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Biological effects of  UltraSound King Saud University, college of Applied medical sciences, Radiological Sciences Department. Radiological Protection Course Presented by: Shatha Jamal Al Mushayt At  2009-2010
Main Objectives  ,[object Object]
How can they be predicted and prevented?
How did they help in developing other techniques?
Examples of some reported effects and if their relationship with ultrasound is proved or not yet.,[object Object]
Biological Effects of US
Thermal effects Def:  temperature within a medium (locally). How? As the sonic energy is absorbed &  converted into heat. Thermal effect depends on: Beam intensity, tissue absorption coefficient, blood  flow, exposure parameters(e.g. Duration  of exposure, frequency, …) 1.
Transducer Self-heating  ,[object Object],energy instead of sonic energy. ,[object Object],stationary for several minutes. ,[object Object],e.g. trans-esophageal exams. Endocavity probe
Mechanical(direct) effects e.g.Particledisplacement & fluid streaming: Target particles are pushed away from  the transducer acoustic streaming in fluids, cell distortion* and lysis. Non-thermal effects  2.
Non-thermal effects 2.  B. Cavitation Regions of compression & rarefaction are created in the medium. increases & decreases in pressure alternatively.  Gas bubbles form(how?) & grow until critical size then collapse.  generates the energy for mechanical effects.
Cavitation Types Cavitation may be transient or stable. ,[object Object],violent collapse.  ,[object Object]
May cause genetic damage in vitro.
Stable cavitation : bubbles oscillating with sound beam. ,[object Object],& sometimes cell lysis.
Safety Indices Thermal Index (TI) & mechanical Index (MI)  Not perfect; but they are the most common &   practical measurements available at present. Indicate the probability of thermal & non thermal  effects. Assist the sonographer in  patient exposure. How? > By keeping these indices as low as possible while  obtaining the best possible diagnostic images.
Thermal Index(TI) An indicator of the temp. elevation possible  at a particular equipment setting. TI has 3 subdivisions : Soft tissues (TIS);  bone (TIB);  and adult cranial exposure (TIC).
An indicator of the probability of cavitation events. Generally,  MI should be < 1.9  Mechanical Index(MI)
[object Object],[object Object]
Imaging modes and thermal effects In routine practice : B-mode, M-mode and 3D imaging are less likely  to give rise to thermal injury. >> figures Doppler  US can cause significant temp. rises. Doppler image  M-mode image B-mode image
Mechanical Effect ,[object Object],in humans from currently used exposure in diagnostic US.
Cavitation Currently,  ,[object Object],[object Object]
Therapeutic U/S Usually continues  US wave or pulses of much higher intensities than in diagnostic. Examples  of applications: Lithotripsy, (mechanical) Tumor therapy by high intensity focused ultrasound  (HIFU): heat tissue (thermal) & produce necrosis.
Diagnosis vs. Therapy Diagnostic exposures  are designed to  the interaction of US with tissue  to avoid potential bioeffects. Therapeutic  application depends on the direct interaction of US with tissue  to produce the  desired beneficial bioeffect. Exposure parameters are often different. Therapeutic intensities, pulse durations far  exceed the diagnostic devices output.
 US Exposure During Pregnancy ,[object Object],receives one or more US scans. Risks  & benefits are different  depending on: Types of US, stages of pregnancy, machines, centers,  & sonographers Each situation must be judged in  its own merit. Major centers are preferable for better trained sonographers & powerful machines No long or  repeated scans.
Long Term Edverse Effect During Pregnancy Some reported fetal effects of US exposure: Delayed speech, dyslexia*, growth restriction,   & non-right-handedness. ,[object Object],to conclude that there is a causal relationship between diagnostic US & long-term adverse fetal effects.
Recommendation for clinical practice of diagnostic US No routine US with no clear indications for use. Should only be used when benefits outweigh risks.  Users should  know the exposure parameters of  US  equipment they employ. Users must know how to alter machine settings so as to  reduce exposure. Instruments must be checked routinely  to maintain the capability of obtaining reliable diagnostic information at  ALARA exposures.
Recommendation for clinical practice of diagnostic US For US scans for operator training, memorial  pictures & videos of the fetus, or research, a lower  threshold is recommended ) TI 0.5 , MI 0.3 (  It is not recommended to use colorDoppler mode  of the 1sttrimester embryo routinely; as this mode has a potential to produce significant temp. rises.  Acoustic output from B-mode, M-mode, 3D imaging is  safe  during all pregnancy stages(if used as needed).

