TWI834668B - Portable ultrasound system - Google Patents

Abstract

Exemplary embodiments provide systems and methods for portable medical ultrasound imaging. Preferred embodiments utilize a hand portable, battery powered system having a display and a user interface operative to control imaging and display operations. A keyboard control panel can be used alone or in combination with touchscreen controls to actuate a graphical user interface. Exemplary embodiments also provide an ultrasound engine circuit board including one or more multi-chip modules, and a portable medical ultrasound imaging system including an ultrasound engine circuit board.

Description

Mobile ultrasound system

Medical ultrasound imaging has become an industry standard for many medical imaging applications. In recent years, there has been an increasing need for medical ultrasound imaging equipment that is mobile and more user-friendly. The mobility allows medical personnel to easily transport the equipment between hospitals and/or field locations, and the user-friendly performance can be adapted to the needs of the user. Medical personnel with a certain level of skills.

Conventional medical ultrasound imaging equipment usually includes at least one ultrasound probe/transducer, a keyboard and/or a knob, a computer and a monitor. In a typical mode of operation, the ultrasound probe/transducer generates ultrasound waves that can penetrate tissue to different depths based on frequency levels and receives ultrasound waves reflected back from the tissue. In addition, medical personnel can enter system input into the computer via the keyboard and/or knobs and view ultrasound images of tissue structures on the monitor.

However, conventional medical ultrasound imaging equipment employing such keyboards and/or knobs can be bulky and therefore may not be portable for use in hospital and/or field locations. Additionally, since such keyboards and/or knobs often have uneven surfaces, they can be difficult to keep clean in hospital and/or field environments, where maintaining a sterile field can be critical to patient health. Some conventional medical ultrasound imaging equipment already utilize touch screen technology to provide a partial user input interface. However, conventional medical ultrasound imaging equipment employing these touch screen technologies often provide limited touch screen functionality combined with a traditional keyboard and/or knobs, and can therefore be difficult to keep clean and complex to use.

According to this application, systems and methods for medical ultrasound imaging are disclosed. Currently disclosed systems and methods of medical ultrasound imaging employ medical ultrasound imaging equipment that includes a handheld housing having the appearance size of a laptop computer or a tablet computer. The user interface may include a keyboard control panel or a multi-touch touch screen. The system may include a graphics processing unit within the system housing coupled to a central processor operative to perform ultrasound imaging operations. A preferred embodiment may employ a plurality of machine learning applications, including, for example, neural networks for processing ultrasound imaging data and quantitative data generated by the system. The touch screen interface is configured to enable selection of one or more machine learning applications from a touch-activated menu on the display. The system may utilize a shared memory within the tablet housing to access data and utilize software modules operating on one or more processors in the tablet housing to perform one of those described herein or multiple ultrasound imaging operations or data processing operations. This enables operation of third-party applications running on the tablet or mobile ultrasound device. Yet another embodiment may process image data from a second imaging modality, such as a camera or other medical imaging system, where the system processes the multi-modal image data to provide an overlay image of a region of interest, for example.

Yet another touch screen enabled operation can include harmonic imaging for different imaging applications. Quantitative methods can utilize graphics processors or core processors to apply quantitative analysis to ultrasound data containing harmonic components.

Touch screen embodiments can recognize and distinguish one or more single touches, multi-touch and/or simultaneous touches on a surface of the touch screen display, thereby allowing ranges from a simple single touch Gestures ranging from hand gestures to complex multi-point movement gestures are used as user input in medical ultrasound imaging equipment.

According to one aspect, an exemplary medical ultrasound imaging system includes: a housing having a front panel and a rear panel rigidly mounted to each other in parallel planes; a touch screen display; and a computer having At least one processor and at least one memory; an ultrasonic beamforming system; and a battery. The housing of the medical ultrasound imaging equipment is implemented in the appearance size of a tablet computer. The touch screen display is disposed on the front panel of the housing and includes a multi-touch LCD touch screen. The multi-touch LCD touch screen can identify and distinguish one of the touch screen displays. One or more single touch, multi-touch and/or simultaneous touches or gestures on the surface. The computer, the ultrasonic beamforming system or engine and the battery are operatively disposed within the housing. The medical ultrasound imaging equipment may use a live wire connection between the computer and the ultrasound engine operatively connected within the housing and have a probe attachment/detachment lever to facilitate at least one ultrasound probe/transducer One of the probe connections is the probe connector. Additionally, the exemplary medical ultrasound imaging system includes an I/O port connector and a DC power input.

In an exemplary operating mode, medical personnel may use simple single-point gestures and/or more complex multi-point gestures as user input to the multi-touch LCD touch screen for controlling the exemplary medical ultrasound Operating modes and/or functions of imaging equipment. These single-point gestures/multi-point gestures may correspond to single-point and/or multi-touch events mapped to one or more predetermined operations that may be performed by the computer and/or the ultrasound engine. Medical personnel can make these single-point gestures/multi-point gestures through various finger, palm and/or stylus movements on the surface of the touch screen display. The multi-touch LCD touch screen receives the single-point gestures/multi-point gestures as user inputs and provides the user inputs to the computer, which uses the processor to execute the operations stored in the memory. The program instructions are combined with the ultrasonic engine at least at certain times to perform the predetermined operations associated with the single-point gesture/multi-point gesture. The single-point gestures/multi-point gestures on the surface of the touch screen display may include, but are not limited to, a one-point gesture, a pinch gesture, a flick gesture, a rotation gesture, a double-point gesture, a A spread gesture, a drag gesture, a press gesture, a press and drag gesture, and a palm gesture. In contrast to existing ultrasound systems that rely on numerous control features operated by mechanical switches, keyboard elements, or trackball trackball interfaces, the preferred embodiment of the present invention utilizes a single on/off switch. All other operations have been performed using touch screen controls. Additionally, preferred embodiments employ a capacitive touch screen display that is sufficiently sensitive to detect touch gestures actuated by the user's bare fingers as well as the user's gloved fingers. Typically, medical personnel must wear sterile plastic gloves during medical procedures. Therefore, it is highly desirable to provide a removable ultrasound device that can be used by gloved hands; however, this has previously prevented the use of touch screen display control functionality in ultrasound systems for many applications requiring sterility precautions. Preferred embodiments of the present invention provide gloved human control of all ultrasound imaging operations on the touch screen display using programmed touch gestures.

According to an illustrative aspect, at least one flicking gesture may be employed to control the tissue penetration depth of ultrasound waves generated by the ultrasound probe/transducer. For example, a single flick gesture in the "up" direction on the touch screen display surface can increase the penetration depth by one (1) centimeter or any other suitable amount, and the touch screen display surface A single flick gesture in the "down" direction may reduce the penetration depth by one (1) centimeter or any other suitable amount. Additionally, a dragging gesture in the "up" or "down" direction on the touch screen display surface may increase or decrease the penetration depth by a multiple of one (1) centimeter or any other suitable amount . Additional operating modes and/or functional controls controlled by specific single-point gestures/multi-point gestures on the surface of the touch screen display may include but are not limited to freeze/save operations, 2D mode operations, gain control, color control, split screen control, PW imaging control, frame/time sequence image editing scroll control, zoom and pan control, full screen control, Doppler and 2D beam steering control and/or subject mark control. At least some of the operating modes and/or functions of the exemplary medical ultrasound imaging device may be controlled by one or more touch controls implemented on the touch screen display, which may be controlled by Move the touch gesture to reset the beamforming parameters. The medical personnel may provide one or more specific single-point gestures/multi-point gestures as user input for specifying viewing requirements and/or at least one selection of the touch controls implemented on the touch screen display as needed. Subgroup. When several or more virtual buttons or icons are utilized, a larger number of touch screen controls achieve greater functionality when operating in full screen mode.

According to another illustrative aspect, a press gesture may be employed within a region of the touch screen display, and in response to the press gesture, a virtual window may be provided on the touch screen display for display on the touch screen display. At least one enlarged portion of an ultrasound image displayed on the control screen display. According to yet another illustrative aspect, a press and drag gesture can be employed within the area of the touch screen display, and in response to the press and drag gesture, a predetermined feature of the ultrasound image can be traced. Additionally, a point gesture can be employed substantially simultaneously with a portion of the press and drag gesture within the area of the touch screen display, and in response to the point gesture, the predetermined characteristics of the ultrasound image can be accomplished The tracing. These operations can operate in different areas of a single display format, so that a movement gesture within an area of interest within the image can (for example) perform the same as if it were performed within the image but outside the area of interest. Gestures have different functions.

