Reviews and News on Ultrasound Machines

Many developing countries are lacking the financial resources necessary to obtain medical equipment for imaging. Those that do lack the expertise of professionally trained imaging technicians and many can not afford the cost of skilled labor technicians to perform necessary maintenance on these complex machines. Fairly inexpensive, portable ultrasound machines, being both lightweight and capable of handling a wide range of diagnostic procedures, is at the forefront for meeting the needs of medical imaging technology in developing countries. As these machines become more compact and the quality of their imaging improves, many doctors now keep these portable units on hand. Prior to these devices, hospitals with access to transitional imaging medical equipment were limited by their ability to supply them as well as the equipment’s bulky size. While full-sized imaging units cost millions of dollars, this mobile unit sells for $25,000 to $60,000

Dr. Ronald Adler chief of Ultrasound and Body CT at the Hospital for Special Surgery’s Department of Radiology and Imaging has studied the use of ultrasound machines for preventative and emergency care in hospitals in developing countries such as Ghana, West Africa. Hoping to evaluate the effectiveness of portable ultrasound machines in a wide range of physical conditions, the studies were conducted in several clinical settings. The studied targeted musculoskeletal complaints, women’s health including obstetrical and breast, abdominal and genitourinary conditions.

The results of the study concluded that portable ultrasound machines were a constructive tool for diagnosing and treating disease and trauma in developing countries. The challenge lies in training doctors and health staff to recognize when a referral for this kind of imaging is necessary for patients health. Additional training will be required for medical personnel to be able to operate the machines and perform the scans and for physicians to interpret the results of the scan and inform patients of their treatment options.

Developed by a Cornell University graduate student, this revolutionary new battery-powered ultrasound device fits snugly in the palm of your hand. Don’t be misled by its diminutive size, this machine has enough brawn to administer medication to brain cancer patients or even to stabilize a gunshot wound.

A third-year Ph.D. student majoring in biomedical engineering, George K. Lewis is credited with creating portable ultrasound machine devices that are not only smaller than today’s standard models but much more powerful as well. Conventional ultrasound machines weigh on average 30 pounds with a price tag of around $20,000. In contrast, this first of its kind device weighs under 5 pounds and can be manufactures at a cost of $100.

From his Olin Hall Laboratory, Lewis works with higher-energy ultrasound that can offer advanced treatment options outside of the range of capabilities demonstrated by traditional ultrasound machines. In addition to the typical ultrasound imaging techniques used in medical settings to generate images through soft tissue, Lewis’ device can be utilized to break up the tissues that form prostate tumors or kidney stones and to aid in the relief of arthritis pressure.

Lewis hopes this equipment will lead to advances in medical technology such as hand held devices that can be carried by military medics to cauterize wounds, or dental machines that would assist the body in metabolizing locally injected anesthetics, allowing for instant absorption. Tests are currently being performed in laboratories to determine whether administering a low dose of hydrogen sulfide to animals can aid in minimizing injuries that occur when their bodies do not receive sufficient blood flow to the tissues. With the use of Lewis’ portable ultrasound machine, doctors are hoping to enable specific areas of the body to be targeted by the hydrogen sulfide, resulting in using decreased amounts and thereby diminishing the risk of toxicity.

OIt has long been noted that there are ever expanding uses for ultrasound machine technology in the medical environment. But in the mind of most non-medical people, ultrasound is still associated with obstetrics. The increasingly-less-fuzzy images of a unborn baby still in its mother’s womb are powerful indeed, while the new 3D images are even more so. But the power of ultrasound use in medical practice extends far beyond the obstetrical practice and fuzzy baby picture keepsakes.

Eye surgeons are beginning to use ultrasound machine technology more and more. In the case of trauma to the eye, a way had to be found to obtain an image of the injured eye while minimizing the brain’s exposure to ionizing radiation like x rays or CT scans. Ultrasound meets those requirements nicely and uses no ionizing radiation. Ultrasound machines can also be used to provide guidance when the surgeon must perform delicate procedures in and behind the fragile structures of the eye.

But there a more common use for ultrasound one that eye surgeons have placed at the center of corneal procedures. In corneal surgery, both for vision correction and transplantation, the measurement of the thickness of the cornea has become more and more important. There is even a type of surgery where the cornea is removed and shaped to become a living contact lens.

