bells the frequency range can be selected by the right choice of pressure against the skin = 16-f2, P = 16- fh 5 i I _~ 100/— 1 ' 4 ao Heart Lung! | = a sounds |! sounds ! > 1 I @ 1 | & 1 I = 1 1 g T 1 5 ! 1 a” I 20 100 300 1000 3000 10000 Frequency (Hz) Typical sounds associated with the heart beat due to blood turbulences are in the 20 to 200 Hz range, sounds associated with the operation of the lung (air turbulences during inhaling and exhaling) are in the frequency range between 200 - 2000 Hz. 185EXAMPLE Calculate the tension necessary for an open bell stethoscope with a bell diameter of 2 cm to pick up a 15 Hz heart murmur. What is the pressure on the skin? Adopt a areal density of o ~0.5 [kg/m] fea = 55 4-@ f2,0 _ 4-4 10-4{m4] 15? [1/s4] 0.5 [kg/m?] T= B ~ 0.76 % 0.24 [N] T 0.24 [N] P= aa = 3-110 = 764 [Pa] What pressure is necessary to hear with the same stethoscope lung sounds of 500 Hz? T 4-@ fio p= = res a-(d/2? Ba (d/2)* 4-4 10-4[m?] 500? [1/s?] 0.5 [kg/m?] es 0.763.141 10* [m?] ~ 840000 [Pa] This corresponds to a pressure of about 8 bar. 186‘The dimensions of the stethoscope tube must be optimized for good sound transmission without significant intensity losses due to friction of the pressure wave on the tube walls. The volume must be small to maximize the pressure changes along the tube. Impedance matching between diaphragm and pipe is necessary to guarantee optimal transmission of sound. The acoustic impedance Z of a pipe is the ratio of pressure P to volume velocity U which is the amount of air flowing through a cross sectional area S in [m?] per [s] due to the sound wave. The acoustic impedance is: pis the density of the transmitting medium, v is speed of sound. Impedance increase with decreasing pipe radius and changes only above 100 Hz with pipe length. Matching the impedances of the skin, the eardrum and the pipe requires a pipe radius of: r= [S = (ES ~ (Sx om “Na Vad mE This is too large because at reasonable tube length of L © 30 cm it would cause intensity losses due to attenuation of the large volume involved. A reasonable diameter is 3 mm. 187ULTRASOUND AS DIAGNOSTICAL TOOL The reflection of acoustical waves at body tissue layers due to impedance mismatch can be used for ultrasound imaging by monitoring the ultrasound echo. Biological tissues, with the exception of bone and air (lungs) have similar impedances for the transmission of sound, they act like fluids and the speed of sound is given by the density p and the elastic modulus K, = 1540 + 92 [m/s] Speed of Sound (ms~!) © 1000 2000 3000 4000 5000 6000 lung’ "galls. one, glass, a lung) x ra dry frais tooth brass Steel bt velocity of sound is frequency independent. This constancy warrants good timing conditions between emission of the ultrasound signal and the detection of the echo signal. This timing allows to probe echos from various depths of body tissue. The spatial resolution As depends on the speed and the timing resolution At ~ 10 ns of the electronics. As = v- At (1540 + 92 [m/s]) - 108 [s] ~ 20 [um] 188However spatial resolution is not only limited by timing, but also by wavelength of sound v Asx A= f For low frequencies in the audible range 10 kHz, A ® 1540 [m/s]/104 [1/s] = 20 [em] for frequencies in the ultrasound range 10 MHz, d & 0.154 [mm] The choice of frequency determines the limits of spatial resolution. The quality of ultrasound imaging is determined by the interaction of the acoustic wave with the body tissue: attenuation depends on absorption and scattering of acoustic waves; reflection and transmission depend on the impedances; refraction depends on axial direction of acoustic radiation field. The quality of the image depends on the: shape and intensity distribution of the acoustic field of the ultrasound signal quality of image generation through data processing 189ATTENUATION OF ULTRASOUND All media attenuate ultrasound due to absorption and scattering effects. ‘The attenuation is exponentially in the direction of the traveling wave and depends on the attenuation coefficient = Habs + Hscat Only total attenuation coefficient can be measured and depends on tissue characteristics (density) and on frequency. 