By providing medical ultrasound imaging equipment with a multi-touch touch screen, medical personnel can control the equipment using simple single-point gestures and/or complex multi-point gestures without the need for a traditional keyboard or knobs. . Since the multi-touch touch screen does not require a traditional keyboard or knob, the medical ultrasound imaging equipment is easier to keep clean in the hospital and/or field environment, provides an intuitive user-friendly interface, and provides complete Functional operation. Additionally, by providing the medical ultrasound imaging device in a tablet form factor, medical personnel can easily transport the device between hospitals and/or field locations.

Certain exemplary embodiments provide a multi-chip module for an ultrasound engine of a mobile medical ultrasound imaging system, including a transmit/receive (TR) chip, a preamplifier/time gain compensation (TGC) chip, and A beamformer die is assembled in a vertical stack configuration. The transmission circuit provides high voltage electrical drive pulses to the transducer elements to generate a transmission beam. A CMOS program using a 1 micron design rule has been used for the transmission chip and sub-micron design rules have been used for low voltage receiver circuits (less than 5V) when the transmission chip operates at voltages greater than 80V.

Preferred embodiments of the present invention utilize sub-micron processes to provide integrated circuits with sub-circuits operating at a plurality of voltages (eg, 2.5V, 5V, and 60V or higher). According to certain preferred embodiments of the present invention, these features may be used in conjunction with a dual planar transducer probe.

Therefore, a single IC chip can be utilized that incorporates high voltage transmission, low voltage amplifier/TGC, and low voltage beamforming circuitry in a single chip. Using a 0.25 micron design rule, this mixed-signal circuit can accommodate beamforming of 32 transducer channels in a die area of less than 0.7 × 0.7 (0.49) cm ² . Therefore, four 32-channel dies can be used to process 128 channels in ^a total circuit board area of less than 1.5 × 1.5 (2.25) cm.

As used herein, the term "multi-chip module" refers to an electronic package in which multiple integrated circuits (ICs) are packaged together with an integrated substrate to facilitate their use as a single component, that is, with As one of the higher processing capacity IC packages in a smaller volume. Each IC may include a circuit fabricated in a thinned semiconductor wafer. Exemplary embodiments also provide: an ultrasound engine including one or more such multi-chip modules; and a mobile medical ultrasound imaging system including an ultrasound having one or more multi-chip modules Engine circuit board. Exemplary embodiments also provide methods for fabricating and assembling multi-chip modules, as taught herein. Vertically stacking the TR chip, the preamplifier/TGC chip, and the beamformer chip on a circuit board minimizes package size (eg, length and width) and the footprint occupied by the chips on the circuit board.

The TR chip, the preamplifier/TGC chip, and the beamformer chip in a multi-chip module may each include multiple channels (eg, 8 channels/chip to 64 channels/chip). In some embodiments, the high voltage TR chip, the preamplifier/TGC chip, and the sample interpolation receive beamformer chip may each include 8, 16, 32, or 64 channels. In a preferred embodiment, each circuit in a two-layer beamformer module has 32 beamformer receive channels to provide a 64-channel receive beamformer. A second 64-channel two-layer module may be used to form a 128-channel handheld flat-panel ultrasound device with a total thickness of less than 2 cm. One can also use a transmit multi-chip beamformer with the same or similar channel density in each layer.

Exemplary numbers of chips vertically integrated in a multi-chip module may include, but are not limited to, two, three, four, five, six, seven, eight, etc. In one embodiment of an ultrasound device, a single multi-chip module is provided on a circuit board of an ultrasound engine that performs ultrasound specific operations. In other embodiments, a plurality of multi-chip modules are provided on a circuit board of an ultrasonic engine. The plurality of multi-chip modules can be vertically stacked on each other on the circuit board of the ultrasonic engine to further minimize the package size and the occupied area of the circuit board.

Providing one or more multi-chip modules on a circuit board of an ultrasonic engine enables a high channel count while minimizing total package size and footprint. For example, a 128-channel ultrasonic engine circuit board can be assembled using a multi-chip module within an exemplary planar size of approximately 10 cm x approximately 10 cm, which is superior to the larger space requirements of conventional ultrasonic circuits. A significant improvement. In some embodiments, a single circuit board containing one or more multi-chip modules may have 16 to 128 channels for an ultrasound engine. In some embodiments, a single circuit board containing one or more multi-chip modules for an ultrasound engine may have 16, 32, 64, 128, or 192 channels, etc.

Preferred embodiments of the flat-panel ultrasound system utilize a graphics processor configured to perform machine learning operations using acquired images to perform automated image processing and guidance of real-time imaging procedures. This machine learning operation can be performed on the main system processor and graphics processor, where automated computing techniques utilize an iterative process in which a selected metric converges to a stored reference level or level to define a set of images for diagnosis. or calculated value.

Cross-references to related applications This application claims the priority of U.S. Provisional Application No. 62/819,276 filed on March 15, 2019, and claims the priority of U.S. Provisional Application No. 62/830,200 filed on April 5, 2019, and Claiming priority over U.S. Provisional Application No. 62/673,020 filed on May 17, 2018. The entire contents of all the above applications are incorporated into this case for reference.

Systems and methods for medical ultrasound imaging are disclosed. The currently disclosed medical ultrasound imaging system and method adopt medical ultrasound imaging equipment. The medical ultrasound imaging equipment includes: a casing, which has the appearance size of a tablet computer; and a touch screen display, which is placed in the casing. one on the front panel. The touch screen display includes a multi-touch touch screen that can recognize and distinguish one or more single-touch, multi-touch touches on a surface of the touch screen display. Touch and/or simultaneous touch, thereby allowing gestures ranging from simple single-point gestures to complex multi-point gestures to be used as user input for medical ultrasound imaging equipment. U.S. Application No. 10/997,062 filed on November 11, 2004, U.S. Application No. 10/386,360 filed on March 11, 2003, and U.S. Patent No. 6,969,352 describe flat-panel ultrasound systems. and further details of operation, the entire contents of these patents and applications are incorporated herein for reference.

1A and 1B illustrate illustrative embodiments of exemplary medical ultrasound imaging equipment 10, 100 in accordance with the present application. As shown in Figure 1A, medical ultrasound imaging equipment 100 includes: a housing 102; a touch screen display 104; a computer having at least one processor and at least one memory implemented on a computer motherboard 106 ; An ultrasonic engine 108; and a battery 110. For example, the housing 102 may be implemented in the form of a tablet computer, or any other suitable form factor. The housing 102 has a front panel 101 and a rear panel 103 . The touch screen display 104 is disposed on the front panel 101 of the housing 102 and includes a multi-touch LCD touch screen that can recognize and distinguish one surface of the touch screen display 104 One or more multi-touch and/or simultaneous touches on 105. The computer motherboard 106, the ultrasonic engine 108 and the battery 110 are operationally placed in the housing 102. The medical ultrasound imaging equipment 100 further includes: a live wire connection 112 (see also Figure 2A) operatively connected between the computer motherboard 106 and the ultrasound engine 108 within the housing 102; and a probe connector 114. It has a probe attachment/detachment lever 115 that facilitates connection of at least one ultrasound probe/transducer (see also Figures 2A and 2B). In certain preferred embodiments, the transducer probe housing may contain circuit components including a transducer array, transmit and receive circuitry, and beamformer and beamformer control circuitry. In addition, the medical ultrasound imaging equipment 100 has one or more I/O port connectors 116 (see FIG. 2A ). The I/O port connectors 116 may include, but are not limited to, one or more USB connectors, one or more SD card, one or more network ports, one or more mini display ports, and a DC power input. Another embodiment shown in Figure 1B uses a battery-powered portable system weighing less than 15 pounds. The battery-powered portable system has a folding display 12 and a keyboard control panel 14 with a Keyboard 18 and a handle 16.

In an exemplary mode of operation, medical personnel (also referred to herein as "users" or "users") may enter as user input using simple single-point gestures and/or complex multi-point gestures. The multi-touch LCD touch screen of the screen display 104 is used to control one or more operating modes and/or functions of the medical ultrasound imaging equipment 100 . Such a gesture is defined herein as a movement, a tap, or a position of at least one finger, a stylus, and/or a palm on the surface 105 of the touch screen display 104. For example, such single-point gestures/multi-point gestures may include static gestures or dynamic gestures, continuous gestures or segmented gestures, and/or any other suitable gestures. A single-point gesture is defined herein as a gesture that can be performed using a finger, a stylus, or a palm on a single point of touch contact on the touch screen display 104 . A multi-point gesture is defined herein as a gesture that can be performed using multiple touch points of contact on the touch screen display 104 using multiple fingers or any suitable combination of at least one finger, a stylus, and a palm. A static gesture is defined herein as a gesture that does not involve the movement of at least one finger, a stylus, or a palm on the surface 105 of the touch screen display 104 . A dynamic gesture is defined herein as a gesture involving the movement of at least one finger, a stylus, or a palm, such as movement resulting from dragging one or more fingers across the surface 105 of the touch screen display 104 . A continuous gesture is defined herein as one that can be performed by a single movement or tap of at least one finger, a stylus, or a palm on the surface 105 of the touch screen display 104. A segmented gesture is defined herein as one that can be performed by multiple movements or taps of at least one finger, a stylus, or a palm on the surface 105 of the touch screen display 104 .

