DMS 202 – Sonographic Physics II


DOPPLER INSTRUMENTS		4	0	0
	Analyze the following dynamic factors in the role of Hemodynamics to include: a. Energy gradient b. Effects of viscosity, friction, inertia c. Pressure/flow relationships d. Velocity e. Steady flow vs pulsatile flow f. Laminar versus turbulent flow g. Effects of stenosis on flow characteristics h. Venous resistance i. Hydrostatic pressure j. Pressure/volume relationship k. Effects of respiration (phasicity)
	Discuss the Doppler Effect as it relates to the sampling of red blood cell movement
	Analyze the Doppler equation and the factors influencing the magnitude of the Doppler shift frequency
	List the Range of the Doppler shift frequency
	Discuss the effects of beam angle, transmitted frequency, flow velocity, and flow direction on Doppler velocities
	Compare and contrast continuous wave and pulsed wave Dopplers while listing the advantages and disadvantages of each
	Discuss Aliasing and the Nyquist criteria including Range ambiguity
	Identify and diagram Doppler Instrumentation to include: a. Receiver b. Demodulater c. Wall filter for clutter rejection d. Directional devices
	Define the basic principles and instrumentation associated with Duplex ultrasound and Spectral analysis
	Discuss the effect of a. Direction b. Velocity c. Duration d. Character e. Magnitude f. Fast Fourier transform (FFT)
	Discuss the usefulness of pulsatility and resistive indices
	Describe the Basic Principles of Color Flow Imaging including: a. Sampling methods b. Display of Doppler information c. Reflector direction d. Average velocity e. Velocity variance f. Advantages and limitations
	Diagram and define Instrumentation issues including a. Autocorrelation b. Time domain processing c. Color field size and frame rate i) Ensemble length (packet size, pulse packet) ii) Line density iii) Maximum depth d. Color maps, assignment, or coding i) Hue ii) Saturation iii) Luminance (significance, brightness, intensity)
	Define and analyze Doppler Artifacts
	Compare and contrast the properties, advantages and limitations of Color Power (Energy) Mode
PERFORMANCE		5	0	0
	Demonstrate the general concepts regarding the need for and nature of a quality assurance program
	Compare and contrast the Methods for Evaluating Instrument Performance including a. Test objects i) Phantoms (tissue, Doppler, flow) ii) Parameters to Be Evaluated iii) Test object iv) Dead zone v) Axial resolution and lateral resolution (beam width) vi) Depth calibration accuracy vii) TGC characteristics viii) Uniformity ix) System sensitivity b. Tissue equivalent (mimicking) phantom i) Dead zone ii) Depth calibration accuracy iii) Lateral (horizontal) distance measurement accuracy iv) Axial, lateral, and section thickness (elevational) resolution v) GC characteristics vi) System sensitivity vii) Dynamic range viii) Contrast resolution ix) Lesion detection c. Doppler flow, string, or belt phantoms i) Maximum depth ii) Pulsed Doppler sample volume alignment (gate position accuracy) iii) Velocity accuracy iv) Color flow penetration v) Image congruency test
	Organize and plan a Preventive Maintenance program including Practice standard precautions in regards to equipment cleaning including a. Cleaning b. Disinfecting c. Sterilization
	Summarize the details record keeping
	Calculate Statistical Indices including: a. Sensitivity/specificity b. Negative/positive predictive value c. Accuracy
SAFETY		5	0	0
	Define Acoustic Output Quantities including : a. Pressure i) Units (MPa, mmHg) ii) Peak pressures (compression, rarefaction) b. Power i) Units (mW) c. Intensity i) Units (mW/cm², W/cm²) ii) Spatial and temporal considerations iii) Average and peak intensities
	Compare and Contrast the Common intensities a. SATA b. SPTA c. SPPA d. SPTP
	Compare and Contrast the methods for determining intensity, power, pressure a. Hydrophones b. Radiation Force
	Compare the Intensity and power values for different operating modes
	Discuss Acoustic Output Labeling Standards including a. Thermal Index i) TIS ii) TIB iii) TIC b. Mechanical index
	Define the concepts of prudent use (ALARA) in reducing acoustic exposure
	Discuss the primary mechanisms of Biologic Effect Production to include: a. Cavitation mechanisms: relevant acoustic parameters b. Thermal mechanisms: relevant acoustic parameters
	Distinguish the details of the various Experimental Biological Effect Studies to include: a. Animal studies b. In vitro studies c. Epidemiologic studies
	Recite the key points of the following Guidelines and Regulations regarding ultrasound safety to include: a. American Institute of Ultrasound in Medicine (AIUM) statements (e.g., mammalian, epidemiology, in vitro) b. National Electrical Manufacturers Association (NEMA) c. Food and Drug Administration (FDA)
	Discuss the electrical and mechanical hazards of ultrasound examinations to include: a. Patient susceptibility to electrical hazard b. Equipment components which could present a hazard
ARTIFACTS		5	0	0
	Define Ultrasound Artifacts Recognize artifacts while performing and interpreting examinations including: a. Echoes not representing actual interfaces including b. Missing echoes c. Misrepresented interface location d. Misrepresented interface amplitude
	Define and recognize artifacts associated with Resolution and Propagation to include: a. Axial Resolution b. Lateral Resolution c. Section Thickness d. Acoustic Speckle
	Discuss the mechanisms of resolution artifacts production
	Define and recognize artifacts associated with Propagation a. Reverberation b. Comet-tail c. Ring-down d. Mirror Image e. Multipath f. Side Lobes g. Grating Lobes h. Refraction i. Speed Error j. Range Ambiguity
	Discuss the Mechanisms of propagation artifacts production
	Define and recognize artifacts Associated with Attenuation a. Shadowing b. Enhancement c. Focal Enhancement or Focal Banding
	Discuss the Mechanisms of attenuation artifacts production
	Define and recognize artifacts associated with Doppler and Color Flow Instrumentation a. Aliasing b. Slice Thickness c. Reverberation d. Mirror Imaging e. Ghosting or Flash f. Registration g. Incident Beam Angle h. Clutter
	Discuss the Mechanisms of Doppler and Color Flow artifacts production
	Define and recognize artifacts caused by Electronic Noise and Equipment Malfunction
	Define and recognize artifact Effects on Measurements including a. velocity or speed error b. range ambiguity
REDUCTION OF ARTIFACTS		1	0	0
	Describe methods of reducing artifacts

