Medical Ultrasound History and Echocardiography Application

Introduction

Ultrasounds are known by numerous names such as the sonogram, diagnostic sonography or ultrasonography (Leonard 89). The diagnostic medical imaging technique that is ultrasound-based and utilized in visualizing muscles, tendons and many internal organs in order to capture their size, structure and any pathological lesions with real time tomographic images is referred to as medical sonography (ultrasonography) i (Chaudhuri 317). The sonogram as a technology usually employs high frequency sound waves to create the image of a specific part of the inside of a human body and this may range from the stomach, liver, heart, tendons, muscles to many other parts (Vaezy 379).

This particular technology utilizes the sound waves as opposed to radiation and to this effect, it is considered safe because it does not cause harm to the body (Hoskins 8). Ultrasounds can detect any problems that affect the parts of the body being tested and they are preferred because in comparison to the other modalities such as the MRI and the CT (magnetic resonance imaging and computed tomography), they are found to be much cheaper, safer and even portable (Alter 56). This explains why it is the most commonly used diagnostic tool in the current world of medicine.

History of Ultrasound

The history of ultrasound dates back to the continent of Europe between the 19^th and 20^th century when, during World War I the French government asked Paul Langevin, a physician to invent a device that would be capable of detecting any of their underwater enemy submarines through the usage of high frequency sonar.

The decades that followed saw many experiments being conducted within the military, scientific and industrial potential ultrasound technology fields. Despite all these developments, it was not until the 1940s that the use of an ultrasound as a diagnostic medical tool emerged, when the neurologist and psychiatrist Karl Dussik from the University of Vienna developed its concept. He worked with his brother at the time and used the ultrasound beam to scan for and detect brain tumors and even locating cerebral ventricles as well as cavities in the brain that had cerebro-spinal fluid.

Within the five decades that followed, other pioneers from America and Europe emerged and widened the scope of the diagnostic medical ultrasound (Mamou 19-24). The inventors utilized this to detect increasingly diverse medical conditions and also made developments in the hardware and imaging quality. In the 1950s, Ian Donald pioneered the use of ultrasound in the evaluation of the fetal development during his experimental works in Glasgow (Rantanen 1). At the same time he published a seminal diagnostic study in 1958 after he had worked together with a group of researchers to and even invented a prototype ultrasound machine that was specifically focused on conducting medical diagnosis. With time, technology advancement assisted the manufacturers to invent and create smaller and portable ultrasound machines and this development resulted in creation of future machines which took pictures that were sharper, clearer and of high quality.

It was these developments and the innovation that resulted in the invention of the two, three and four dimensional ultrasounds in addition to the dropper imaging which assisted medical professionals and patients to better decipher the revelations made by the ultrasound tests. It was only in the 1970s that medical profession had accepted sonography as a special and distinct occupation and in 1973 the department of education in the United States only recognized it as a profession with its own rights. The field of sonography has since grown immensely to the present status within the medical field.

Uses and Applications of a Medical Sonogram

Today, there is widespread utilization of medical sonography in many medical surveys and these include anesthesiology, where ultrasound is employed by anesthetists to guide them in injecting local anesthetic solutions near the nerve using needles.Furthermore, the technology is also employed in echocardiography to diagnose dilations on the paths of the heart as well as confirming whether the heart and nerves are functioning properly. The emergency medicine field uses the ultrasound in emergency departments to quickly offer care to those patients that might be experiencing upper abdominal pain as well as those who may be suffering from gallstones.

In addition, this technology is is often used in managing pregnancy whereby it helps a medic to trace the fetal heartbeat of a baby, predict the expected delivery time as well as locate the position of the fetus and during pregnancy, the ultrasound can be additionally applied to accurately identify the sex of a baby (Bruno 325). Moreover, there are also diverse uses and applications of a sonogram and these are being effectively utilized within the Neonatology, Neurology, Otolaryngology and gastroenterology fields.

Working Principle of an Ultrasound

It is only through the transmission of high frequency sound pulses (echoes) into the body of the patient that the ultrasound can operate. The sound waves produced travel through the body into different tissues at an average speed of 1540 m / s; yet this speed can vary depending on the type of the tissue and whilst the speed of the ultrasounds through fat is 1459m/s, the speed through the bones is approximately 4080m/s. Once the sound transmitted traverses through the tissues with different acoustic properties, a reflection of a proportionate of the sound is generated (Hoskins 8). The borders between two different tissues are referred to as acoustic interfaces and the amount of sound reflected through the acoustic interface is dependent on the type or properties of materials on the sides of the interface.

Echocardiography

Echocardiogram is commonly known as ECG in short and it is the form of ultrasound that is conducted on the heart during a procedure known as echocardiography. It is commonly used today in diagnosing, detecting and even monitoring the patients who may have heart problems. It is one of the popular diagnostic tests in cardiology owing to the fact that it can provide vital information such as the size and the shape of the heart, pumping capacity of the heart, position as well as the magnitude of any damage of a heart tissue and many other features including the estimates of heart functions.

Furthermore, this diagnostic test can also be used to calculate the cardiac output and ejection fraction hence assist a medic to detect the cardiomyopathies which may include the hypertrophic cardiomyopathy and dilated cardiomyopathy among other things. Another major importance of echocardiography is that it can be used in testing for chest pains as well as other symptoms related to heart disease. Given the fact that this technology is noninvasive has made it even more beneficial because it does not in any way entail the breaking of the skin, hence, has neither risks nor side effects.

Applications of Echocardiography

As mentioned earlier, echocardiogram involves a noninvasive sonograph evaluation of the heart and big vessels which in most cases, is differentiated from the ordinary ultrasound because it can provide pertinent information on the human anatomy, haemodynamics, functions, both dynamic systolic and diastolic of the heart in addition to those of the big vessels. Of high importance is the fact that echocardiogram can be performed under a resting condition as baseline comprehensive assessment or even in cases where the stress conditions are controlled with the objective of conducting a functional evaluation of the significance of the vascular lesion.

