Tissue harmonic imaging is an ultrasound technique that provides higher quality images compared to conventional ultrasound by collecting harmonic signals generated in tissues and filtering out transducer-generated fundamental echo signals, resulting in clearer images with improved contrast resolution, reduced artifacts, and better visualization of deeper structures and vessels. While tissue harmonic imaging improves image quality in many clinical applications, it can decrease axial resolution compared to fundamental frequency imaging due to the narrowed signal bandwidth.
presentation on ultrasound elastography-introduction ,techniques,physics,application, interpretation and future prospects.sourced from multiple articles.
presentation on ultrasound elastography-introduction ,techniques,physics,application, interpretation and future prospects.sourced from multiple articles.
Usg transducer and basic principles of ultrasound Doppler, this slide describe the basic physics of ultrasound transducer and Doppler , must know thing is given in this presentaion. Good review for radiology resident. Thanks.
MDCT Principles and Applications- Avinesh ShresthaAvinesh Shrestha
Multidetector CT (MDCT) is one of the most commonly used imaging modality in the field of Radiology. Development and advancement in MDCT has made it's application as a major component in diagnosis and treatment planning of multitude of disease across the planet. This presentation briefly describes its basic principle and it's wide variety of application in medical imaging.
Image Quality, Artifacts and it's Remedies in CT-Avinesh ShresthaAvinesh Shrestha
CT is one of the frequently used diagnostic imaging modalities in Radiology. Knowledge about image quality and artifacts is essential when diagnosing a patient with the help of CT images. Moreover, Radiology Technologist's should be very well aware about the ways to identify and eliminate or minimize the artifacts in CT for better image quality.
Definition of Side lobes and the principle behind its production during ultrasound imaging. Side lobes artifact and its result on image. Explanation of harmonic imaging, its production and the techniques use to eliminate fundamental frequency to produce optimal harmonic images.
Introduction to mammography and its equipment.
Different views on mammography & supplementary views.
Birads mammographic lexicon
Birads ultrasound lexicon
Imaging of suspicious mammary lymph nodes
Categories in BIRADS 2013.
Basic physics of multidetector computed tomography ( CT Scan) - how ct scan works, different generations of ct, how image is generated and displayed and image artifacts related to CT Scan.
Ultrasound Physics Made easy - By Dr Chandni WadhwaniChandni Wadhwani
History of ultrasound, Principle of Ultrasound.
Ultrasound wave and its interactions
Ultrasound machine and its parts, Image display, Artifacts and their clinical importance
what is Doppler ultrasound, Elastography and Recent advances in field of ultrasound.
Safety issues in ultrasound.
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
Usg transducer and basic principles of ultrasound Doppler, this slide describe the basic physics of ultrasound transducer and Doppler , must know thing is given in this presentaion. Good review for radiology resident. Thanks.
MDCT Principles and Applications- Avinesh ShresthaAvinesh Shrestha
Multidetector CT (MDCT) is one of the most commonly used imaging modality in the field of Radiology. Development and advancement in MDCT has made it's application as a major component in diagnosis and treatment planning of multitude of disease across the planet. This presentation briefly describes its basic principle and it's wide variety of application in medical imaging.
Image Quality, Artifacts and it's Remedies in CT-Avinesh ShresthaAvinesh Shrestha
CT is one of the frequently used diagnostic imaging modalities in Radiology. Knowledge about image quality and artifacts is essential when diagnosing a patient with the help of CT images. Moreover, Radiology Technologist's should be very well aware about the ways to identify and eliminate or minimize the artifacts in CT for better image quality.
Definition of Side lobes and the principle behind its production during ultrasound imaging. Side lobes artifact and its result on image. Explanation of harmonic imaging, its production and the techniques use to eliminate fundamental frequency to produce optimal harmonic images.
Introduction to mammography and its equipment.
Different views on mammography & supplementary views.
Birads mammographic lexicon
Birads ultrasound lexicon
Imaging of suspicious mammary lymph nodes
Categories in BIRADS 2013.
Basic physics of multidetector computed tomography ( CT Scan) - how ct scan works, different generations of ct, how image is generated and displayed and image artifacts related to CT Scan.
Ultrasound Physics Made easy - By Dr Chandni WadhwaniChandni Wadhwani
History of ultrasound, Principle of Ultrasound.
