Department of Physics, Loyola Marymount University, Los Angeles, CA 90045, USA.
Med Phys. 2012 Jun;39(6):3124-33. doi: 10.1118/1.4709598.
The purpose of this paper was to take the first steps toward applying noncontact ultrasound (NCU) to the tasks of monitoring osteoporosis and quantitative ultrasound imaging (QUS) of cortical bone. The authors also focused on the advantages of NCU, such as its lack of reliance on a technologist to apply transducers and a layer of acoustical coupling gel, the ability of the transducers to operate autonomously as specified by preprogrammed software, and the likely reduction in statistical and systematic errors associated with the variability in the pressure applied by the clinician to the transmitting transducer that NCU might provide. The authors also undertook this study in order to find additional applications of NCU beyond its past limited usage in assessing the severity of third degree burns.
A noncontact ultrasound imaging system using a pair of specially designed broadband, 1.5 MHz noncontact piezoelectric transducers and cortical bone phantoms, were used to determine bone mineral density (BMD), speed of sound (SOS), integrated response (IR), and ultrasonic transmittance. Air gaps of greater than 3 cm, two transmission and two reflection paths, and a digital signal processor were also used in the collection of data from phantoms of nominal mass densities that varied from 1.17 to 2.25 g/cm(3) and in bone mineral density from 0 to 1.7 g/cm(3).
Good correlations between known BMD and measured SOS, IR, and transmittance were obtained for all 17 phantoms, and methods for quantifying and minimizing sources of systematic errors were outlined. The BMD of the phantom sets extended through most of the in vivo range found in cortical bone. A total of 16-20 repeated measurements of the SOS, thickness, and IR for the phantom set that were conducted over a period of several months showed a small variation in the range of measurements of ±1%-2%. These NCU data were shown to be in agreement with similar results using contact ultrasound to be within 1%-2%. Transmittance images of cortical bone phantoms showed differences in the nominal overall BMD values of the phantoms that were large enough to be distinguished by a visual examination. A list of possible sources of errors in quantitative NCU was also included in this study.
The results of this paper suggest that NCU might find additional applications in medical imaging, beyond its original and only previous usage in assessing third degree burns. The fact that the authors' phantom measurements using conventional, gel coupled ultrasound are in agreement with those obtained with NCU demonstrates that in spite of large additional levels of attenuation of up to 150 dB and new error sources, NCU could have comparable levels of accuracy to those of conventional quantitative ultrasound, while providing the medical and patient comfort-related advantages of not involving direct contact.
本文旨在探索将非接触式超声(NCU)应用于监测骨质疏松症和皮质骨定量超声成像(QUS)的初步步骤。作者还关注了 NCU 的优势,例如它不需要依赖技术人员来应用换能器和一层声学耦合凝胶,换能器能够按照预编程软件的规定自主运行,以及 NCU 可能提供的与临床医生施加于发射换能器的压力变化相关的统计和系统误差的降低。作者还进行了这项研究,以寻找 NCU 在评估三度烧伤严重程度以外的其他应用。
使用一对特殊设计的宽带、1.5MHz 非接触式压电换能器和皮质骨仿体的非接触式超声成像系统,确定骨矿物质密度(BMD)、声速(SOS)、积分响应(IR)和超声透过率。在收集标称质量密度从 1.17 到 2.25g/cm3 和骨矿物质密度从 0 到 1.7g/cm3 的仿体数据时,使用大于 3cm 的气隙、两个发射和两个反射路径以及数字信号处理器。
对于所有 17 个仿体,均获得了已知 BMD 与测量的 SOS、IR 和透过率之间的良好相关性,并概述了量化和最小化系统误差源的方法。仿体组的 BMD 扩展到了皮质骨中发现的大部分体内范围。在几个月的时间内,对仿体组进行了 16-20 次重复测量 SOS、厚度和 IR,测量值的变化范围在±1%-2%之间。这些 NCU 数据与使用接触式超声获得的类似结果一致,误差在 1%-2%以内。皮质骨仿体的透过率图像显示了仿体的标称整体 BMD 值之间的差异,这些差异大到足以通过视觉检查来区分。本文还列出了定量 NCU 中可能存在的误差源。
本文的结果表明,NCU 可能会在医学成像领域找到额外的应用,而不仅仅是其最初的和唯一的以前在评估三度烧伤方面的应用。作者使用传统的、凝胶耦合超声进行的仿体测量与使用 NCU 获得的测量结果一致,这表明尽管存在高达 150dB 的大量额外衰减和新的误差源,NCU 仍可以达到与传统定量超声相当的准确度,同时提供不涉及直接接触的医疗和患者舒适相关的优势。