Such single/multi-point gestures performed on the surface 105 of the touch screen display 104 may correspond to single or multi-touch events, which are mapped to executable signals that may be executed by the computer and/or ultrasound engine 108 One or more scheduled operations. The user can form these single-point gestures/multi-point gestures through various movements of a single finger, multiple fingers, a stylus and/or a palm on the surface 105 of the touch screen display 104 . The multi-touch LCD touch screen receives single-point gestures/multi-point gestures as user input and provides the user input to a processor that executes in memory at least sometimes in conjunction with the ultrasonic engine 108 The stored program instructions are used to implement the predetermined operations associated with the single-point gestures/multi-point gestures. As shown in FIG. 3A , these single-point gestures/multi-point gestures on the surface 105 of the touch screen display 104 may include, but are not limited to: one-point swipe gesture 302 , a pinch gesture 304 , and a flick gesture 306 , 314 , a rotation gesture 308, 316, a pair of tap gestures 310, a spread gesture 312, a drag gesture 318, a press gesture 320, a press and drag gesture 322 and/or a palm gesture 324. For example, these single-point gestures/multi-point gestures may be stored in at least one gesture library in a memory implemented on the computer motherboard 106 . Computer programs for operational control of system operations may be stored on a computer-readable medium and optionally implemented using a touch processor connected to an image processor and a control processor connected to the system beamformer. Thus, beamformer delays associated with both transmission and reception can be adjusted in response to both static and moving touch gestures.

According to the illustrative embodiment of FIG. 1A , a user of medical ultrasound imaging apparatus 100 may employ at least one flick gesture 306 or 314 to control the tissue penetration depth of ultrasound waves generated by the ultrasound probe/transducer. For example, a dynamic, continuous flick gesture 306 or 314 in one of the "upward" directions or any other suitable direction on the surface 105 of the touch screen display 104 may increase the penetration depth by one (1) centimeter or any other Suitable amount. Additionally, a dynamic, continuous flick gesture 306 or 314 on the surface 105 of the touch screen display 104 in a "down" direction or any other suitable direction may reduce the penetration depth by one (1) centimeter or any other suitable direction. amount. Additionally, a dynamic, continuous drag gesture 318 on the surface 105 of the touch screen display 104 in one of the "up" or "down" directions, or any other suitable direction, can increase or decrease the penetration depth by a few centimeters or whatever. Other suitable amounts.

Additional operating modes and/or functions controlled by specific single-point gestures/multi-point gestures on the surface 105 of the touch screen display 104 may include, but are not limited to, freeze/save operations, 2D mode operations, gain control, color control, Split screen control, PW imaging control, frame/time sequence image editing scroll control, zoom and pan control, full screen display, Doppler and 2D beam steering control, and/or subject mark control. At least some of the operating modes and/or functions of medical ultrasound imaging equipment 100 may be controlled by implementing one or more touch controls on touch screen display 104 . Additionally, the user may provide one or more specific single-point gestures/multi-point gestures as user input to specify at least a selected subset of touch controls to be implemented on the touch screen display 104 as desired and/or as needed. .

Figure 3B shows a sequence of procedures for controlling ultrasound beamforming and imaging operations 340 in response to touch gesture input on a touch screen. Various static touch gestures and mobile touch gestures are programmed into the system such that the data processor is operable to control beamforming and image processing operations 342 within the tablet device. A user may select 344 a first display operation associated with a first plurality of touch gestures. Using a static or moving gesture, the user may perform one of the plurality of gestures operable to control imaging operations and may specifically select one of the plurality of gestures that may adjust the beamforming parameters 346 for Image data associated with the first display operation is generated. The displayed image is updated and displayed in response to the updated beamforming process. The user may further choose to perform a different gesture with a different speed characteristic (direction or velocity or both) to adjust 350 a second characteristic of the first ultrasound display operation. The displayed image is then updated 352 based on the second gesture, which may modify imaging processing parameters or beamforming parameters. Examples of this process are described in more detail herein, where changes in speed and direction of different gestures can be associated with different imaging parameters of a selected display operation.

Ultrasound images of blood flow movement or tissue movement, whether color blood flow Doppler or spectral Doppler, are essentially obtained from the measurement of movement. In an ultrasound scanner, a series of pulses are transmitted to detect blood movement. The echoes from stationary targets are identical between pulses. Echoes from moving scatterers exhibit subtle differences in the time it takes for the signal to travel back to the scanner.

As can be seen from Figure 3C to Figure 3H, there must be motion in the direction of the beam; if the blood flow is perpendicular to the beam, there is no relative motion between the pulse and the pulse reception, so the blood flow cannot be detected. These differences can be measured as a direct time difference or more commonly as a phase shift in terms of obtaining a "Doppler frequency". The differences are then processed to produce a color flow image or a Doppler spectrogram. In Figures 3C to 3D, the blood flow direction is perpendicular to the beam direction, and no blood flow is measured by Doppler of the pulse wave spectrum. In Figures 3G to 3H, when the ultrasound beam is steered to an angle that better aligns with the blood flow, weak blood flow is demonstrated in the color blood flow map and additionally measured by pulse wave Doppler Blood flow. In Figure 3H, the color blood flow map is clearer when the ultrasound beam is steered to an angle more aligned with the blood flow direction in response to a movement, and when the correction angle of the PWD is placed to align with the blood flow direction, PWD measured strong blood flow.

In this flat-panel ultrasound system, a ROI (Region of Interest) is also used to define the direction of the ultrasound transmission beam in response to a moving gesture. Since the ROI comes directly from the transducer, Figure 3I shows a liver image with a branch of renal blood flow in color blood flow mode. The blood flow direction is almost normal to the ultrasound beam, so extremely weak renal blood flow is detected. . Therefore, color flow mode is used to image blood flow in the liver or kidneys. As can be seen, the beam is almost normal to the blood flow and very weak blood flow is detected. Use a flick gesture with your finger outside the ROI to steer the beam. As can be seen in Figure 3J, by resetting the beamforming parameters to manipulate the ROI, the beam direction is more aligned with the blood flow direction, and stronger blood flow is detected in the ROI. In Figure 3J, a flicking gesture with a finger outside the ROI is used to steer the ultrasound beam in a direction more aligned with the direction of blood flow. Stronger blood flow can be seen within the ROI. A panning gesture made with the finger within the ROI will move the ROI block to a position covering the entire kidney area, that is, panning allows the ROI block to perform a translational movement so that the block covers the target area.

Figure 3K illustrates a pan gesture. By placing your finger within the ROI, you can move the ROI block to anywhere in the image plane. In the above embodiments, it is easy to distinguish the following two situations: a finger outside an "ROI" block making a "flick" gesture intended to control a beam; and a finger within the "ROI" In this case, make one of the "drag and move, pan" gestures to move the ROI box. However, in some applications, there is no ROI as a reference area, and it is easy to understand that it is difficult to distinguish a "flick" or a "pan" gesture. In this case, the touch screen program needs to track the finger. Initial velocity or acceleration to determine if it is a "flick" gesture or a "drag and move" gesture. Therefore, the touch engine that receives data from the touch screen sensor device is programmed to distinguish between speed thresholds indicating different gestures. Therefore, the time, rate, and direction associated with different movement gestures may have preset thresholds. Two- and three-finger static gestures and mobile gestures may have their own thresholds to distinguish these control operations. Note that preset display icons or virtual buttons can have different static pressure or duration thresholds. When operating in full screen mode, static icons are turned off by the touch screen processor, which preferably operates on the system's central processing unit that performs other imaging operations, such as scan conversion.