Suggested Resources

Edelman, S. (2006). Understanding Ultrasound Physics. (2^nd ed.) ESP, Inc. ISBN-13: 978-096-26-4444-3

Hedrick, W. (2005). Ultrasound Physics and Instrumentation. (4^th ed.) St. Louis: Mosby. ISBN-10: 0-323-03212-5

Kremkau, F.W. (2006). Diagnostic Ultrasound: Principles and Protocols, (6^th ed.) W.B. Saunders. ISBN: 0-7216-7143-8

Miele, F. (2006). Ultrasound Physics and Instrumentation. Forney, Tx: Miele Enterprises

Mosby’s Pocket Dictionary of Medicine, Nursing & Health Professions. (5^th ed.) Elsevier. ISBN-13: 978-0-323-03943-7

Taber’s Cyclopedic Dictionary. (20^th ed) F. A. Davis. ISBN13: 978-0-8036-1207-5

Zagzabski, J. (1997). Essentials of Ultrasound Physics. St. Louis. Mosby: ISBN-10: 0-8151-9852-3

Competency Areas	Hours
Doppler Instruments	Class	2
Performance	D. Lab	0
Safety	P. Lab/O.B.I.	0
Artifacts	Credit	2
Reduction of Artifacts

Prerequisite:	DMS 136
Corequisite:	None

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