Ultrasound wave and its interactions
Ultrasound machine and its parts, Image display, Artifacts and their clinical importance
what is Doppler ultrasound, Elastography and Recent advances in field of ultrasound.
Safety issues in ultrasound.
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
2. TISSUE HARMONIC IMAGING
• Harmonic imaging is a (image optimization) technique in ultrasound that
provides images of better quality as compared with conventional
ultrasound technique.
7. Ability of the imaging system to differentiate the echoes returning from different parts
of the body and display there amplitude in different shades of gray
CONTRAST RESOLUTION
8. TEMPORAL RESOLUTION
Represents the ability of the ultrasound system to distinguish
between instantaneous events of rapidly moving structure.
consecutive unique images
Continuous moving
image on real time
image monitor
10. Increased
frequency
Increased - -
Increased focal
point
Increased - Decreased
Compound
Imaging
Increased Increased Decreased
Tissue Harmonic
Imaging
Increased Increased Decreased
Gain - Increased -
Dynamic Range - Increased -
Grey Scale - Increased -
Colour B Imaging - Increased -
Increasing Depth Decreased - Decreased
Increasing Sector
Width
Decreased - Decreased
Increasing Line
Density
Decreased - Decreased
Spatial resolution Contrast resolution Temporal resolution
11. PHYSICS
HARMONICS (A new grayscale imaging technique)
• Harmonic imaging exploits non-linear propagation of ultrasound through the body tissues.
• The high pressure portion of the wave travels faster than the low pressure portion resulting in
distortion of the shape of the wave.
• This change in waveform leads to the generation of harmonics (multiples of the fundamental or
transmitted frequency) from a tissue.
• Transmitting a band of frequencies centered at 2MHz will result in production of harmonic
frequency bands at 4 MHz, 6MHz . This doubled frequency sound is called the second harmonic
• At present, the 2nd harmonic is being used to produce the image because the subsequent
harmonics are of decreasing amplitude and insufficient to generate a proper image.
• These harmonic waves that are generated within the tissue, increase with depth to a point of
maximum intensity and then decrease with further depth due to attenuation. Hence there is an
optimum depth below the surface at which maximum intensity is achieved.
12.
13.
14.
15. Tissue harmonic images are obtained by collecting harmonic signals that
are tissue generated and filtering out the fundamental echo signals that
are transducer generated resulting in crisper images.
16. TECHNICAL CONCEPTS AND TERMINOLOGY
• Fundamental frequency is the original frequency of the acoustic beam emitted from the
transducer. Harmonic wave generation is an acoustic phenomenon. Harmonic waves are integer
multiples of the fundamental frequeancy.
• The second harmonic (twice the fundamental frequency) is currently used for tissue harmonic
imaging (THI). With THI, the fundamental frequency is eliminated with image processing
techniques. THI advantages include improved signal-to-noise ratio and artifact reduction.
17. Linear (left) and nonlinear (right) US wave
propagation.
The transmitted pulse consists of a range of frequencies
centered around fc.
In a linear medium, the echo pulse frequency is the
same as the fundamental frequency but has lower
energy,
whereas the nonlinear medium results in harmonic
waves of higher frequency and lower energy in addition
to the fundamental frequency.
fc = fundamental frequency, 2fC = example of a
harmonic frequency.
18. HARMONIC FREQUENCIES
• Harmonic frequencies are integer multiples of the fundamental frequency (ie, if the fundamental
frequency is f, the harmonics have frequencies of 2f, 3f, and so on).
• The amplitudes of the harmonic waves are almost always lower than those of the fundamental
frequency waves.
• Subharmonic frequencies are integer fractions of the fundamental frequency (eg, f/2, f/3, and so
on).
• Subharmonic imaging is generally suitable for deep imaging because there is less attenuation of
lower-frequency subharmonic signals.
• Frequency multiples of the subharmonic frequency component (eg, 3f/2, 5f/2, 7f/2, and so on) are
called ultraharmonic frequencies.
• US ultrasound wave travels trough more tissues, more harmonics are generated
• The production of harmonics is proportional to the square of the fundamental intensity
19.
20. Diagram shows the harmonic energy profile.
Higher-amplitude US pulses produce more harmonic waves.
