Ultrasound medical imaging equipment has experienced more than half a century of development, especially since the rapid development of medicine, mechanical materials, computers, and electronic engineering technologies since the 1990s, the performance of ultrasonic diagnostic instruments has been continuously improved, functions have been continuously improved, and their uses have been continuously expanded. . At present, no hospital can be separated from ultrasound imaging diagnosis technology. Ultrasound imaging diagnosis has the characteristics of high spatial resolution, high soft tissue contrast, real-time rapid imaging, simple operation method, no contraindications, no damage, repeatable, portable and economical. Together with CT, MRI, and isotope imaging, it constitutes the four essential imaging diagnostic techniques in clinical medicine.
Overview of the application of ultrasound imaging diagnosis technology in medicine
The application of ultrasound imaging diagnosis technology in medicine began in the middle of the last century. At first, it only used A-type ultrasound to detect the thickness of isolated organs, and explored some clinical disease diagnosis; followed by using M-type ultrasound to detect normal people and The heart of patients with rheumatic heart disease; until the early 1970s, B-mode ultrasound imaging technology that can show changes in morphology and structure of organs and lesions has been used in clinical practice. page. In the mid-1980s, the color Doppler ultrasound diagnostic instrument came out. Because it can display the dual information of the morphological structure and hemodynamic changes of organs and lesions, it has advanced the level of ultrasound imaging diagnostic technology. Until the widespread application of computer digital technology in the 1990s, the successful research of medical ultrasound three-dimensional imaging technology has made ultrasound imaging diagnostic technology enter a higher level and a new development stage. In other words, from the end of the last century to the beginning of this century, the development of ultrasound imaging diagnostic technology is amazing, and it has made many major technical breakthroughs. Throughout the development process of ultrasound imaging diagnosis technology, it is a development process from "point" (type A ultrasound) → "line" (M type ultrasound) → "surface" (two-dimensional ultrasound) → "body" (three-dimensional ultrasound) ; Is a development process from one-dimensional array to two-dimensional array to three-dimensional array; is a development process from static imaging to real-time dynamic imaging; is a development process from single-parameter diagnostic technology to multi-parameter diagnostic technology; It is also a development process of molecular imaging from anatomical structure morphological image to anatomical structure functional image, metabolic image, enzyme and receptor and gene expression imaging fusion.
Application of Digital Technology in Ultrasound Image Diagnosis Equipment
The digitization of ultrasonic diagnostic equipment, from the beginning of the digital scan converter to the full digitization of today's ultrasonic transmission, reception, and imaging processes, digital technology has been widely used for high-performance ultrasonic imaging diagnostic equipment, such as the probe's new coded transmission and reception technology, digital sound beam Technology, digital delay technology, dynamic apodization technology, dynamic electronic focusing, dynamic aperture technology, etc. The development and application of digital technology has also promoted and driven the high-performance, intelligence and miniaturization of ultrasound imaging diagnostic equipment. The high-performance ultrasound imaging diagnosis device can not only meet the various needs of clinical disease diagnosis, but also can carry out in-depth relevant basic theory and clinical medical research, thereby further promoting the ultrasound imaging diagnosis technology from simple morphology to morphology and function and molecular The development of imaging. Intelligent can realize one-key operation, such as one-key multi-function, which can adjust many parameters such as TGC, receiving gain, dynamic range, speed scale, Doppler baseline, etc., thereby avoiding complicated and cumbersome adjustment operations during the inspection process . Under the premise of ensuring the required functions, the miniaturization of ultrasonic instruments, the structure of the device is simple, such as the size of a laptop computer, whether it is bedside examination or on-site rescue examination of outpatient or emergency department, it can reflect the important clinical status of ultrasound imaging diagnostic technology At the same time, it also broadens the scope of clinical application of ultrasound diagnostic technology. In addition, with the rise of the information superhighway and the wide application of communication and network technology, the ultrasound imaging diagnostic equipment of different manufacturers and different models are now equipped with DICOM3.0 standard interfaces. The DICOM3.0 standard not only covers the data dictionary, information interaction, network communication, media storage and file format, display printing, management and other aspects directly related to medical imaging, but also gradually covers the entire medical environment. Trends in capacity and data exchange. In other words, the ultrasound imaging diagnostic equipment or the ultrasound imaging workstation can be integrated into the hospital image management and communication system (PACS), or even into the entire hospital information system.
