TEAS 9.5.03 -00 Ultrasonic investigation with breast dummy
Contents
1. 60 70 Gain Output Curso EA Difference Amplitude ga MPT 35 dB 3OdB 115mm 207mm 92mm 0985V At Z 11 6 sec Fig 7 Sonographic image of tumour 2 PHYWE xcetience in science 6 PHYWE Systeme GmbH amp Co KG All rights reserved P59503002. 3 Ultrasonic investigation with breast dummy PHYWE 00 expert Hi Brightness Mode B i 18 x File Options Scale View Modi About Signalview Save Zoom Area Measurement f yay AScan aaie TM mode CT Start z fo 4 gt 70 4 gt Tete leon 141 PathLength rom f 2S 1 MHZ Sound Velocity m s 1400 0 4 gt frames sec OHz color scale 7 FFT Fiter Stat Full Time Depth HF Amp HFsAMP G gay C rainbow evd o afol ale inverted pielwidth ims 20 4 gt r OE E Depth 14 mmidiy 70 mm At 8 Ssec Depth 11 6mm 08 Input Voltage Y Reflection 1 0 a TGC dB 35 30 0 10 20 30 40 50 60 70 Gain Output Cursor Cursor Difference Amplitude g aMPT 35 dB 30dB 115mm 207mm 92mm 0624Y At E 14 1 sec Fig 6 Sonographic image of tumour 1 Brightness Mode i 218 amp gt File Options Scale View Modi About Signalview Save E Ziom Area Measurement i AScan B mode TM mode CT 1 fo 70 al gt Tasia TE T Path Length mm 70 E TM Ma l 1 MHz Sound Velocity m s 1400 0 4 gt frames sec 15 color scale FFT Fiter Stop Full Time Depth HF Amp HF AMP level aiai on G C rainbow widi fo 4 p 64 4 gt inverted pixelwidth ms 20 4 gt tested input Voltage Y Reflection 1 0 s p Depth 14 mmidiv 70 mm At 11 4sec Depth 2 5mm 08 06 a 0 4 0 2 0 0 0 10 20 30 40 50 60 70 tt Depth mm 0 10 20 30 40 50
3. aiy TEAS TESS PHVYWE Ultrasonic investigation with breast dummy 9 5 03 expert 00 Related Topics Breast sonography tumour size benign Tumour ultrasound imaging procedures ultrasound echogra phy A mode B mode Principle This experiment shows a typical application of ultrasounds in medical diagnostics On a realistic breast dummy a benign tumour has to bee diagnosed localized and measured with an ultrasound cross section imaging method Equipment 1 Basic Set Ultrasonic echoscope 13921 99 consisting of 1x Ultrasonic echoscope 1x Ultrasonic probe 1 MHz 1x Ultrasonic probe 2 MHz 1x Ultrasonic test block 1x Ultrasonic cylinder set 1x Ultrasonic test plates 1x Ultrasonic gel 1 Extension set medical ultrasonic diagnostics 13921 04 consisting of 1x simplified heart dummy for echocardiography 1x breast dummy 1x eye dummy Additionally needed 1 PC with USB port Windows XP or higher Fig 1 Equipment for ultrasonic investigation of breast dummy experimental set up P5950300 PHYWE Systeme GmbH amp Co KG All rights reserved 1 15 03 TESS 9 5 03 Ultrasonic investigation with breast dummy gt HYWE 00 expert Caution This is not medical equipment don t apply to human body Pay attention to the special operation and safety instructions included in the user manual of the ultrasonic echoscope Tasks 1 Examine the breast dummy and search for any pathological changes Try to characterize them as acc
4. bottom of the window The cursors can be positioned by mouse click The time of flight is displayed un der the cursor buttons Note The breast dummy and the probes should be cleaned immediately after use with water or a normal de tergent Dried residues of ultrasonic gel are hard to remove If necessary use a soft brush Never use al cohol or liquids with solvents to clean the dummy or the probes Theory and Evaluation Ultrasound is an imaging test that sends high frequency sound waves through your breast and converts the reflected waves into images on a viewing screen The ultrasound technician places a sound emitting probe on the breast to conduct the test There is no radiation involved Mammography and sonography are the standard imaging techniques for detection and evaluation of breast disease Mammography is the most established screening modality Especially in young women and women with dense breasts sonography appears superior to mammography and differentiation be tween solid tumours and cysis is easier Sensitivity and specificity of sonography or mammography are higher if sonography and mammography are combined Ultrasound is not used on its own as a screening test for breast cancer Rather it is used to complement other screening tests If an abnormality is seen on mammography or felt by physical exam ultrasound is the best way to find out if the abnormality is solid Such as a benign fibroadenoma or cancer or fluid filled s
5. n sound velocity c the distance s between the ultra sonic probe and the boundary of a solid can be determined for perpendicular sound incidence in the fol lowing way c t 2 From a geometrical point of view the detected signals come always from the direction perpendicular to the probe surface As the surface of the dummy Fig 4 is not a horizontal flat surface the image is not a real cross section image of the breast dummy but gives a deformed image Press only slightly the pro be on the surface of the dummy Don t deform the surface the probe should look in a different direction then normal perpendicular direction In reflection mode 1 s Fig 4 Schematic representation and typical image of tumour in breast dummy in B scan mode PHY WE excellence in science 4 PHYWE Systeme GmbH amp Co KG All rights reserved P5950300 TEAS TESS PHYWE Ultrasonic investigation with breast dummy 9 5 03 expert 00 raS Fig 5 A clinical instrument clinical B scan and schematic representation of a phase array scan Without a scanner only dept measurements give significant results For lateral information the beam must be mechanically or electronically scanned over the area of interest The most clinical ultrasound equipment use phase array electronic scanning method The probe is fixed and the ultrasound beam scans the object by varying the incident angle Results Tumour 1 The tumour was located by palpati