4A-4C illustrate exemplary subsets 402, 404, 406 of touch controls that a user of medical ultrasound imaging apparatus 100 can implement on touch screen display 104. Note that any other suitable subset of touch controls may be implemented on touch screen display 104 as desired and/or as needed. As shown in Figure 4A, subgroup 402 includes a touch control 408 for performing two-dimensional (2D) mode operations, a touch control 410 for performing gain control operations, a touch control for performing color control operations. A touch control 412 and a touch control 414 for performing imaging/editing, freezing/storing operations. For example, a user may use press gesture 320 to actuate touch control 408 to return medical ultrasound imaging equipment 100 to 2D mode. Additionally, the user can use a press gesture 320 on one side of the touch control 410 to decrease a gain level, and use a press gesture 320 on the other side of the touch control 410 to increase the gain level. Additionally, the user can use a drag gesture 318 on the touch control 412 to use a predetermined color code to identify density ranges on a 2D image. In addition, the user can use the press gesture 320 to activate the touch control 414 to freeze/save a still image or obtain a frame image clip.

As shown in Figure 4B, subgroup 404 includes a touch control 416 for performing split screen control operations, a touch control 418 for performing PW imaging control operations, a touch control 418 for performing Doppler and 2D beam steering A touch control 420 is used to control the operation and a touch control 422 is used to perform the annotation operation. For example, a user may employ a press gesture 320 with the touch control 416, allowing the user to alternately employ a tap gesture 302 on opposite sides of the split touch screen display 104 by alternately employing a tap gesture 302 on each side of the split screen. Upper two-state switching. Additionally, the user can use press gesture 320 to actuate touch control 418 and enter PW mode, which allows (1) the user to control angle correction, (2) move (e.g., " up" or "down") that may be displayed on the touch screen display 104, and/or (3) increase by using a tapping gesture 302 on a ruler bar that may be displayed on the touch screen display 104. Increase or decrease the size. Additionally, the user may employ a press gesture 320 on one side of the touch control 420 to perform 2D beam steering "left" or in any other suitable direction in increments of five (5) or any other suitable increment, and A press gesture 320 is employed on the other side of the touch control 420 to perform 2D beam steering "right" or in any other suitable direction in increments of five (5) or any other suitable increment. Additionally, the user may employ a tapping gesture 302 with the touch control 422, allowing the user to enter annotation information via a pop-up keyboard that may be displayed on the touch screen display 104.

As shown in Figure 4C, subgroup 406 includes a touch control 424 for performing dynamic range operations, a touch control 426 for performing Teravision™ software operations, a touch control 428 for performing mapping operations, and One touch control 430 for performing needle guidance operations. For example, a user may use press gesture 320 and/or press and drag gesture 322 with touch control 424 to control or set dynamic range. In addition, the user can use a tapping gesture 302 on the touch control 426 to select a desired level of the Teravision™ software to be executed from the memory by the processor on the computer motherboard 106 . Additionally, the user can use a tapping gesture 302 on the touch control 428 to perform a desired mapping operation. Additionally, the user can use press gesture 320 on touch control 430 to perform a desired needle guidance operation.

According to the present application, single-point gestures/multi-point gestures on the surface 105 of the touch screen display 104 can be performed on objects (such as organs, tissues, etc.) as ultrasound images displayed on the medical ultrasound imaging equipment 100 (see Figure 1 ) various measurements and/or tracings on the touch screen display 104. The user can directly create an original ultrasound image based on the displayed object in a virtual window 506 (see FIG. 5C and FIG. 5D ) on the touch screen display 104 , an enlarged version of the ultrasound image based on the displayed object, and/or Or perform such measurements and/or mapping of the object based on an enlarged portion of the ultrasound image.

5A and 5B illustrate a raw ultrasound image of an exemplary object (i.e., a liver 502 having a cystic lesion 504) displayed on a touch screen display 104 of a medical ultrasound imaging device 100 (see FIG. 1 ). Note that the medical ultrasound imaging device 100 may generate such an ultrasound image in response to ultrasound waves penetrating liver tissue generated by an ultrasound probe/transducer operatively connected to the device 100. Measurements and/or delineation of the liver 502 having a cystic lesion 504 may be performed directly based on the raw ultrasound image displayed on the touch screen display 104 (see FIGS. 5A and 5B ) or based on an expanded version of the ultrasound image. For example, the user may obtain such an enlarged version of the ultrasound image by using an expand gesture (e.g., see expand gesture 312 of FIG. 3 ) by placing two (2) fingers on the surface 105 of the touch screen display 104 and expanding them to enlarge the original ultrasound image. Such measurements and/or tracing may also be performed on the liver 502 and the cystic lesion 504 based on an enlarged portion of the ultrasound image in a virtual window 506 (see FIGS. 5C and 5D ) on the touch screen display 104.

For example, using their finger (eg, see finger 508 in FIGS. 5A-5D ), the user can touch the touch screen display 104 by touching the touch screen display 104 near an area of interest, such as the area corresponding to the cystic lesion 504 . The virtual window 506 is obtained using a press gesture (eg, see press gesture 320 of FIG. 3 ) on the surface 105 (see FIG. 5B ). In response to the pressing gesture, a virtual window 506 that may at least partially overlap the original ultrasound image is displayed on the touch screen display 104 (see FIGS. 5C and 5D ), thereby providing the user with information about the cystic lesions of the liver 502 A view of one of the expanded sections near 504. For example, virtual window 506 of FIG. 5C may provide a view of an enlarged portion of an ultrasound image of cystic lesion 504 covered by finger 508 pressing on surface 105 of touch screen display 104 . To reposition the enlarging cystic lesion 504 within the virtual window 506, the user may use a press and drag gesture (e.g., see Press and Drag in FIG. 3) on the surface 105 of the touch screen display 104 (see FIG. 5D). Gesture 322), thereby moving the image of the cystic lesion 504 to a desired position within the virtual window 506. In one embodiment, the medical ultrasound imaging device 100 may be configured to allow the user to select a magnification level within the virtual window 506 to be 2 times larger, 4 times larger, or any other suitable multiple of the original ultrasound image. . The user may remove virtual window 506 from touch screen display 104 by lifting a finger from surface 105 of touch screen display 104 (eg, see finger 508 in FIGS. 5A-5D ).

FIG. 6A illustrates an ultrasound image of another exemplary object, namely, an apical four (4) chamber view of a heart 602 , displayed on a touch panel of the medical ultrasound imaging device 100 (see FIG. 1 ). on screen display 104. Note that the medical ultrasound imaging device 100 may generate this ultrasound image in response to ultrasound generated by an ultrasound probe/transducer operatively connected to the device 100 penetrating cardiac tissue. Measurements and/or mapping of the heart 602 may be performed directly based on the original ultrasound image displayed on the touch screen display 104 (see FIGS. 6A-6E) or based on an enlarged version of the ultrasound image. For example, using their fingers (eg, see fingers 610, 612 of Figures 6B-6E), the user can move the heart 602 by using one or more multi-finger gestures on the surface 105 of the touch screen display 104. A manual tracing is performed on an endocardial border 604 (see Figure 6B) of a left ventricle 606 (see Figures 6B-6E). In one embodiment, using their fingers (eg, see fingers 610, 612 of FIGS. 6B-6E), the user can perform a dual-click gesture on the surface 105 of the touch screen display 104 (eg, see Double-tap gesture 310 of Figure 3A) to obtain a cursor 607 (see Figure 6B), and a drag gesture (e.g., see drag gesture 318 of Figure 3A) can be employed by using one finger (such as finger 610) ) to move the cursor 607, thereby moving the cursor 607 to a desired position on the touch screen display 104. The systems and methods described herein may be used to quantitatively measure cardiac wall motion and, in particular, ventricular dyssynchrony, as described in U.S. Application No. 10/817,316, filed April 2, 2004. was elaborated in detail, and the entire content of the U.S. application is incorporated into this case for reference.

Once the cursor 607 is at the desired location as determined by the position of finger 610 on the touch screen display 104, the user can use another finger, such as finger 612, to employ a point gesture (eg, see the point gesture of FIG. 3 Potential 302) to fix the cursor 607 at that position. To perform a manual tracing of the endocardial margin 604 (see FIG. 6B ), the user can use a finger 610 to perform a press and drag gesture (e.g., see press and drag gesture 322 of FIG. 3 ), as shown in FIG. 6C and FIG. Illustrated in 6D. This manual tracing of the endocardial border 604 may be highlighted on the touch screen display 104 in any suitable manner, such as by a dashed line 608 (see Figures 6C-6E). Manual tracing of the endocardial margin 604 may continue until the finger 610 reaches any suitable position on the touch screen display 104, or until the finger 610 returns to the position of the cursor 607, as illustrated in Figure 6E. Once finger 610 is at the position of cursor 607 or at any other suitable position, the user can complete the manual tracing operation by using finger 612 using a one-click gesture (see, for example, point gesture 302 in FIG. 3 ). Note that this manual tracing operation can be used to trace any other suitable features and/or waveforms, such as a pulse wave Doppler (PWD) waveform. In one embodiment, the medical ultrasound imaging apparatus 100 may be configured to perform any feature(s) related to the feature(s) and/or waveform(s) based at least in part on manual tracing of the respective feature(s)/waveform(s). Suitable for calculation and/or measurement.