Development of probe technology of ultrasonic imaging diagnostic instrument
The probe is also called a transducer. It is one of the most important components in an ultrasound imaging diagnostic instrument. Its main function is to transmit ultrasound to the human body and then receive the ultrasound echo signal in the human body. A high-performance, high-quality probe is not only a prerequisite for obtaining high-quality images, but also a technical guarantee for various new ultrasound imaging methods. The structure of the probe is generally composed of three parts: the main body, the housing and the wire, wherein the Piezoelectric Material (wafer) is the core of the main body. From single-chip and multi-chip development to dozens, hundreds or even thousands of chips, at the same time, the number of probe array elements composed of several chips in parallel is constantly expanding. At present, the main development trends of probes are new materials, new processes, multi-array elements (high density), high frequencies, wide frequency bands and special applications. New materials: mainly including composite materials and organic thin-film materials; new technology: it is composed of piezoelectric ceramics and polymers according to a certain connection method, a certain volume ratio and a certain spatial geometric distribution, with high sensitivity and low resistance Resistance (favorable for matching with human tissue) and lower mechanical quality factors (favorable for widening of frequency band) and other advantages; high density: 1 dimension (256 array elements), 1.5 dimension (8 × 1 2 8 array elements), 2 dimensions (60 × 60 array elements); high frequency: 3MHz-7MHz frequency probe is used to diagnose abdominal and heart diseases, 10MHz-15MHz frequency probe is used for superficial organ inspection, 20MHz-40MHz frequency probe is used Ultrasound imaging of the eye and skin, and 100MHz-200MHz frequency probes are mainly used in ultrasound microscopes; Broadband: Broadband refers to the upper and lower limits of the operating frequency of the transducer. It can realize the transmission from shallow to deep when using a probe to inspect and Receive ultrasonic echo signals with different frequencies from high to low, and at the same time, it is also an important guarantee for realizing frequency-domain composite imaging, harmonic imaging and other new nonlinear imaging technologies; special: it is to make the probe into a special shape The dedicated esophagus, rectum, vagina, urethra, bladder, abdominal cavity, blood vessel lumen dedicated inspection probe.
Development of several new imaging techniques in ultrasound imaging diagnosis
1. Ultrasound three-dimensional imaging technology
Ultrasound three-dimensional imaging technology is a major breakthrough in the field of ultrasound diagnostic technology, and is a new technology emerging in clinical ultrasound. It can obtain image information in three-dimensional space, thereby making up for the deficiencies of two-dimensional planar imaging technology. The three-dimensional imaging technology can be divided into static three-dimensional imaging to observe inactive organs and dynamic three-dimensional imaging to observe the morphological structure of the heart and its activity and real-time three-dimensional imaging according to the imaging principle. Static three-dimensional imaging is the use of two-dimensional probes for rotary scanning or fan scanning. Several slice images are acquired within a certain time and fed into the computer for image reconstruction. The three-dimensional image of the organ is displayed. The reconstructed image is clear, the boundary is clear, and the surface The contour and depth of the three-dimensional sense are strong, and the shape of the organs and lesions is characteristic. It is mainly used for those who have liquid in the organ or surround the object with liquid, such as liver and kidney cysts and abscesses, biliary stones and polyps, hydronephrosis and Tumor, etc .; 3D image reconstruction of pancreas and duodenum can observe the three-dimensional anatomical structure of pancreatic head and surrounding tissues, which is helpful for the diagnosis of pancreatic head and common bile duct diseases; 3D reconstruction of blood vessels can realize a vascular tree without parenchymal tissue reflection This kind of image is helpful to understand the direction of blood vessels in the organs, the branching status, the presence or absence of deformity, thrombosis, etc .; it also has distinctive characteristics for sand table-like structural lesions such as ulcers, fetal facial deformities, and umbilical cord around the neck. In addition, three-dimensional ultrasound imaging can provide doctors with the spatial location and three-dimensional shape of tumor lesions in the body, thereby providing more accurate positioning information for ultrasound-guided interventional therapy, which helps to improve and further improve the clinical treatment effect.