1000} 09 Attenuation coefficient (48 cmt!) Frequency (MHz) Absorption is due to energy transfer from acoustic wave to vibration of molecules and cells (heating of body tissue). Scatter of ultrasound takes place on cells or boundaries between different body tissues. Scatter changes the direction of the acvoustical waves. 190The attenuation for the initial wave intensity Ip to the intensity [, at a depth o is: Tz = Ip-eap(-n-t) = -3.in(2) a The attenuation coefficient 1 [1/cm] is often expressed in terms of decibels ([db/em]}): In 1. (Ie pleifer) = -2a0 — (%) =ahin (F) 20tes.0e = 4.343-y[1/om] EXAMPLE The typical ultrasound signal has an intensity of 2-10° W/m? and a frequency of 10 MHz. This indicates a fat attenuation coefficient of Hye: % 50 db/em after traveling through a 5 cm fat layer the intensity of the acoustical signal is only: 50 - 0-85) 4.343 About 50% of the intensity is absorbed, echo would be mostly absorbed. Probe depth is limited by attenuation, choice of lower frequencies would allow deeper penetration of ultrasound, but would reduce resolution. A frequency of 3 MHz would reduce the attenuation to ya © 2 [db/cm] i = deeew) = 2-105 exp (— ) = 11-10? (W/m? Iz =2-+105- exp (-2:28) = 195-105 [W/m] The attenuation loss is reduced to 2% only, but the resolution decreases to As © 0.5 mm.REFLECTION AND REFRACTION ‘The reflection of a perpendicular acoustic wave is determined by the acoustic impedances of the body tissues. — Tees Any 48 oR ( 2+ Zi Perpendicular reflection originates the echo signal. If the wave enters boundary between two body layers at an angle Qin reflection and refraction occurs. The direction of the reflected ©,.; and refracted signal Oqut is determined by ’Snells law’, sin@in _ vi _ Zirfo sinBnt Ve Zo Pi the reflection angle is equal to the incident angle. Gin = Ovex This yields an intensity ratio for nonperpendicular reflection: _ Det _ (Biie=Fa-coe8y" Foo = Te, = (Zyrcos0, + Dy 0080; 192(dB) 10 Lo, 9(RI Roectect) 30: -50- The intensity loss due to nonperpendicular reflection can be approximated by the coefficient: Ry 10- logy? Rp Air/solid or liquid Bross/soft tissue orwater Bone sot tissue or water ‘Specular boundary: Perspex soft tissue or water : eee taiolions = {Very ile scatter Fendon fat P iercrinicsaressnccnanns SFat/non-tatty soft tissues ~ Water/ muscle Water /soft tissues Fot/ water Muscle Blood ough surface ee ‘boundary variations Muscle liver — Se scatter Kidney liver spleen/ blood Liver/ spleen, blocd/ brain ‘The calculated reflection coefficients (in db relative to a perpendicular reflector) for a variety of boundaries between biological and nonbiological tissues range between -10 db and -50 db. This corresponds to enormous intensity losses due to insufficient reflection of sound wave. On the other hand, insufficient reflection means good transmission, deeper layers of the body can be reached. Limitations are layers with large reflection (air-filled cavities) which cannot be probed due to the nearly 100 % reflection of the sound wave at the boundary. 193EXAMPLE What is the approximate intensity loss of a 5 MHz ultrasound wave of traveling to a depth of 4 cm in liver and reflecting on an encapsulated blood clot. ‘The attenuation coefficient is ~5 [db/em]. After 4 [cm] the intensity is: Le 5-4 ho c= (-~Z3a) = 0.08 Only 1% of the intensity reaches the blood clot. The reflection depends on the impedance; the reflection for liver/blood boundary yields: — Tret _ ay ~ m= 72 = (Zaz) ~ om Tuto _ Ie p te 6 = 2. += = 0.01-0.01-0.01 = 10 ho de? Tgp ° Only 1% of the incoming wave is reflected, and only 1% of the reflected wave travels back to the receiver. This means that only 1/1000000 of the initial intensity returns. This requires extremely sensitive detection systems. If a echo signal