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Intensity
The strength of a sound beam, or concentration of energy in a particular area (cross section) of the sound beam
mW/cm²
The sound beam will have greater or less intensity at different locations and times

Why does Intensity Matter in Ultrasound?
understanding power and intensity is crucial for creating clear images of the inside of the body
Too much intensity = harmful —- Too little —- not a clear picture
Ultrasound machines: control the power and intensity of the sound waves to ensure safety and effectiveness
Sonographers can control the output power on the machine, so they need to understand how these changes effect the intensity and bioeffects
evaluate and understand exposure to sound energy (BIOEFFECTS)
Intensity Equation
Intensity = power/beam area
W/cm² or mW/cm²
Varying Intensities
Intensity is not uniform across space
at different depths of imaging, there will be differing intensities
Intensity is not uniform in time
depends on send and receive times
Spatial
space/distance, intensity at a specific place which changes depending on location
Peak
max value
Average
middle value
Temporal
time (both transmit and receive)
Pulsed
only transmit time (avg intensity over the transmit time or “on” time)
Spatial Peak Intensity (Isp)
beams location of maximum intensity
center of the beam

Spatial Average Intensity (Isa)
average intensity across entire area
*HINT* this will always be less than spatial peak intensity

Temporal Peak Intensity (Itp)
intensity at exact instant of max intensity
Imax (Im)
average intensity over the most intense half cycle
also a way of measuring peak intensity
Pulse Average Intensity (IPA)
average intensity during the transmit time (pulse duration)

Temporal Average Intensity (Ita)
average intensity over the entire transmit and receive times (PRP)

Highest to Lowest Values
Itp —→ Imax —→ Ipa —→ Ita

Isptp (spatial peak temporal peak)
maximum intensity based on location and time (highest of all intensities)
Isppa (spatial peak pulse average)
location of maximum intensity averaged over transmit time
Ispta (spatial peak temporal average)
maximum intensity based on location and averaged over ALL time (both transmit and receiving)
Isata (spatial average temporal average)
average of entire cross sectional area of the sound beam and average over all time (this has the lowest of all intensities)
_____ is often referenced with bioeffects (how ultrasound effects the tissue through which it travels
SPTA
Spatial Average Pulse Average (SAPA)
average intensity across the beam (SA)
averaged during pulse duration (PA)
Spatial Average Temporal Peak (SATP)
average intensity across the beam (SA)
Peak intensity at point in time (TP)
Intensities are reported in all different ways in relation to ____ and ____
time and space
Intensity is the main _____ when talking about ______ in tissue
parameter , bioeffects
_____ is the most commonly referred to and the most relevant in regards to _____
SPTA , bioeffects
_____ is ALWAYS greater than ____
peak , average
SPTP (greatest value)
SATA (lowest value)
10 Commandments of Intensity According to Edelman
Intensities reported in various ways with respect to time and space
intensities important when studying bioeffects (SPTA most relevant)
Units for ALL intensities w/cm²
SPTP has highest value - peaks are higher than averages
The beam uniformity coefficient (SP/SA factor) describes the spread of beam in space - it is unitless with a value greater than 1
Duty Factor describes relationship of beam intensity with time - unitless between 0 and 1
Continuous Wave - beam is always on so pulse average and temporal average are the same (SPTA=SPPA and SATA=SAPA)
When pulsed and continuous have the same SPTP intensities, the continuous wave will have the higher SPTA intensity (because continuous wave is always on)
Temporal Considerations: Temporal peak intensity is max intensity in time
Im intensity is averages over the most intense half-cycle
Pulse average intensity (Ipa) is averaged only during the pulse duration (on time)
Temporal average intensity (Ita) is averaged during PRP (both on and off time
10. Spatial Considerations: Spatial peak intensity (Isp) is the maximum in space
spatial average intensity (Isa) is averaged over the cross-sectional area of the beam
What Principle does DMS rely on?
as an ultrasound wave moves through human anatomy, small echoes return from the boundaries between different mediums
The system _______ THEN it ________
keeps track of all the parameters and variables of the transmit wave
measures all the variables and parameters of the receive wave
Behavior of Sound
sound waves propagate (travel) through the body and ATTENUATE
these waves move from one medium to another and can change directions
As sound hits different tissue types and reflect back to the transducer, the signal is then strengthened or amplified to be processed and displayed clearly
Reflections are created at boundaries between two media (tissue types)
These reflections create images
Attenuation and Amplification
The Decrease in the bigness of a sound as it travels
bigness being amplitude, power, intensity
wave loses energy as it travels deeper
The further sound travels, the more attenuation occurs
Not ALL sound attenuates - some is reflected back to the transducer
The reflected signals are weak and must be amplified
The amplified signals are processed to become an image
will result in negative number value because the wave is a WEAKENING as it travels
attenuation and speed = NOT RELATED
Decibel Notation
way to express changes in sound intensity or power
describes how much sound is attenuated or how much the system is amplifying the sound wave
dB make it easier to express these changes
uses a logarithmic scale
log10(100) =
2
Decibels
measure the strength of the sound beam created by transducers
logarithmic
decibel notation measures relative change and requires two intensities
reference or starting intensity
actual intensity at time of measurement
Decibel Equation
dB = 10 * Log (actual intensity/starting intensity)
Decibel Typical Values
• When signal strength doubles = 3 dB
• When signal strength is cut in half = -3 dB
• When signal strength increases 10 times = 10 dB
• When signal strength reduced one tenth = -10 dB
Describe changes in signal strength
Decibels Synonyms
“change in intensity” or “change in signal strength”
Decibel Shortcuts (memorize)
+ 3dB increase by factor of 2
• -3dB decrease TO ½
• + 6 dB increase by a factor of 4
• -6dB decrease TO ¼
• + 9dB increase by a factor of 8
• -9dB decrease TO 1/8
• + 10 dB increase by a factor of 10
• -10dB decrease TO 1/10
• +20dB increase by a factor of 100
• -20dB decrease TO 1/100
• +30 dB increase by a factor of 1000
• -30dB decrease TO 1/1000
What Determines Attenuation?
Distance traveled/path length
The farther the sound travels, the greater the attenuation, and the
weaker the beam
• Distance and attenuation are DIRECTLY related
The frequency of sound
• Attenuation in soft tissue depends on the wave’s frequency
• Frequency and attenuation are DIRECTLY related