But all of these options are dependent on one thing: the thickness of the cornea. Measurement of the corneal thickness has a term, pachymetry. Ultrasound technology has become so ingrained with this term that the two are now used together. Ultrasound pachymetry is now what these measurements are called.

A specially designed and sized ultrasound probe is placed in the center of the eye and measures the thickness of the cornea much as the more common ultrasound collects images, with reflected sound waves. In this instance, the software that interprets the waves is a bit simpler.

In fact, other newer methods of pachymetry are being measured against ultrasound pachymetry. It has been, and will remain the gold standard for measurement both before and after eye surgery. One other essential for accurate ultrasound pachymetry is the skill of the technician, an important component of any successful ultrasound procedure.

The evolution of ultrasound machine technology has progressed to the point that more and more clinical needs are being met by the most basic of instruments. These needs range from routine prenatal care to complex pictures of the beating heart. One recent advance in ultrasound technology is a new type of receiver that will add to the detail of many kinds of images, and you can achieve this improved level of detail by merely adding a new receiver to your compatible ultrasound machine.

Remember that ultrasound machines are dependent on both the generation of sound waves and the reception and interpretation of the reflected sound waves. The sound waves are generated in both the continuous wave (CW) and the pulse wave (PW) Doppler forms. A new eight-channel receiver will give new abilities to any compatible ultrasound machine.

New technology now integrates new filtering technology, new data conversion, and a new chip that decreases the interference of the returning signal. In general, ultrasound machines use CW Doppler processing to calculate speed and the direction of the blood. This gives accurate measurements of vascular diseases like faulty arterial valves, just to name one use.

This new eight channel receiver gives doctors the same capabilities of a larger instrument in a smaller size that consumes less power than the larger ultrasound system. In addition, new filters reduce the “noise” that comes from the reflected sound waves, adding to the clarity of the image, and that is what an ultrasound is about after all.

This receiver also features a SPI (Serial Port Interface). It will allow the clinician to further customize the noise reduction and the power performance for any given imaging probe, mode or power requirement. Less power means not only a cost savings in power consumption, but also more power available for the sound output and interpretation software of the ultrasound machine.

If you are looking to expand the capabilities of your existing instrumentation but do not want to abandon your current ultrasound medical equipment, the addition of the eight channel receiver might be a good idea for you and your clinic.

Imagine yourself experiencing the worst pain imaginable. Now imagine that you are told that the most common diagnostic tools available cannot be used on you because to do so would be dangerous for you. Many arthritis patients have found themselves in this very situation, but fortunately, they had another option for diagnosis: ultrasound.

Many patients who are diagnosed with heart arrhythmia receive implanted pacemakers, and then go on with their lives. These days it is a fairly common and routine procedure. Patients who have implanted pacemakers often develop shooting pains in their joints, often debilitating joint pain. If their physician suspects a form of arthritis, the next step would typically be to confirm the diagnosis with a traditional MRI. But for a patient with an implanted pacemaker, this is not possible. Not only would the intense magnetism of the MRI fry the delicate electronics, it might cause the device to become dislodged. Any movement of the precisely placed pacemaker would render it ineffective, perhaps painfully so.

Though ultrasound machines have been mostly associated in recent years with obstetrics, rheumatologists are finding new uses for this well established technology. In addition to its clinical efficacy, ultrasound may also be a cheaper and safer tool for viewing soft tissues instantly.

The ultrasound machine can not only be used to help in the diagnostic process, but also with the delivery of drugs. Ultrasounds can help to guide needles right to the inflamed spot in a joint, maximizing the drugs’ effectiveness.

Before the use of ultrasound machines, doctors would have an initial MRI, but after that, they relied on patient reports to find out if they hurt more or if they felt the medicine was working. However, recent studies comparing ultrasound and MRI to routine clinical assessments (without imaging) have shown that, while up to a fifth of all rheumatoid arthritis patients felt they were in remission, they were, in fact continuing to experience joint-damaging inflammation–inflammation that was only detectable by imaging.