Echocardiograms comes in diverse types and forms that are used to take pictures of the heart, namely the transthoracic echocardiography, which is sometimes referred to as the most popular type of echocardiogram test (St 203). In this type of ECG, the sinologist places a device on the chest that sends special sound waves through the chest wall to the heart in which case the waves are resounded back to a computer and then converted into pictures.

In stress echocardiography, part of the stress test may entail being asked to run or take some medicine that trigger the heart to beat faster and technicians takes the echo from the heart before the exercise or taking the medicine and after the exercise or medicine depending on the patient. This can help in the comparison of the situation and ultimate diagnosis of some problems such as the coronary heart disease.

In transesophageal echocardiography a transducer is attached to the end of a flexible tube which is guided down the throat into the esophagus and gives a sonologist a more detailed picture of the heart. Fetal echocardiography on the other hand, is a technique that is used to detect the movement of the unborn baby’s heart and the women who are around 18 to 22 weeks pregnant are advised to take this diagnostic test. Finally, 3D images of the heart can be created as the echo is being conducted through a three dimension echocardiography which is commonly utilized in diagnosing various heart problems in children. In addition, the heart valve surgery also utilizes this technology in the planning and monitoring process.

Chest pains are usually linked to a number of reasons and triggers including coronary artery disease, aortic dissection, pulmonary embolism and peptic ulcer disease, reflux esophagus among other factors that may include muskeletal pain, neuritis, pleurities, gallstones, psychosomatic and pericarditis. Clinicians are therefore expected to eliminate possibility of coronary heart disease and the aortic dissections because they are not only treatable but also exhibit most of the presenting symptoms. Important hints and diagnosis of an acute syndrome or any other possible infection that a patient may be suffering from can easily be revealed through conducting a thorough echocardiogram. Any revelations concerning an abnormality and thinning around the regional wall motions , can be assumed as symptoms of poor functioning of the old myocardial infarction.

In the recent times, many manufacturers have come up with new harmonic imaging within echocardiography machines and this is mainly attributed to the fact that reflected sound waves may contain second degree harmonics which occur as wavelengths but have a half life or half of the wavelength magnitude. Harmonic imaging is essential and unique because it enables the system to emit sonography energy at the frequency that is generally of a lower rate and to retain normal frequencies, in order to avoid interfering with the quality of the image. Nevertheless, it is important to exercise caution during its application because if used continually it may lead to the image having unusual textures.

Another emerging application that can be utilized in reflecting shunts by the giving an intravenous injection of agitated saline is the contrast echocardiography (Walsh 198). The agents used in the contrast echocardiography are produced commercially and are made up of free and encapsulated gases bubbles and these tiny air bubbles enhance the backscatter, therefore highlighting the tissue that has the contrast agent. The technology is used in diverse applications such as filling of cavities, a process through which blood is visualized in the left ventricle as the borders between the blood and the myocardium are highlighted more conspicuously. In myocardial perfusion, this technology is done through intracoronary injection and it monitors alterations that are linked to the increased workloads, in addition to delineating the myocardium that is supplied by every coronary artery.

The use of contrast helps to enhance the flow when it is injected to raise the number of reflectors and thereby raise the intensity of the resultant spectral trace and this makes the technology particularly vital in the dropper studies. The three dimensional echocardiography is not used on its own but instead, it is utilized mostly in combination with the transoephagueal and intravascular ultrasounds in order to provide real time imaging of the cardiac structure and functioning. Apart from being noninvasive this technique is also more effective in giving a descriptive communication regarding the abnormalities to the specialists. Moreover, it also helps to accurately detect the position of the structural defects of the heart in connection with each other and the other heart structures as well. During the surgical repair procedure, this technology can provide accurate direction and information.

Experts advise that echocardiography should only be utilized during initial diagnosis in cases of noticeable changes in the clinical status of a patient, but overuse is not recommended, unless the condition of a patient deteriorates based on the results of the testing. In conclusion, echocardiogram has helped doctors to diagnose, monitor and evaluate the conditions of the heart for any abnormal heart rates, heart murmurs, infection in the heart, sources of blood clots and pulmonary hypertension and also facilitated the conduction of other tests and this makes it a very important diagnostic tool.

Works Cited

Alter, Katharine E. Ultrasound-guided Chemodenervation Procedures: Text and Atlas. Demos Medical Publishing, 2013.

Bruno, Michael A, and Hani H. Abujudeh. Quality and Safety in Radiology. New York: Oxford University Press, 2012. Print.

Chaudhuri, Zia, and Murugesan Vanathi. Postgraduate Ophthalmology. New Delhi, India: Jaypee Brothers Medical Publishers, 2012. Print.

Hoskins, P R, Kevin Martin, and Abigail Thrush. Diagnostic Ultrasound: Physics and Equipment. Cambridge, UK: Cambridge University Press, 2010. Print.

Leonard, Peggy C. Quick & Easy Medical Terminology. St. Louis, Mo: Elsevier, 2014. Print.

Mamou, Jonathan, and Michael L. Oelze. Quantitative Ultrasound in Soft Tissues. , 2013. Print.

St, John S. M, and Susan E. Wiegers. Echocardiography in Heart Failure. Philadelphia, PA: Elsevier/Saunders, 2012. Internet resource.

Vaezy, Shahram, and Vesna Zderic. Image-guided Therapy Systems. Boston, MA: Artech House, 2009. Internet resource.

Walsh, Catherine A, and Peter Wilde. Practical Echocardiography. London: Greenwich Medical Media, 1999. Print. 198.

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