With the development of high-speed scanning and sampling technology, the time parameter of ECG synchronization technology is added to the static three-dimensional imaging, and then the dynamic three-dimensional imaging (also called four-dimensional parameter) displayed in quasi-real-time mode can be realized; if the speed is added Information, you can achieve real-time three-dimensional imaging (also known as five-dimensional parameters). Dynamic three-dimensional imaging can display the origin, position, direction, front-rear, left-right relationship of large blood vessels, observe the presence of defects and determine the location and shape of the defects, provide complex and difficult diagnosis and differential diagnosis of congenital heart disease; can accurately display the three-dimensional shape of the heart, more Finely measure heart function, observe the location, range and degree of segmental dyskinesias on the wall of the chamber, provide diagnosis and treatment basis for coronary heart disease; can display the overall structure of the valve orifice, for the diagnosis of valve stenosis and incomplete closure, especially the mitral Valvular diseases such as valvular fissures and prolapses, tendon ruptures, etc. are of great significance; they can also display stereoscopic dynamic images of intracardiac blood flow, which is of great significance for the observation of blood flow direction, regurgitation and shunt. In short, dynamic three-dimensional imaging technology observes the three-dimensional shape, spatial relationship, activity and blood flow dynamics of various structures of the heart from different positions, thereby greatly improving the accuracy of clinical diagnosis.
2. Wide-field ultrasound imaging technology
Wide-field ultrasound imaging technology, also known as ultra-wide-field imaging, wide-field imaging or panoramic ultrasound imaging technology, is to obtain a series of two-dimensional slice images through the movement of the probe, and then use a computer reconstruction method to stitch this series of two-dimensional images into A cross-sectional image of a continuous ultra-wide field of view. The main feature of the wide-range ultrasound imaging technology is to provide better structural hierarchy and spatial relationship, clearly show the location, size, range, internal echo and its adjacent of the lesion, quantitatively and accurately measure the size or volume of the lesions or Tumors, which better display and extend the pipeline structure, have the main disadvantage that they will be disturbed by the movement of tissues or organs and cause blurred images. Broad-spectrum ultrasound imaging technology has been widely used in the diagnosis of musculoskeletal, peripheral vascular, and peripheral nerve diseases of the thorax and abdomen, gynecology and obstetrics, breast, thyroid, testis, and other small organs, as well as limb trunks. A wide-range ultrasound image can completely display the entire breast. The acquired image shape is the same as the natural shape of the breast. The anatomical level of the breast is clear, the lesion features are clear, the imaging contrast of different tissue structures is obvious, and the breast augmentation surgery filling material and the pectoralis major can be clearly displayed. , The relationship between breast glands. A wide-range ultrasound image can also obtain a complete picture of the entire fetus that cannot be obtained by conventional two-dimensional ultrasound, and even the complete structure including the placenta. And grading have important value. In particular, a large-scale rapid tomographic scan of the limb trunk and soft tissues using a high-frequency linear array probe can obtain a wide-range anatomical image of normal and diseased tomography from the skin, subcutaneous tissue, muscles, tendons, blood vessels, peripheral nerve trunks, and periosteum , And the structural features of each layer are clear at a glance. Wide-field ultrasound imaging technology has great development potential and good application prospects. It combines conventional real-time grayscale and color Doppler ultrasound to make modern ultrasound diagnostic technology more perfect, and at the same time, it also lays the foundation for the research and application of ultrasound CT Foundation.
3. Molecular imaging technology
Molecular imaging is based on modern imaging technology, based on molecular biology, from the molecular level to study and observe the occurrence of diseases, the development of pathophysiological changes and changes in metabolic function, that is to determine and describe the biological processes at the cellular and molecular level An imaging method. The term molecular imaging first appeared in the mid to late 1990s and was formally proposed and applied by the National Cancer Institute in 1998. Molecular imaging is different from traditional imaging methods. It reveals the abnormalities of cells and molecules that cause human diseases, rather than the abnormalities of the final anatomical structure caused by the changes of cells or molecules. Clinically, because many diseases have obvious changes in functions or cell molecules before pathological changes in organs and tissues, cell molecular imaging technology can not only detect and identify the disease earlier, but also treat the disease The effect is directly evaluated at the cellular and molecular levels, thereby establishing a brand new scientific understanding of the occurrence, development and cure of diseases. Ultrasound can be used for targeted diagnosis of cardiovascular, tumor, etc., the treatment of thrombosis, atherosclerotic plaque, etc., and the delivery of drugs and genes through molecular imaging of microbubble contrast agents in molecular imaging. Microbubbles and acoustically active substances can be used as targeted contrast agents for ultrasound imaging, carry targeting ligands, and can be combined with living cells for molecular imaging and therapy. Targeted micro / nano bubbles open a new frontier for molecular imaging . Molecular imaging is the result of multidisciplinary integration of molecular biology, biochemistry, nanotechnology, genetic engineering technology, data processing, and image processing. It is also the inevitable trend of the revolutionary development and future development of modern medical imaging technology.
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