As explained above, a user may perform measurements and/or traces of an object based on an enlarged portion of an original ultrasound image of an object displayed within a virtual window on the touch screen display 104 . 7A-7C illustrate raw ultrasound images of an exemplary object, namely, liver 702 with a cystic lesion 704, as displayed on medical ultrasound imaging equipment 100 (see FIG. 1) on the touch screen display 104. 7A-7C further illustrate a virtual window 706 that provides a view of an enlarged portion of an ultrasound image of a cystic lesion 704 that is pressed against the surface 105 of the touch screen display 104 covered by the user's finger (such as finger 710). The user may perform one or more multi-finger gestures on the surface 105 of the touch screen display 104 using their fingers (eg, see fingers 710, 712 of FIGS. 7A-7C) to perform actions on the cystic lesion 704 within the virtual window 706. A big measurement.

For example, the user may use his or her fingers (eg, see fingers 710, 712 in FIGS. 7A-7C) to perform a one-point gesture (eg, see the two-point gesture 310 in FIG. 3) on the surface 105 to obtain a first Cursor 707 (see FIG. 7B, FIG. 7C), and a finger (such as finger 710) can be used to move the first cursor 707 using a drag gesture (eg, see drag gesture 318 of FIG. 3), thereby moving the first cursor 707. The first cursor 707 moves to a desired position. Once the first cursor 707 is at the desired location determined by the position of finger 710, the user may use another finger, such as finger 712, to move the cursor using a one-click gesture (eg, see point gesture 302 of FIG. 3). The first cursor 707 is fixed at that position. Similarly, the user can use a double-tap gesture on surface 105 (eg, see double-tap gesture 310 of Figure 3) to obtain a second cursor 709 (see Figure 7C), and can use finger 710 to use a drag A gesture (eg, see drag gesture 318 in FIG. 3 ) is used to move the second cursor 709 , thereby moving the second cursor 709 to a desired position. Once the second cursor 709 is at the desired position determined by the position of the finger 710, the user can use the finger 712 to employ a one-click gesture (eg, see click gesture 302, see Figure 3) to secure the second cursor 709 to That's where it is. In one embodiment, medical ultrasound imaging equipment 100 may be configured to perform any suitable size calculations and/or quantities associated with cystic lesion 704 based at least in part on the positions of first cursor 707 and second cursor 709 Test.

8A-8C illustrate raw ultrasound images of an exemplary object, namely, a liver 802 having a cystic lesion 804, as displayed on the medical ultrasound imaging device 100 (see FIG. 1 ) on the touch screen display 104. 8A-8C further illustrate a virtual window 806 that provides a view of an enlarged portion of an ultrasound image of a cystic lesion 804 that is pressed against the surface 105 of the touch screen display 104 The user's finger (such as one finger 810) covers. The user may perform one or more multi-finger gestures on the surface 105 of the touch screen display 104 using fingers (eg, see fingers 810, 812 of FIGS. 8A-8C) to perform a procedure on the cystic lesion 804 within the virtual window 806. Diameter measurement.

For example, the user may use fingers (eg, see fingers 810, 812 in FIGS. 8A to 8C) to perform a double-click gesture (eg, see double-click gesture 310 in FIG. 3) on the surface 105 to obtain a first A cursor 807 (see FIGS. 8B and 8C ), and a finger (such as finger 810 ) can be used to move the cursor 807 using a drag gesture (eg, see drag gesture 318 of FIG. 3 ), thereby moving the cursor 807 Move to a desired location. Once the cursor 807 is at the desired position determined by the position of finger 810, the user may use another finger, such as finger 812, to move the cursor using a one-click gesture (eg, see point gesture 302 of FIG. 3). 807 is fixed in that position. Then, the user can use a press and drag gesture (for example, see the press and drag gesture 322 of Figure 3) to obtain a connection line 811 (see Figures 8B and 8C), and connect the connection line 811 from the first cursor 807 Extend across the cystic lesion 804 to a desired location on the other side of the cystic lesion 804 . Once the connecting line 811 has been extended across the cystic lesion 804 to a desired location on the other side of the cystic lesion 804, the user can use a finger 812 to perform a one-click gesture (eg, see point gesture 302; see Figure 3). A second cursor 809 (see Figure 8C) is obtained and fixed at the desired position. In one embodiment, medical ultrasound imaging equipment 100 may be configured to perform any operation related to cystic lesion 804 based at least in part on connecting line 811 extending between the locations of first cursor 807 and second cursor 809 . Suitable for diameter calculation and/or measurement.

Figure 9A shows a system 140 in which a transducer housing 150 having an array of transducer elements 152 can be attached to the housing 102 at a connector 114. Each probe 150 may have one probe identification circuit 154 that specifically identifies the attached probe. When the user inserts a different probe with a different array, the system identifies the probe operating parameters. Note that preferred embodiments may include a display 104 having a touch sensor 107. The touch sensor 107 may be connected to a touch processor 109. The touch processor 109 analyzes touches from the sensor 107. Control screen data and transmit commands to image processing operations and a beamformer control processor (1116, 1124). In a preferred embodiment, the touch processor may include a computer-readable medium storing instructions that operate an ultrasonic touch screen engine operable to control the processes described herein. display and imaging operations.

Figure 9B shows a software flow diagram 900 of a typical transducer management module 902 within an ultrasound application. When a TRANSDUCER ATTACH 904 event is detected, the transducer management software module 902 first reads the transducer type ID 906 and hardware modification information from the IDENTIFICATION section. The information is used to retrieve a specific set of transducer profile data from the hard disk and load it into the application's memory, 908. The software then reads the adjustment data from the FACTORY segment, 910, and applies the adjustment to the profile data just loaded into memory, 912. The software module then sends a TRANSDUCER ATTACH message to the host ultrasound application, 914, which uses the loaded transducer profile. After getting the response 916, an ultrasound imaging sequence is performed and the USAGE segment is updated, 918. The transducer management software module then waits for a TRANSDUCER DETACH event or for the elapse of 5 minutes, 920. If a TRANSDUCER DETACH event is detected 921, a message 924 is sent and a response 926 is made, the transducer profile data set is removed 928 from memory, and the module returns to wait for another TRANSDUCER ATTACH event. If the 5-minute period expires without detecting a TRANSDUCER DETACH event, the software module increments the cumulative usage counter in USAGE segment 922 and waits for another 5-minute period or a TRANSDUCER DETACH event. The accumulated usage is recorded in the memory as a maintenance and replacement record.

There are many types of ultrasonic transducers. These ultrasonic transducers differ in geometry, number of components and frequency response. For example, a linear array with a center frequency of 10 to 15 MHz is better for breast imaging, and a curved array with a center frequency of 3 to 5 MHz is better for abdominal imaging.

Often different types of transducers must be used for the same or different stages of ultrasound scanning. For ultrasound systems with only one transducer connection, the operator will change the transducer before starting a new scan session.

In some applications, it is also necessary to switch between different types of transducers during an ultrasound scan session. In this case, it is more convenient to connect multiple transducers to the same ultrasound system, and the operator can quickly switch between these connected transducers by pressing a button on the operator console. Switch without having to spend a long time physically detaching and reattaching the transducer. Preferred embodiments of the present invention may include a multiplexer within the tablet case that can select between a plurality of probe connector ports within the tablet case, or alternatively, the tablet The computer case can be connected to an external multiplexer, which can be mounted on a truck as described herein.

Figure 9C is a perspective view of an exemplary needle sensing positioning system using an ultrasonic transducer without any active electronics in the sensor assembly. The sensor transducer may include a passive ultrasonic transducer element. These elements can be used in a similar manner to a typical transducer probe, using ultrasonic engine electronics. System 958 includes additional ultrasonic transducer elements 960 added to a needle guide 962 as shown in Figure 9C, but may have any suitable external dimensions. A needle guide mounting bracket 966 may be used to mount the ultrasound transducer element 960 and needle guide 962 to an ultrasound transducer probe sonic handle or an ultrasound imaging probe assembly having a transducer array 968 into 970. A disk (ultrasonic reflector disk 964) of needles is mounted on the exposed end to reflect ultrasonic waves.