Therefore, harmonic waves are predominantly created in the
central, most intense portion of the beam.
which causes a narrower imaging plane and reduced artifacts
because of side lobes and grating lobes.
Note the increase in harmonic wave energy with increasing
depth.
At the skin, tissue harmonics are virtually zero; their intensity
increases with depth to the point where tissue attenuation
predominates and harmonic amplitudes decrease.
22. • Bandwidth Receive Filtering.—
Bandwidth receive filtering is a signal processing technique in which lower frequencies that are more likely to
have emerged from the fundamental beam are filtered out, and higher-frequency harmonic echoes are used to
generate the image.
In this technique, noise diminishes and enhancement is improved. However, narrowing the received bandwidth
reduces axial resolution because axial resolution can be estimated as the speed of sound in the tissue divided by
two times the bandwidth.
Selection of an appropriate cutoff frequency is a compromise between harmonic frequency signal loss and
contamination by the fundamental frequency signal. To overcome this limitation, pulse-inversion methods were
developed.
23.
24.
25. • Pulse Inversion.—
Pulse inversion is a technique in which two pulses with a 180° phase difference (ie, opposite phase) are emitted
sequentially into the tissue along the same line.
The summation of these received pulses results in fundamental echoes canceled out with odd harmonic
frequency components, and the retention of harmonic waves at even frequency multiples of the fundamental
frequency, with a doubling of the amplitude of even frequency multiple harmonic waves.
This technique is also termed a phase cancellation or a temporal cancellation technique. The principal advantage
of this technique is that axial resolution is not degraded and tissue contrast is better preserved.
pulse-inversion harmonic imaging is highly dependent on a fixed tissue frame, and tissue motion can markedly
degrade the US image. In addition, some reduction in frame rate will occur.
26.
27.
28.
29. • Side-by-Side Phase Cancellation.—
Side-by-side phase cancellation is similar to pulse inversion, but two pulses with opposite phase are
transmitted along adjacent lines of sight. These adjacent lines are then added to cancel fundamental echoes
and odd harmonics.
This technique is a spatial cancellation technique. As with pulse inversion, side-by-side cancellation
preserves harmonic frequency bandwidth.
30. Pulse-coded Harmonics.—
• The pulse-encoding technique transmits relatively complex pulse sequences into the body with a
unique and recognizable code imprinted on each pulse.
• The unique code is then recognized in the echoes . Because the fundamental echoes have a
specific code, they can be identified and canceled.
• The remaining harmonic echo is then processed to form the image.
31. CLINICAL APPLICATIONS
THI improves image quality and conspicuity, and has been shown to be
useful in multiple clinical scenarios, including
(1) Obesity
(2) Hollow structures (e.g., Cysts, gallbladder, urinary bladder) ( figure 4-
1 ), and
(3) The deep-seated major vessels (inferior vena cava [IVC] and
abdominal aorta) ( figure 4-2 ).
32. A, Image without harmonic imaging: the fundus and neck areas (arrows) of the
gallbladder (GB) and intraportal venous area (PV, arrow) appear echogenic and
cloudy.
B, With harmonic technique, the figure shows a clear GB and portal venous
structure. In addition, the tiny calcification on the anterior wall of the
GB (arrowhead) is well shown on the harmonic image in B but invisible in the blurred
image in A.
33. Figure 4-2Comparison of image conspicuity without/with harmonic
imaging in the sagittal plane of the left liver and the long axis of the
inferior vena cava (IVC). The arrows point to the intra-IVC area, which is
obviously cloudy and blurring in the nonharmonic image (A) compared
with the harmonic image (B).
34. ADVANTAGES OF THI
• Improved contrast resolution
• Beneficial effects on artifacts
• Reduced noise in the near field
• Improved imaging of deeper tissue
• Improved lateral resolution and reduced section thickness
35. DISADVANTAGES OF THI
• Axial resolution is decreased by THI because of the narrowed bandwidth.
• Fundamental frequency imaging may be clinically more efficacious than harmonic imaging in other
situations, such as diffuse fatty liver, because of compromise of axial resolution from filtration-related
bandwidth reduction, and higher attenuation of the higher frequency harmonic component.
36. THI SAFETY
Both the thermal and mechanical indexes remain the same for THI as for conventional B-mode US, and
therefore THI is considered safe for routine clinical use.