How Echocardiography is Used for Cardiac Diagnosis and Treatment

Echocardiography, also known as cardiac ultrasound, is an ultrasound- based diagnostic imaging technique used for visualizing of subcutaneous body structures, including: tendons, muscles, joints, vessel and internal organs, for possible pathology or lesions. In physics, "ultrasound" applies to all sound waves with a frequency above the audible range of human hearing, about 20,000 Hz. The frequencies used in diagnostic cardiac ultrasound are typically between 2 and 18 MHz.

The choice of frequency of the cardiac ultrasound is a trade-off between spatial resolution of the image and imaging depth: lower frequencies produce less resolution but image deeper into the body. Higher frequency sound waves have a smaller wavelength and are therefore capable of reflecting or scattering from smaller structures. Higher frequency waves also have a larger reduction coefficient and are therefore more readily absorbed in tissue, limiting the depth of penetration of the sound wave into the body.

Cardiac ultrasound is most effective for imaging soft tissues of the body.

Superficial structures such as muscles, tendons, testes, breast and the neonatal brain are imaged at a higher frequency, which provides better axial and lateral resolution. Deeper structures such as liver and kidney are imaged at a lower frequency with lower axial and lateral resolution, but greater penetration.

Ultrasonography uses probes containing multiple acoustic transducers to send pulses into the tissue. Whenever the wave encounters a tissue with a different density, part of the sound wave is reflected back to the probe and detected as an echo. The time it takes for the echo to travel back to the probe is measured and used to calculate the depth of the tissue interface causing the echo. The greater the difference between cardiac ultrasound acoustic impedances, the larger the echo is. If the pulse hits gases or solids, the density difference is so great that most of the acoustic energy is reflected and it becomes impossible to see deeper.

To generate a 2D-image, the cardiac ultrasonic beam is swept. A transducer may be swept mechanically by rotating or swinging. The received data is processed and used to construct the image. The cardiac ultrasound image is then a 2D representation of the slice into the body.

3D cardiac ultrasound images can be generated by acquiring a series of adjacent 2D images. Commonly, a specialized probe that mechanically scans a conventional 2D-image transducer is used.

Doppler cardiac ultrasound is used to study blood and muscle motion. The different detected speeds are represented in color for ease of interpretation, for example leaky heart valves: the leak shows up as a flash of unique color. Colors may alternatively be used to represent the amplitudes of the received echoes. Echocardiography is an essential tool in cardiology, to diagnose, for example, dilatation of parts of the heart and function of heart ventricles and valves.

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