An ultrasound transducer element 960 located on the needle guide 962 can be connected to the ultrasound engine. Connection is made via a separate cable to a dedicated probe connector on the engine, which is similar to a common pencil CW probe connector. In an alternative embodiment, a short cable can be plugged into the larger image transducer probe handle, or a split cable can be connected to the same probe connector at the engine. In another alternative embodiment, the connection may be made via an electrical connector between the imaging probe handle and the needle guide rather than a cable therebetween. In an alternative embodiment, the ultrasound transducer element on the needle guide can be connected to the ultrasound engine by enclosing the needle guide and transducer element in the same mechanical housing of the imaging probe handle.

Figure 9D is a perspective view of the needle guide 962 positioned with the transducer element 960 and the ultrasonic reflector disk 964. The reflector disk 964 is positioned to transmit ultrasound waves 972 from the transducer element 960 on the needle guide 962. Ultrasonic waves 972 travel through the air toward and are reflected by reflector disk 964 . The reflected ultrasound 974 reaches the transducer element 960 on the needle guide 962. The distance 976 between the reflector disk 964 and the transducer element 960 is calculated based on the elapsed time and the speed of sound waves in the air.

9E is a perspective view of an alternative embodiment of an exemplary needle sensing positioning system using an ultrasonic transducer, where no active electronics are required in the sensor assembly. The sensor transducer may include a passive ultrasonic transducer element. These elements can be used in a similar manner to a typical transducer probe, using ultrasonic engine electronics.

System 986 includes a needle guide 962 mountable to a needle guide mounting bracket 966 that can be coupled to an ultrasound imaging probe assembly 982 for imaging the patient's body, or instead Fits the exterior dimensions. Ultrasonic reflector disk 964 may be mounted at the exposed end of needle 956. In this embodiment, a linear ultrasonic acoustic array 978 is mounted parallel to the direction of movement of needle 956. Linear ultrasonic acoustic array 978 includes an array of ultrasonic transducers 980 positioned parallel to needle 956 . In this embodiment, an ultrasound imaging probe assembly 982 is positioned to image the patient's body. An ultrasonic imaging probe assembly 982 for imaging a patient's body is configured with an ultrasonic transducer array 984.

In this embodiment, the position of the ultrasonic reflector disk 964 may be detected using an ultrasonic transducer array 980 coupled to an ultrasonic imaging probe assembly 978 for imaging. The reflector disk 964 is positioned to transmit ultrasound waves 972 from the transducer element 980 on the ultrasound imaging probe assembly 978 for imaging. Ultrasonic waves 972 travel through the air toward and are reflected by reflector disk 964 . The reflected ultrasound 974 reaches the transducer element 980 on the ultrasound imaging probe assembly 978 for imaging. The distance 976 between the reflector disk 964 and the transducer element 980 is calculated based on the elapsed time and the speed of sound waves in the air. In an alternative embodiment, an alternative algorithm may be used to sequentially scan the polarity of elements in the transducer array and analyze the reflected waves generated by each transducer array element. In an alternative embodiment, a plurality of scans may occur before an ultrasound image is formed.

Figure 9F illustrates a system that can use a SIM card 120 to provide wireless 36/46 cellular service to communicate with a mobile ultrasound system as described herein, including those of Figures 1A and 1B Illustrated system. Card 120 may be inserted into a housing port 119 that communicates with system processor 106 using circuitry 118 .

Figure 10A illustrates an exemplary method for monitoring synchrony of a heart, according to an exemplary embodiment. Through this method, a reference template is loaded into the memory and used to guide a user to identify an imaging plane (according to step 930). Next, a user identifies a desired imaging plane (per step 932). Typically, an apical four-chamber view of the heart is used; however, other views may be used without departing from the spirit of the invention.

Sometimes, it may be difficult to identify the endocardial rim, and when such difficulties are encountered, tissue Doppler imaging of the same view may be used (per step 934). A reference template for identifying the medial partition wall and the outer free wall is provided (per step 936). Next, standard tissue Doppler imaging (TDI) with a preset velocity scale (ie, ±30 cm/sec) may be used (per step 938).

Then, a reference to one of the desired three-dimensional images may be provided (per step 940). B-mode or TDI may be used to guide the range gate (per step 942). B-mode may be used to direct the range gate (per step 944) or TDI may be used to direct the range gate (per step 946). Using TDI or B mode to guide the range gate also allows the use of a directional correction angle to allow the spectral Doppler display of the radial average velocity of the partition. Then, using the duplex mode or the triplex mode, a first pulse wave spectrum Doppler is used to measure the average velocity of the mid-barrel (according to step 948). Software used to process the data and calculate asynchrony can use a location (eg, a center point) to automatically set an angle between past locations on the heart wall to help simplify parameter setting.

A dual image or a TDI (per step 950) is also used to guide a second range gate position, and a directional correction angle is optionally used. After step 950, the system tracks the average velocity of the middle bulkhead and the outer free wall. The time integration 952 of the spectral Doppler mean velocity at the region of interest (eg, the septum and the left ventricular free wall) then provides the respective displacements of the septum and left free wall.

The above method steps may be used in combination with one of the high-pass filtering methods known in the related art (analog high-pass filtering method or digital high-pass filtering method) to remove any baseline disturbance present in the collected signal. In addition, the disclosed method uses multiple simultaneous PW spectral Doppler to track the movement of the interventricular septum and left ventricular free wall. Additionally, a multi-gate structure can be employed along each spectral line, thus allowing quantitative measurement of local wall motion. Averaging multiple gates allows full range wall motion to be measured.

FIG. 10B is a detailed schematic block diagram 1000 of an exemplary embodiment of an integrated ultrasound probe 1040 that can be connected to any PC 1010 through an interface unit 1020 . Ultrasound probe 1040 is configured to transmit ultrasound waves to one or more imaging targets 1064 and reduce ultrasound waves reflected from one or more imaging targets 1064 . One or more cables 1066, 1068 may be used to couple the transducer 1040 to the interface unit 1020. The interface unit 1020 may be positioned between the integrated ultrasound probe 1040 and the host computer 1010 . Two-stage beamforming systems 1040 and 1020 can be connected to any PC via a USB connection 1022, 1012.

The ultrasonic probe 1040 may include a sub-array/aperture 1052 consisting of adjacent elements with a smaller pore than the entire array. The ID transducer array 1062 receives the returned echoes and transmits them to the controller 1044 . The controller initiates formation of a coarse beam by transmitting signals to memory 1058, 1046. The memory 1058, 1046 transmits a signal to a transmission driver 1 1050 and a transmission driver m 1054. Then, transmit driver 1 1050 and transmit driver m 1054 send signals to multiplexer 1 1048 and multiplexer m 1056 respectively. The signal is transmitted to subarray beamformer 1 1052 and subarray beamformer n 1060.

The output of each coarse beamforming operation may be further processed through a second-stage beamforming in the interface unit 1020 to convert the beamforming output into a digital representation. Coarse beamforming operations can be coherently summed to form one of the narrow beam outputs of the array. Signals can be transmitted from sub-array beamformer 1 1052 and sub-array beamformer n 1060 of ultrasound probe 1040 to A/D converters 1030 and 1028 in interface unit 1020. Within the interface unit 1020 are A/D converters 1028, 1030 for converting the first stage beamforming output into a digital representation. A client ASIC (such as an FPGA 1026) can receive the digital conversions from the A/D converters 1030, 1028 to complete the second stage beamforming. FPGA digital beamforming 1026 can transmit information to system controller 1024. The system controller can transmit information to a memory 1032, and the memory 1032 can send a signal back to the FPGA digital beamforming 1026. Alternatively, system controller 1024 can transmit information to custom USB3 chipset 1022. The USB3 chipset 1022 can then transmit the information to a DC-DC converter 1034. In turn, the DC-DC converter 1034 can transmit power from the interface unit 1020 to the ultrasound probe 1040 . Within the ultrasonic probe 1040, a power supply 1042 can receive the power signal and interface with the transmission driver 1 1050 to provide power to the front-end integrated probe.

The interface unit 1020 customization or the USB3 chipset 1022 may be used to provide a communication link between the interface unit 1020 and the host computer 1010 . The custom or USB3 chipset 1022 transmits a signal to the custom or USB3 chipset 1012 of the host computer 1010 . The custom or USB3 chipset 1012 then interfaces with the microprocessor 1014. Microprocessor 1014 can then display the information or send the information to a device 1075.

In an alternative embodiment, a narrowband beamformer may be used. For example, one analog phase shifter is applied to each of the received echoes. The phase-shifted outputs within each sub-array are then summed to form a coarse beam. Each of the coarse beams can be digitized using A/D conversion; then, a digital beamformer can be used to form the narrow beams.