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Bioeffect Of Ultra Sound

  • 1. Biological effects of UltraSound King Saud University, college of Applied medical sciences, Radiological Sciences Department. Radiological Protection Course Presented by: Shatha Jamal Al Mushayt At 2009-2010
  • 2.
  • 3. How can they be predicted and prevented?
  • 4. How did they help in developing other techniques?
  • 5.
  • 7. Thermal effects Def:  temperature within a medium (locally). How? As the sonic energy is absorbed & converted into heat. Thermal effect depends on: Beam intensity, tissue absorption coefficient, blood flow, exposure parameters(e.g. Duration of exposure, frequency, …) 1.
  • 8.
  • 9. Mechanical(direct) effects e.g.Particledisplacement & fluid streaming: Target particles are pushed away from the transducer acoustic streaming in fluids, cell distortion* and lysis. Non-thermal effects 2.
  • 10. Non-thermal effects 2. B. Cavitation Regions of compression & rarefaction are created in the medium. increases & decreases in pressure alternatively. Gas bubbles form(how?) & grow until critical size then collapse.  generates the energy for mechanical effects.
  • 11.
  • 12. May cause genetic damage in vitro.
  • 13.
  • 14. Safety Indices Thermal Index (TI) & mechanical Index (MI) Not perfect; but they are the most common & practical measurements available at present. Indicate the probability of thermal & non thermal effects. Assist the sonographer in  patient exposure. How? > By keeping these indices as low as possible while obtaining the best possible diagnostic images.
  • 15. Thermal Index(TI) An indicator of the temp. elevation possible at a particular equipment setting. TI has 3 subdivisions : Soft tissues (TIS); bone (TIB); and adult cranial exposure (TIC).
  • 16. An indicator of the probability of cavitation events. Generally, MI should be < 1.9 Mechanical Index(MI)
  • 17.
  • 18. Imaging modes and thermal effects In routine practice : B-mode, M-mode and 3D imaging are less likely to give rise to thermal injury. >> figures Doppler US can cause significant temp. rises. Doppler image M-mode image B-mode image
  • 19.
  • 20.
  • 21. Therapeutic U/S Usually continues US wave or pulses of much higher intensities than in diagnostic. Examples of applications: Lithotripsy, (mechanical) Tumor therapy by high intensity focused ultrasound (HIFU): heat tissue (thermal) & produce necrosis.
  • 22. Diagnosis vs. Therapy Diagnostic exposures are designed to  the interaction of US with tissue to avoid potential bioeffects. Therapeutic application depends on the direct interaction of US with tissue to produce the desired beneficial bioeffect. Exposure parameters are often different. Therapeutic intensities, pulse durations far exceed the diagnostic devices output.
  • 23.
  • 24.
  • 25. Recommendation for clinical practice of diagnostic US No routine US with no clear indications for use. Should only be used when benefits outweigh risks. Users should know the exposure parameters of US equipment they employ. Users must know how to alter machine settings so as to reduce exposure. Instruments must be checked routinely to maintain the capability of obtaining reliable diagnostic information at ALARA exposures.
  • 26. Recommendation for clinical practice of diagnostic US For US scans for operator training, memorial pictures & videos of the fetus, or research, a lower threshold is recommended ) TI 0.5 , MI 0.3 ( It is not recommended to use colorDoppler mode of the 1sttrimester embryo routinely; as this mode has a potential to produce significant temp. rises. Acoustic output from B-mode, M-mode, 3D imaging is safe during all pregnancy stages(if used as needed).
  • 28.
  • 29. Article: Ultrasound safety and collapsing bubbles: http://www.highbeam.com/doc/1G1-4600240.html- access with KSU password
  • 30. [PDF] Ultrasonic imaging of the human bodyP N T Wells.
  • 31. Practical radiation protection in healthcare, by Martin & Sutton
  • 32. [PDF] Guidelines for the Safe Use of Diagnostic Ultrasound
  • 33. Ultrasound Physics and instrumentation by Hedrick, hykes, starchman >>image
  • 34. [PDF] ULTRASOUND: AN OVERVIEW OF THE LITERATUREhttp://www.sonochemistry.info/Research.htm

Hinweis der Redaktion

  1. NOT completely safe
  2. Cavitation: contrast agents to enhance echogenicity and,therefore, visualisation of blood vessels andcapillaries in a diagnostic image.
  3. Blood flow, redistribute any heat generated
  4. grow by a process known as rectified diffusion i.e. small amounts of vapour (or gas) from the medium enters the bubble during its expansion phase and is not fully expelled during compression. The bubbles grow over the period of a few cycles to an equilibrium size for the particular frequency applied. It is the fate of these bubbles when they collapse in succeeding compression cycles which generates the energy for chemical and mechanical effects
  5. In vitro: within a glass. Sometimes: when shearing forces are high.
  6. Doppler: vastly beneficial in high-risk pregnancies management
  7. Living organisim
  8. Stone fragmentation by the mechanical interaction of the acoustic waves with the kidney stone
  9. Difficulty in learning, reading, spelling in kids
  10. De. Dwelltimes &amp; total exposure times. If adjustable, de. Intensities. (dwell t: amount of time that the transducer remains in one place.)