Now, with ultrasound testing, doctors can watch in real-time the progression of inflammation as blood gathers around a joint – just like a TV weatherman sees a radar picture of a storm system.

And the savings are not to be ignored, either. An MRI has an average cost of around twelve hundred dollars. It is too cost prohibitive to use to track the progression of the disease. But the in office ultrasound has a cost of about $120 per use or less. Add to that the readily accessible nature of the technology, and you have a new way to approach the prevalent problem of rheumatoid arthritis.

There is an insidious nature to osteoporosis. It is a gradual loss of bone tissue that is so slow that it is usually not noticed until there is a traumatic event like a fracture. Screens exist that can predict osteoporosis and allow treatment to begin early, and one of the best screens is ultrasound based.

Quantitative ultrasound (QUS) measures the speed of sound and broad band ultrasonic attenuation of the ultrasound beam as it passes between two ultrasound transducers. QUS can become a screen that may be predict future fractures in peri-menopausal and immediate post-menopausal women, and senior citizens of both genders. Those who have low QUS values for the ankle bone, the most common bone screened, are referred for further testing, like measurements of the spine.

QUS works by measuring how the ultrasound machine beam changes as it passes through the bone. The name for this type of ultrasound is Broad Band Ultrasonic Attenuation, or BUA. QUS can also measure how quickly the ultrasound beam passes through the patient’s bone; the name for this is Speed of Sound, abbreviated as SOS.

These two readings when taken together can tell us about how bones are structured, whether or not they are elastic, and how strong they are—in short, measures of the quality of the bone. That can be compared to the bone density. Taken together, these two assessments can help doctors predict each patient’s risk of suffering a bone fracture.

The bones of the foot are used because just like the lumbar spine, as we age these bones change. Spinal changes cause the majority problems in patients with osteoporosis. In addition, QUS is a simple process, the equipment is portable, and for the patient there is no radiation exposure.

Studies have shown that a combination of QUS and an inquiry about personal and familial risk factors would detect more cases of osteoporosis and had slightly better chance to predict fractures than the risk factors inquiry alone. It has also been discovered that ultrasound test alone have much better predictive value than risk factors alone. It is, however, still good clinical practice to do an overall assessment of risk for osteoporosis rather than QUS alone.

Ultrasound machine scanning, therefore, is a simple, quick, safe, portable, and inexpensive clinical test. It can provide physicians an opportunity to improve on the current method of identifying patients at risk for osteoporosis and the associated fractures.

The Ultrasound Transducer is a highly sensitive and technical piece of medical equipment. As with any equipment which comes into contact with a patient, it requires special care and handling.

The most important thing to remember when caring for your transducer is that you must follow your manufacturer’s directions for care and cleaning. If you do not, you run the very real risk not only of irreparably damaging your transducer, but of also voiding your warranty. So step one is, alas, read the manual.

That said, there are some general guidelines for care and safety of ultrasound transducers in general.

1. Properly store transducers when not in use. Most machines have a designated storage place for transducers, such as a dedicated holder.
2. Avoid dropping the transducer, or subjecting it to any kind of impact.
3. Mind the cable. The cable is, in essence, an electrical cord. Unnecessary bending or folding of the cable can damage the cable insulation, which may lead to electrical shock.
4. Always inspect the transducer apparatus, including lens and cable, before each use. If the transducer is damaged, it can cause injury to the patient or operator. If you notice a problem with a transducer, do not use it and contact the manufacturer for service and/or replacement.
5. Use only approved coupling gels to avoid damage to the medical equipment and discomfort for the patient.

Now that you know how to care for your transducer, how about cleaning?

1. Step one is read the manual and follow the manufacturer’s instructions. The importance of this step cannot be overstated.
2. Use the manufacturer’s specified cleaning products and germicides. To do otherwise can damage your equipment and void your warranty.
3. Do not allow the connector end of the cable or transducer to become immersed in the cleaning product.
4. If your transducer must be soaked in germicide, follow the manufacturer’s instructions as to length of soaking time.
5. Steam cleaning, using a heat autoclave or gas process, is generally not recommended.

As long as you follow the proper procedures for transducer care, use and cleaning, your equipment will serve you well, allowing you to better serve your patients.