In another embodiment, forming a 64-element linear array may use 8 adjacent elements to form a coarse beam output. This configuration utilizes 8 output analog cables connecting the outputs of the integrated probes to the interface unit. The coarse beam can be sent via cable to the corresponding A/D converter located in the interface unit. Use digital delay to form a narrow beam output. Eight A/D converters may be required to form a digital representation.

In another embodiment, 16 sub-array beamforming circuits may be used to form a 128-element array. Each circuit may form a coarse beam from an adjacent eight-element array disposed in the first stage output to the interface unit. This configuration can utilize 16 output analog cables that connect the output of the integrated probe to the interface unit to digitize the output. A PC microprocessor or a DSP can be used to perform down-conversion, basebanding, scan conversion and post-image processing functions. A microprocessor or DSP can also be used to perform all Doppler processing functions.

10C is a detailed schematic block diagram 1080 of an exemplary embodiment of an integrated ultrasound probe 1040 with a first sub-array beamforming circuit and a second-level beamforming circuit integrated within the host computer 1082. With the second-stage beamforming circuit, the back-end computer can be a PDA, tablet computer or mobile device case. Ultrasound probe 1040 is configured to transmit ultrasound waves to one or more imaging targets 1064 and reduce ultrasound waves reflected from the one or more imaging targets 1064 . The transducer 1040 is coupled to the host computer 1082 using one or more cables 1066, 1068. Note that the A/D circuit components can also be placed in the transducer probe housing.

The ultrasonic probe 1040 includes a subarray/aperture 1052 consisting of adjacent elements whose pores are smaller than those of the entire array. The ID transducer array 1062 receives the returned echoes and transmits them to the controller 1044 . The controller initially forms a coarse beam by transmitting the signal to memory 1058, 1046. The memory 1058, 1046 transmits a signal to a transmission driver 1 1050 and a transmission driver m 1054. Then, transmit driver 1 1050 and transmit driver m 1054 send signals to multiplexer 1 1048 and multiplexer m 1056 respectively. The signal is transmitted to subarray beamformer 1 1052 and subarray beamformer n 1060.

The output of each coarse beamforming operation then undergoes a second stage of beamforming in interface unit 1020 to convert the beamformed output into a digital representation. The coarse beamforming operations are correlated and summed to form one of the narrow beam outputs of the array. The signals are transmitted from the ultrasonic probe 1040 sub-array beamformer 1 1052 and sub-array beamformer n 1060 to the A/D converters 1030 and 1028 in the host computer 1082. Within the host computer 1082 are A/D converters 1028, 1030 for converting the first stage beamforming output into a digital representation. A client ASIC (such as an FPGA 1026) receives the digital conversions from the A/D converters 1030, 1028 to complete the second stage beamforming. FPGA digital beamforming 1026 transmits information to system controller 1024. The system controller transmits the information to a memory 1032, which sends a signal back to the FPGA digital beamforming 1026. Alternatively, system controller 1024 can transmit information to custom USB3 chipset 1022. The USB3 chipset 1022 can then transmit the information to a DC-DC converter 1034. In turn, the DC-DC converter 1034 can transmit power from the interface unit 1020 to the ultrasound probe 1040 . Within the ultrasound probe 1040, a power supply 1042 can receive the power signal and interface with the transmission driver 1 1050 to provide power to the front-end integrated probe. The power supply may include a battery to enable wireless operation of the transducer assembly. A wireless transceiver can be integrated into the controller circuit or into a separate communications circuit to enable wireless transmission of image data and control signals.

The custom or USB3 chipset 1022 of the host computer 1082 may be used to provide a communication link between the custom or USB3 chipset 1012 to transmit a signal to the microprocessor 1014 . Microprocessor 1014 can then display the information or send the information to a device 1075.

FIG. 11 is an exemplary embodiment of the ultrasound engine 108 (ie, front-end ultrasound special circuit system) illustrated in FIGS. 1 and 2A and the computer motherboard 106 (ie, host computer) of the ultrasound device A detailed schematic block diagram of an exemplary embodiment. The components of ultrasonic engine 108 and/or computer motherboard 106 may be implemented in the form of application specific integrated circuits (ASICs). In certain exemplary embodiments, the exemplary ASIC has a high channel count and may pack 32 or more channels per die. Those skilled in the art will recognize that the ultrasonic engine 108 and the computer motherboard 106 may include more or fewer modules than those shown. For example, the ultrasonic engine 108 and the computer motherboard 106 may include the module shown in FIG. 17 .

A transducer array 152 is configured to transmit ultrasound waves to and receive reflected ultrasound waves from one or more imaging targets 1102 . Transducer array 152 is coupled to ultrasound engine 108 using one or more cables 1104 .

The ultrasonic engine 108 includes a high voltage transmit/receive (TR) module 1106 for applying driving signals to the transducer array 152 and for receiving from the transducer array 152 Send back the echo signal. The ultrasonic engine 108 includes a preamplifier/time gain compensation (TGC) module 1108 that amplifies the returned echo signal and applies a suitable TGC function to the signal. The ultrasound engine 108 includes a sampled data beamformer 1110 that uses delay coefficients in each channel after the return echo signal has been amplified and processed by the preamplifier/TGC module 1108.

In certain exemplary embodiments, high voltage TR module 1106, preamplifier/TGC module 1108, and sample interpolation receive beamformer 1110 may each be a silicon die having between 8 and 64 channels per die, but The exemplary embodiments are not limited to this scope. In some embodiments, the high voltage TR module 1106, the preamplifier/TGC module 1108, and the sample interpolation receive beamformer 1110 may each be one of silicon with 8, 16, 32, 64 channels, etc. wafer. As illustrated in Figure 11, an exemplary TR module 1106, an exemplary preamplifier/TGC module 1108, and an exemplary beamformer 1110 may each take the form of a silicon die containing 32 channels.

The ultrasound engine 108 includes a first-in, first-out (FIFO) buffer module 1112 for buffering the data output processed by the beamformer 1110 . The ultrasonic engine 108 also includes a memory 1114 for storing program instructions and data and a system controller 1116 for controlling the operation of the ultrasonic engine module.

The ultrasonic engine 108 interfaces with the computer motherboard 106 via a communication link 112, which may follow a standard high-speed communication protocol, such as FireWire (IEEE 1394 standard serial interface) or Fast (e.g., 200-400 million bits/second or faster) Universal Serial Bus (USB 2.0 USB 3.0) protocol. Standard communication link to computer motherboard at least 400 million bits/second or higher, preferably at or higher than 800 million bits/second Operating at yuan/second. Alternatively, link 112 may be a wireless connection, such as an infrared (IR) link. Ultrasonic engine 108 includes a communications chipset 1118 (eg, a FireWire chipset) for establishing and maintaining communications link 112.

Similarly, computer motherboard 106 also includes a communications chipset 1120 (eg, a FireWire chipset) for establishing and maintaining communications link 112 . The computer motherboard 106 includes a core computer readable memory 1122 for storing data and/or computer executable instructions for performing ultrasound imaging operations. Memory 1122 forms the main memory of the computer and can store approximately 4 GB of DDR3 memory in an exemplary embodiment. The computer motherboard 106 also includes a microprocessor 1124 for executing computer-executable instructions stored in the core computer-readable memory 1122 to perform ultrasound imaging processing operations. An exemplary microprocessor 1124 may be an off-the-shelf computer processor, such as an Intel Core-i5 processor. Another exemplary microprocessor 1124 may be a digital signal processor (DSP)-based processor, such as one or more DaVinci ^™ processors from Texas Instruments. The computer motherboard 106 also includes a display controller 1126 for controlling a display device that can be used to display ultrasound data, scans, and images.

Exemplary operations performed by microprocessor 1124 include, but are not limited to: down conversion (for generating I, Q samples from received ultrasound data), scan conversion (for converting ultrasound data to one of a display device) display format), Doppler processing (for determining and/or imaging motion and/or blood flow information from ultrasound data), color flow processing (in one embodiment, for using automatic correlation to produce a color-coded map of the Doppler shift that is superimposed on a B-mode ultrasound image), power Doppler processing (used to determine power Doppler data and/or generate a power Doppler Doppler plot), spectral Doppler processing (used to determine spectral Doppler data and/or generate a spectral Doppler plot) and post-signal processing. Such operations are described in detail in WO 03/079038 A2, filed on March 11, 2003, titled "Ultrasound Probe with Integrated Electronics", the entire contents of which are expressly incorporated herein by reference.

