Ultrasound is the term used to describe sound of frequencies above 20 000 Hertz (Hz), beyond the

range of human hearing. Frequencies of 1–30 megahertz (MHz) are typical for diagnostic
ultrasound. Diagnostic ultrasound imaging depends on the computerized analysis of reflected
ultrasound waves, which non-invasively build up fine images of internal body structures. The
resolution attainable is higher with shorter wavelengths, with the wavelength being inversely
proportional to the frequency. However, the use of high frequencies is limited by their greater
attenuation (loss of signal strength) in tissue and thus shorter depth of penetration. For this reason,
different ranges of frequency are used for examination of different parts of the body:
■ 3–5 MHz for abdominal areas
■ 5–10 MHz for small and superficial parts and
■ 10–30 MHz for the skin or the eyes.
SYSTEM BLOCK DIAGRAM
There are a number of different methods of beam steering currently in
use. These can be grouped
into three categories:
1. Mechanical
2. Element selection
3. Phased array
Mechanical Steering

The simplest method of beam steering is to use a mechanism to

reorient a transducer (usually a circular aperture) to a predetermined
set of orientations so as to capture the required two-dimensional data
set. This approach was dominant at first; however, in the last 15 years,
electronically steered systems have become, by far, the most popular.
Mechanical systems usually use either a single-element transducer or
an annular array transducer (Fig. 25.8). The former will have a fixed
focus while the latter does allow the focal point to be moved
electronically. This will be discussed more fully later.
Steering by Element Selection
Another relatively low cost beam-steering approach involves steering of
the beam by element selection. In this approach one doesn’t strictly
steer the beam but rather changes the location of its origin, thereby
achieving coverage over a two-dimensional tomographic slice. This
method is applied with both linear and curvilinear arrays. Figure 25.9
shows the application in the case of curvilinear arrays. For this
particular case, the two-dimensional image will be sector shaped; with
linear arrays, it will, of course, be rectangular. This is a relatively low
cost approach since aside from the multiplexing required for element
selection, the electronics required to accomplish beam formation are
merely the focusing circuitry.
Steering with Phased Arrays
The most complicated form of beam steering involves the use of phased-array concepts derived
from radar (for example, Steinberg, 1976; Thurstone, 1973; Thomenius, 1996). Most ultrasonic
phased-array transducers have between 64 and 128 elements. Transmit beam steering in phased-
array systems is achieved by adding an incremental delay to the firing time of each of the array
elements that is linearly related to the position of that element in the array. Similarly, during
reception the delay that is applied to each of the echoes received by the array elements is
incremented or decremented by a position-dependent factor. This differential time delay ∆ t is given
by
where xn is the location of the array element n and is the desired beam
steering angle. The application of such a delay increment during
reception is illustrated in Figure 25.10. Since the beam steering angle is
such that the echoes will reach the array elements toward the bottom
of the figure first, the longest delays will be imposed on the echoes
from those elements. Since the wavefront is linear, the arrival times of
the remaining echoes have a linear relationship, hence the linear
decrement on the delays from one element to the next.
JENIS PEMERIKSAAN USG
• 1. USG 2 Dimensi
• Menampilkan gambar dua bidang (memanjang dan melintang). Kualitas gambar yang baik sebagian besar keadaan janin dapat
ditampilkan.
• 2. USG 3 Dimensi
• Dengan alat USG ini maka ada tambahan 1 bidang gambar lagi yang disebut koronal. Gambar yang tampil mirip seperti aslinya.
Permukaan suatu benda (dalam hal ini tubuh janin) dapat dilihat dengan jelas. Begitupun keadaan janin dari posisi yang berbeda.