Attenuation Relationship
MORE distance = MORE attenuation
GREATER frequency = GREATER attenuation
less penetration
What Contributes to Attenuation?
reflection
scattering
absorption
Reflection
occurs when sound strikes a boundary between two mediums, a portion of the wave may be reflected back toward the sound source
beam weakens as energy is reflected back to the source
basis for ultrasound imaging
reflection in soft tissue depends on the tissue interface that it strikes
two types of reflection
specular reflection
diffuse reflection (also called backscatter)

Specular Reflection
• When sound hits a smooth boundary, it reflects in only one direction,
in an organized manner
angle of incidence = angle of reflection
Reflection back to the transducer depends on the angle of incidence

Why do Specular Reflectors cause Strong echos that are easily detected by the sound source?
Because if the beam is perpendicular, the echo comes straight back to the source
• If the beam is not perpendicular, the reflection will bounce off at an angle, not toward the source

Diffuse Reflection
reflection that results from sound hitting an irregular surface (backscatter)
Advantage —> allows for reflections from suboptimal angle
Disadvantage —> backscatter produces lower strength signals than specular reflectors
echoes from non 90 degree angles get back to the source even though not all reflected sound will return to the source

Scattering
tissue interface is small (same or less than the wavelength of the incident sound beam)
random redirection of sound in many directions
air in lung tissue scatters sound
Higher Frequency = more scatter

Rayleigh Scattering
structure is MUCH smaller than the beams wavelength
redirects sound equally in all directions
Rayleigh Scattering ∝ frequency^4
ex: blood cells
Absorption
primary cause of attenuation
ultrasound energy is converted to another form of energy (usually heat)
doesn’t give diagnostic info
HIGH frequency absorption = POOR PENETRATION
heat loss is greatest in bone
Absorption Relationship
INCREASE absorption = INCREASE attenuation
MORE absorption = LESS imaging DEPTH (less penetration)
slightly increasing frequency = great increase in absorption
Air and Bone Absorption and Attenuation
HIGH
Attenuation in lung
HIGH due to scattering and absorption
Attenuation in body fluid and water
LOW
total attenuation depends on
distance traveled
frequency
the media through which the sound is traveling
Attenuation Coefficient
A simple way of reporting the attenuation of sound
# of decibels of attenuation that occurs when sound travels 1 cm
UNITS: dB/cm
ADVANTAGES: the value is CONSTANT regardless of how far the sound wave travels
Attenuation Coefficient Equation
Total Attenuation = attenuation coefficient (dB/cm) x distance (cm)
Attenuation Coefficient in Soft Tissue
½ the frequency in MHz (0.5 dB/cm per MHz)