originates at a blood clot at only 2 cm depth the intensity reduction is: i 5-2 h 7°? (-zi) = 0. The total loss is due to the attenuation and the reflection probability: feo _ tz pte = 94.001-01 = 10 Io Io Tret The echo intensity decreases rapidly with depth!CHARACTERISTICS OF THE ACOUSTIC RADIATION FIELD The ultrasound signal is generated and detected by the transducer. An electrical pulse causes a change of the thickness t in a piezoelectric element (PZT lead zirconate titanate) which initiates a pressure wave of high frequency f: f [MHz] = Timm] For example, a 0.4 mm thick crystal resonantes at a frequency of 5 MHz. Acoustic absorber Backing block Piezoelectric crystal Matching layer ‘On the other hand, a received high frequency acoustic wave triggers an electrical signal in the two attached electrodes which can be processed. The sound wave is emitted from the transducer as an overlay of a multitude of single wavelets which form a wave front. Constructive and destructive interference patterns confine beam in the near field Direction of beamThe acoustic beam profile is characterized by the near field and the far field. The pulse in the near zone is characterized by large amplitude variations but the energy is confined within the transducer radius along the axis, In the far zone the field is uniform but spherically divergent. +A ot 3 Loteral distonce, y/o The length of the near field L depends on the frequency and the diameter of the transducer, large radius and frequency cause an extended near zone. The divergence in the far field is given by the divergence angle © x sing = 1.225 Transducer Near field Far field element Radius, r Length of near field Angle of beam divergence: Diameter, d SIR = BAL sin @=1.224/d @ =aresin (1.222/d) 196EXAMPLE A typical PZT-5A piezo-crystal of 2 cm diameter is used to produce an ultrasound frequency of 5 MHz. This allows to calculate the length of the near region: 510° [1/s] - 10-4 [fm] _ > = 1540 [m/s] = 0.325 [rm] The near range covers nearly the body thickness. ‘Scan direction The diverging angle of the far field of the ultrasound beam is: sind = 122-2, = 0.61 2540 m/s] —_ = ° Fea ~ 8 STF T/q - 0.1 ml 0.002 + © 0.11 Only small divergence takes place in the far region. Low frequency signals reduce the size of the near range and increase the divergence of the beam in the far range. 197PULSE-ECHO-TECHNIQUES ‘The simple pulse-emission echo-detection technique is the most common application for ultrasound. It relies on the ability of detection of weak echo signals which originate from relatively low intensity pulses (intensity loss causes unnecessary heating of the body organs). The quality of the signal is determined by its resolution! For pulse echo systems both axial resolution (along the beam axis) and lateral resolution (perpendicular to beam axis) have to be considered. The axial resolution Raziai is defined in terms of the half-width dtrwam of the ultrasound pulse: narrow bandwidth sacl a [A fe te Rosia = Strwam For micro-second pulses ( MHZ) the typical half widths of the pulse range from 2 mm to 7 mm depending on the kind of body tissue. The lateral resolution is determined by the size of the acoustic beam, which depends on the diameter of the transducer element d, the length of the near region and the divergence of the far range. Riaterat © Sdrwum Typically the lateral resolution ranges from 1.0 to 2.0 em. 198The choice of the ultrasound frequency is determined by a compromise between good resolution and deep penetration. The attenuation of high frequency acoustic waves limits the penetration depth, low frequency waves decrease both axial and lateral resolution. Frequencies in the 3 - 5 MHz range are used for liver, heart and abdominal organs, higher frequencies in the 4 - 10 MHz range with better resolution are used to probe smaller structures, like thyroid, arteries infant organs etc. Frequency (MHz) 01:02 05 10 20 50 10 Depth (cm) The loss of intensity of the acoustic signal and the returning echo signal might reduce the echo to intensities below the ‘noise’ level. The noise originates from scattered sounds and from the electronics. 