Ini dimungkinkan karena gambarnya dapat diputar (bukan janinnya yang diputar).
• 3. USG 4 Dimensi
• Sebetulnya USG 4 Dimensi ini hanya istilah untuk USG 3 dimensi yang dapat bergerak (live 3D). Kalau gambar yang diambil dari
USG 3 Dimensi statis, sementara pada USG 4 Dimensi, gambar janinnya dapat “bergerak”. Jadi pasien dapat melihat lebih jelas dan
membayangkan keadaan janin di dalam rahim.
• 4. USG Doppler
• Pemeriksaan USG yang mengutamakan pengukuran aliran darah terutama aliran tali pusat. Alat ini digunakan untuk menilai
keadaan/kesejahteraan janin. Penilaian kesejahteraan janin ini meliputi:
• - Gerak napas janin (minimal 2x/10 menit).
• - Tonus (gerak janin).
• - Indeks cairan ketuban (normalnya 10-20 cm).
• - Doppler arteri umbilikalis.
• - Reaktivitas denyut jantung janin.
Ultrasound techniques
• 1. A- mode : Dalam sistem ini, gambar yang berupa defleksi vertikal pada
osiloskop. Besar amplitudo setiap defleksi sesuai dengan energy eko yang
diterima transducer.
• 2. B- mode : Pada layar monitor (screen) eko nampak sebagai suatu titik
dan garis terang dan gelapnya bergantung pada intensitas eko yang
dipantulkan dengan sistem ini maka diperoleh gambaran dalam dua
dimensi berupa penampang irisan tubuh, cara ini disebut B Scan.
• 3. M- mode : Alat ini biasanya digunakan untuk memeriksa jantung.
Tranducer tidak digerakkan. Disini jarak antara transducer dengan organ
yang memantulkan eko selalu berubah, misalnya jantung dan katubnya.
A-mode
A-mode (A-scan, amplitude modulation) is a one-dimensional
examination technique in which a transducer with a single crystal is
used (Fig. 1.12). The echoes are displayed on the screen along a time
(distance) axis as peaks proportional to the intensity (amplitude) of
each signal. The method is rarely used today, as it conveys limited
information, e.g. measurement of distances.
B-mode
B-mode (brightness modulation) is a similar technique, but the echoes
are displayed as points of different grey-scale brightness corresponding
to the intensity (amplitude) of each signal (Fig. 1.12).
M-mode or TM-mode
M-mode or TM-mode (time motion) is used to analyse moving
structures, such as heart valves. The echoes generated by a stationary
transducer (one-dimensional B-mode) are recorded continuously over
time (Fig. 1.13).
B-scan, two-dimensional
The arrangement of many (e.g. 256) one-dimensional lines in one plane
makes it possible to build up a two-dimensional (2D) ultrasound image
(2D B-scan). The single lines are generated one after the other by
moving (rotating or swinging) transducers or by electronic
multielement transducers. Rotating transducers with two to four
crystals mounted on a wheel and swinging transducers (‘wobblers’)
produce a sector image with diverging lines (mechanical sector
scanner; Fig. 1.14).
Three- and four-dimensional techniques
The main prerequisite for construction of three-dimensional (3D)
ultrasound images is very fast data acquisition. The transducer is
moved by hand or mechanically perpendicular to the scanning plane
over the region of interest. The collected data are processed at high
speed, so that real-time presentation on the screen is possible. This is
called the four-dimensional (4D) technique (4D = 3D + real time). The
3D image can be displayed in various ways, such as transparent views
of the entire volume of interest or images of surfaces, as used in
obstetrics and not only for medical purposes. It is also possible to select
two-dimensional images in any plane, especially those that cannot be
obtained by a 2D B-scan (Fig. 1.16).
B-flow
B-flow is a special B-scan technique that can be used to show
movement without relying upon the Doppler effect. The echoes from
moving scatterers (particularly blood cells in blood vessels) are
separated from stationary scatterers by electronic comparison of
echoes from successive pulses (autocorrelation). These very weak
echoes are amplified and depicted as moving dots on the screen. This
technique is effective in showing the inner surface of blood vessels,
but, unlike Doppler methods (see below), it provides no information
about flow velocity (Fig. 1.17).