Attenuation in Media Chart

Half Value Layer Thickness
simplifies attenuation
distance sound travels in a soft tissue that to reduce the sound to half its original strength
OR
distance required for -3dB attenuation
EQUATION: HVL (cm)= 3dB/atten coeff.
Half Value Layer Thickness Units
of length and distance (cm)
Half Value Layer Thickness Typical Values
.25 to 1cm
Half Value Layer Thickness Synonyms
penetration depth
depth of penetration
half boundary layer
3dB rule
HVL (cm) = 3dB/atten coeff.
Half Value Layer Factors
tissue
frequency
Half Value Layer (tissue factor)
GREATER attenuation in tissue = LESS DISTANCE the sound needs to travel to be decreased by ½
Half Value Layer (frequency factor)
HIGHER frequency = SMALLER HVL
higher frequency means shorter distance before the intensity is bc the higher the frequency the greater the attenuation-happens
faster)
Reflection
redirection of sound to the transducer to create an image
Transmission
portion of the wave that continues on into the tissue
What determines how much sound will reflect and how much sound
with transmit?
Impedance
Impedance
the acoustic resistance to sound traveling in a medium
reflections depend on impedance between two mediums
greater difference = greater reflection
2 medium with equal impedance = NO REFLECTION
Impedance Equation
Impedance = density of the medium (kg/m³) x speed of sound in that medium (m/s)
Impedance units
rayls (z)
Impedance determined by…
medium
Impedance values
1,250,000 - 1,750,000 rayls
Impedance is AKA
characteristic impedance
Angle of Incidence
angle at which the wave strikes the boundary or interface
determines behavior of pulse
Normal Incidence
sound beam strikes boundary at exactly 90 degrees
synonyms:
perpendicular
orthogonal
right angle
90 degrees

Oblique Incidence
sound beam strikes boundary at an angle other than 90 degrees
synonyms:
not at right angles
non-perpendicular

Incident Intensity
the sound wave’s intensity the instant before it strikes a boundary
Reflected Intensity
the intensity of the sound beam that returns back to where it came from after it strikes the boundary
Transmitted Intensity
The intensity of the sound beam that keeps going and continues forward in the SAME direction after striking the boundary
Incident Intensity Equation
Incident Intensity = reflected intensity + transmitted intensity
IT (GREEN) = RI (RED) + TI(PURPLE)

Intensity Reflection Coefficient (IRC)
percentage of intensity that bounces back when a sound beam strikes the boundary between two media
in two soft tissues = 1% or less
MORE reflection = GREATER %
Intensity Transmission coefficient (ITC)
The percentage of intensity that passes in the forward direction (keeps going) when a beam strikes a boundary
in two soft tissues: 99% or more
Relationship Between IRC and ITC
the intensity of those two must equal the intensity of the original sound source
100% = IRC (%) + ITC (%)

Reflection with identical impedances
None
Reflection with slightly different impedances
Small reflection
Reflection with very different impedances
LARGE reflection
Two Principles of Reflection with Oblique Incidence
Conservation of energy (all energy must be accounted for)
Reflection angle = incidence angle (think of looking in a mirror)

Refraction
a change in direction of the wave propagation when traveling from one medium to another (transmission with bending of the beam)

2 Conditions of Refraction
Oblique Incidence (CANNOT BE NORMAL)
Different propagation speeds of the two media

Refraction is more in _____ due to ____
bone/soft tissue , because of the significant difference in media
Snell’s Law
quantifies the physics of refraction
every angle has an associated sine
Speed 1 = Speed 2
No refraction
transmission angle = incidence angle

Speed 1 < Speed 2
transmission angle greater than incident angle

Speed 1 > Speed 2
transmission angle is less than incident angle