199The transducer emits short acoustic signals of & 3 cycles length (for 5 MHz, signal length would be ét © 3/5 10° = 0.6 ys) with a certain frequency (pulse repetition rate PRR). Pulse ——+ Duration pulse sisal listen for echoes... . inet . wait..... 6. pulse +++ 50 100 150 200 . 500 Time, psec 3.85 7. 11.55 184 19.25 38.5 Range, cm The period between the acoustic pulses is determined by the time the echo needs to return from the maximimum distance Dmgz to the transducer. The maximum repetition rate PRRmaz would be: 1540 [m/s] PRRmaz = F- Daas [ra] If the repetition rate is exceeded the echo signals become ambiguous because echos from deep layers triggered by the first pulse overlap with echos from surface layers initiated by the following pulse. Probing organs at a depth of © 20 cm requires a repetition rate of =~ 600 Hz, typically the repetition rate is in the order of 1 KHz. 200SIGNAL-PROCESSING For producing an image the acoustical signal has to be emitted with a constant PRR at a constant db level (-100 mW), the returning weak echo system has to be amplified to a constant db level and electronically processed. ‘Transducer Patient (with cyst and reflecting structures) Tine-gain function generator Voltage-controlled attenuator mac) Variable attenuation | system gain) Timebase ramp generators Afterrec and compression } 20- dB 30 Emvelope(orA-scan) 49 59 tap Pre-processing (eg.differentiation 9 ession Post-processing After standard amplification of echo, the most important part is the time gain control (TGC).The TGC selectively amplifies echo signals which return weak from a deeper depth at a later time to the level of earlier echo signals from less deep layers which have experienced less attenuation. Equally reflective acoustic impedance boundaries ET a ETS Before 3 TGC £ a E < TGC € Amplification © © After 3 TGC 5 E < Time—~ Overall signal intensity is then ~ 40-50 db. 202The signals will be digitized by Analog to Digital Converter (ADC) systems and processed in the computer. The data can be displayed in a one dimensional way as intensity versus time (A-scan), which corresponds to a simple axial scan. B mode Amode Stationary Transducer Valve Leaflets ‘The most common display is the B-scan, where A-scan is coupled with x-y movement of the transducer.The intensity of the echo signals is translated into brightness of display for different x-y positions, this is used to create the two-dimensional image from the intensity as function of x,y-position g(z, y. Compound B-scan Image display The construction of the actual image (in the computer) is a complex mathematical process which takes into account the pulse shape characteristics and the density distribution of the body tissue as reflected by the interaction processes between acoustic wave and body material. 204THE GENERATION AND CONSTRUCTION OF IMAGES The structure of the reflected echo signal is a convolution of the pulse-echo wave and the response of the body through signal scattering. For a two-dimensional description image function g(z, y) can be expressed in terms of the # axial pulse-echo response hy(z) (pulse shape of signal), © the lateral pulse-echo response ha(y) (beam profile), the scattering response f(z, y) of the system 9(e,u) = hale) holy) - fe.) Very simplified form, neglecting noise, multiple scattering, differences in speed of sound ... The scattering response depends on the density of material p(z,y) and the elastic modulus K(x, y which determines speed of sound and impedance. The response can be formulated in terms of fluctuations in density and elasticity in the direction of the pulse ¢ _ 1 & (Sp(e,y) , 6K (ey) f(a,y) = ida ts + (@) (6) (c) The simulated image of a point scatterer convoluted with the time structure of the pulse echo signal andthe extension of the acoustic beam.