6. on at 2 cm at the right of the nipple It is located near the surface and has about a diameter of about 1 3 cm The tumour can be easily moved in the tissue The sonographic image Fig 6 shows the tumour region along a scan line from top to bottom of the breast passing at the right side of the nipple Fig 3 The tumour is located 10 mm below the surface and has an axial expansion of 24 mm The lateral extent can not be accurately determined from the ultra sound image as it is a hand guided B mode image The continuous line at the bottom of the screen comes from the back wall echo of the breast dummy Due to the higher absorption of the tumour a clear acoustic shadow appears in the wall echo of the breast dummy Tumour 2 The 2nd tumour was located approximately 5 cm above the nipple It shows similar properties to palpa tion as the 1st tumour The sonographic image Fig 7 was taken along a line starting just above the nipple and going straight up Fig 3 The tumour is also located at a depth of 10 mm and has a length of about 26 mm The tu mour has an oval shape with a slightly inclined axis Similar to tumour 1 the increased absorption of tu mour tissue causes an acoustic shadow on the back wall echo The reflected signal on the lower right corner is a multiple echoes of the back wall This is an artefact and has non importance for diagnostics P5950300 PHYWE Systeme GmbH amp Co KG All rights reserved 5 ne TESS 9 5 0
7. peak Adjust the transmitter and receiver amplifier settings until the upper and bottom side of the tumour and the back wall echo can clearly be detected Fig 2 The peak shape can be optimised adjusting the time TGC Time Gain Control parameters Keep the settings and toggle to B scan mode Perform some linear scans in the two tumour regions The ultra sound probe is scanned uniformly with plenty of coupling gel and light pressure over the surface of the breast model Several images should be taken in different scan directions to determine an optimal scanning path Recording an ultrasound image with sufficient contrast of all objects of interest requires some practice If necessary the device settings can be varied to achieve better image quality Too strong pressure applied to the probe leads to tissue deformati ons and induces incorrect results Estimate the location and size of the tumour Fig 3 Scan lines for tumour 1 and tumour 2 Software The measure Ultra Echo software records displays and evaluates the data transferred from the echo scope After starting the program the measure mode is active and the main screen A Scan mode is open All actions and evaluations can be selected and started in this window The main screen shows in the upper part the A scan signal the frequency of the connected transducer the mode reflection transmission Actual positions of cursors red and green line are displayed at the
8. uch as a benign cyst It cannot determine whether a solid lump is cancerous nor can it detect calcifications But doctors can use ultrasound to guide biopsy needles precisely to Suspicious areas in the breast If you re under age 30 your doctor may recommend ultrasound before mammography to evaluate a pal P5950300 PHYWE Systeme GmbH amp Co KG All rights reserved 3 sep TESS 9 5 03 Ultrasonic investigation with breast dummy 2HYWE 00 expert pable breast lump a breast lump that can be felt through the skin Mammograms can be difficult to in terpret in young women because their breasts tend to be dense and full of milk glands Older women s breasts tend to be fattier and are easier to evaluate In mammograms this glandular tissue looks dense and white much like a cancerous tumor Some doctors say that locating an abnormality in the midst of dense gland tissue can be like finding a polar bear in a snowstorm Most breast lumps in young women are benign cysts or clumps of normal glandular tissue To interpret the A scan curves and B scan images some physics basics have to be considered An echoscope generates with help of a piezoelectric ceramic a short pulsed mechanical wave If this wave is coupled into solid state material it propagates in a linear way perpendicular to the emitting piezo and will be reflected on interfaces with acoustic impedance changes boundaries From the measured time of flight t and a Know
9. urately as possible size location mobility strength of the change 2 Produce an ultrasonic B scan image of the breast dummy especially in the regions of interest Based on the ultrasound image estimate the location and magnitude of the tumour Set up and Procedure Put the breast dummy in front of you on the table Palpate the dummy with the flat of your hand and your fingers Start with soft pressure to palpate the surface Increase continuously the pressure to examine also deeper layers of the breast dummy With this method you will locate two thickenings close to the nipple Examine he two regions with ultrasounds Connect the 1 MHz probe to the Probe Reflection plug Switch the selection knob to Reflection Select medium gain and output power Switch on the echoscope Start up the measure Ultra Echo software in A scan mode Set the ultrasound velocity to 1300 m s for the dummy For human tissues the normal sound velocity would be 1540 m s Toggle from Time to Depth scale Couple the probe to the test dummy using sufficient coupling gel Scan the region of interest determined by palpating Tumour Backwall Fig 2 Typical A scan image of tumour in breast dummy PHY WE excellence in science 2 PHYWE Systeme GmbH amp Co KG All rights reserved P5950300 TESS TEAS PHYWE Ultrasonic investigation with breast dummy 9 5 03 expert 00 The measure Ultra Echo software shows the reflected wave as a
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