To achieve a more compact and lightweight portable ultrasound device, the ultrasound engine 108 includes a reduction in the overall package size and footprint of the circuit board, thereby providing the ultrasound engine 108 . To this end, exemplary embodiments provide a compact and lightweight mobile ultrasound device that minimizes overall package size and footprint while providing a high channel count. In certain embodiments, a high channel count circuit board of an exemplary ultrasound engine may include one or more multi-chip modules, where each chip provides multiple channels, for example 32 channels. The term "multi-chip module" as used herein refers to an electronic package in which multiple integrated circuits (ICs) are packaged into an integrated substrate to facilitate their use as a single component, that is, as a Larger IC. A multi-chip module may be used in an exemplary circuit board to enable integration of two or more active IC components on a high-density interconnect (HDI) substrate to reduce overall package size. In an exemplary embodiment, a multi-chip module may be assembled by vertically stacking a transmit/receive (TR) silicon die of an ultrasound engine, an amplifier silicon die, and a beamformer silicon die. A single circuit board of an ultrasound engine may contain one or more of these multi-chip modules to provide a high channel count while minimizing the overall package size and footprint of the circuit board.

Figure 12 illustrates a schematic side view of a portion of a circuit board 1200 containing multi-chip modules assembled in a vertically stacked configuration. Two or more layers of active electronic integrated circuit components are vertically integrated into a single circuit. The IC layers are oriented in spaced planes that extend substantially parallel to each other in a vertical stacking configuration. In Figure 12, the circuit board includes an HDI substrate 1202 for supporting a multi-chip module. A first integrated circuit die 1204 including, for example, a first beamformer device is coupled to the substrate 1202 using any suitable coupling mechanism (eg, epoxy application and curing). A first spacer layer 1206 is coupled to the surface of the first integrated circuit die 1204 opposite the substrate 1202 using, for example, epoxy application and curing. A second integrated circuit die 1208 having, for example, a second beamformer device is coupled to the surface of the first spacer layer 1206 opposite the first integrated circuit die 1204 using, for example, epoxy application and curing. A metal frame 1210 is provided to realize mechanical connection and/or electrical connection between integrated circuit chips. An exemplary metal frame 1210 may take the form of a lead frame. Wiring 1212 may be used to couple the first integrated circuit die 1204 to the metal frame 1210 . Wiring 1214 may be used to couple the second integrated circuit die 1208 to the same metal frame 1210 . A package 1216 is provided to encapsulate the multi-chip module assembly and maintain the plurality of integrated circuit dies in a substantially parallel configuration relative to each other.

As illustrated in Figure 12, the vertical three-dimensional stacking of first integrated circuit die 1204, first spacer layer 1206, and second integrated circuit die 1208 provides high density functionality on the circuit board while reducing total package size and Minimized area footprint (compared to an ultrasonic engine circuit board that does not use a vertically stacked multi-chip module). Those skilled in the art will recognize that an exemplary multi-chip module is not limited to two stacked integrated circuit dies. Exemplary numbers of chips vertically integrated into a multi-chip module may include, but are not limited to, two, three, four, five, six, seven, eight, etc.

In one embodiment of an ultrasonic engine circuit board, a single multi-chip module as illustrated in Figure 12 is provided. In other embodiments, a plurality of multi-chip modules are also illustrated in FIG. 12 . In an exemplary embodiment, a plurality of multi-chip modules (for example, two multi-chip modules) can be stacked vertically on each other on a circuit board of an ultrasonic engine to reduce the package size and size of the circuit board. The occupied area is further minimized.

In addition to the need to reduce the occupied area, the total package height of the multi-chip module also needs to be reduced. Exemplary embodiments may thin wafers to less than a few hundred microns to reduce the packaging height of multi-chip modules.

Any suitable technique may be used to assemble a multi-chip module onto a substrate. Exemplary assembly techniques include, but are not limited to: laminated MCM (MCM-L), where the substrate is a multi-layer laminated printed circuit board; deposition MCM (MCM-D), where multi-die modules are deposited using thin film technology on a base substrate; and ceramic substrate MCM (MCM-C), in which several conductive layers are deposited on a ceramic substrate and embedded in a glass layer, and these layers are co-fired at high temperature (HTCC) or low temperature (LTCC) .

13 is a flowchart of an exemplary method of fabricating a circuit board including multi-chip modules assembled in a vertically stacked configuration. In step 1302, an HDI substrate is produced or provided. In step 1304, a metal frame (eg, leadframe) is provided. In step 1306, a first IC layer is coupled or bonded to the substrate using, for example, epoxy application and curing. Wire bond the first IC layer to the metal frame. In step 1308, a spacer layer is coupled to the first IC layer using, for example, epoxy application and curing such that the layers stack vertically and extend substantially parallel to each other. In step 1310, a second IC layer is coupled to the spacer layer using, for example, epoxy application and curing such that all layers stack vertically and extend substantially parallel to each other. Wire bond the second IC layer to the metal frame. In step 1312, a package is used to encapsulate the multi-chip module assembly.

The exemplary chip layers in a multi-chip module may be coupled to each other using any suitable technique. For example, in the embodiment illustrated in Figure 12, a spacer layer may be provided between the wafer layers to separate the wafer layers. Passive silicon layers, die attach paste layers, and/or die attach film layers may be used as spacer layers. "Die Attach Adhesives for 3D Same-Sized Dies Stacked" by Toh CH et al., pages 1538 to 1543 of the 58th Electronic Components and Technology Conference (ECTC2008), Florida, USA (May 27-30, 2008) Exemplary spacer technologies that may be used to fabricate a multi-chip module are described in detail in "Packages", the entire contents of which are expressly incorporated herein by reference.

An important requirement for a die attach (DA) paste or film is excellent adhesion to the passivation material adjacent to the die. Additionally, a large die application requires a uniform bond link thickness (BLT). In addition, high bonding strength at high temperatures and low moisture absorption is better for reliability.

14A-14C are schematic side views of exemplary multi-chip modules including vertically stacked dies that may be used in accordance with exemplary embodiments. Illustration of peripheral pad and center pad wire bonding (WB) packages and their use for wire bonding exemplary die layers in a multi-chip module. Figure 14A is a schematic side view of a multi-die module containing four vertically stacked dies separated from each other by a passive silicon layer with a 2-in-1 diced die attach film (D-DAF) . 14B is a schematic side view of a multi-die module containing four vertically stacked dies separated from each other by a DA film adhesive used as an inter-die spacer. 14C is a schematic side view of a multi-die module containing four vertically stacked dies separated from each other by DA paste or film adhesive used as inter-die spacers. In certain exemplary embodiments, the DA paste or film adhesive may have wire penetrating capabilities. In the exemplary multi-die module of Figure 14C, a film-on-wire (FOW) is used to achieve long wire bonding and center bond pad stacked die packaging. FOW uses a die attach film with wire penetrating capabilities, which allows same or similar sized wire bond dies to be stacked directly on top of each other without the need for passive silicon spacers. This solves the problem of identical or similar sized dies being stacked directly on top of each other, which would otherwise be a challenge due to no or insufficient clearance for the bonding wires of the lower die.

The DA material illustrated in Figures 14B and 14C preferably maintains a bond line thickness (BLT) with little to no voiding and bleeding throughout the assembly process. After assembly is completed, the DA material clamped between the dies maintains excellent adhesion to the dies. The material properties of DA materials are adjusted to maintain high bonding strength to achieve high temperature reliability and stress without block fracture. The material properties of the DA material are adjusted to also minimize or better eliminate moisture accumulation, which can lead to a loss of package reliability (e.g., bursting due to pressure buildup due to moisture in the package). Interface fracture or block fracture occurs).

Figure 15 Using (a) passive silicon layer with a 2-in-1 cut die attach film (D-DAF), (b) DA paste, (c) thick DA film, and (d) over-wire (FOW) A flow diagram of one of some illustrative methods of performing die-to-die stacking using a die attach film with wire penetrating capabilities that allows same or similar sized wire bond dies to be directly stacked on each other without the need for Passive silicon spacers. Each method performs back grinding on the wafer to reduce the thickness of the wafer to enable stacked and high-density packaging of integrated circuits. The wafers are sawed to separate into individual dies. A first die is bonded to a substrate of a multi-chip module using, for example, epoxy resin application and curing in an oven. The first die is coupled to a metal frame using wire bonding.

In method (A), a first passive silicon layer is stack-bonded to the first die using a diced die attach film (D-DAF). A second die is stack-bonded to the first passive layer using D-DAF. The second die is coupled to the metal frame using wire bonding. A second passive silicon layer is stack-bonded to the second die using D-DAF. A third die is stack-bonded to the second passive layer using D-DAF. The third die is coupled to the metal frame using wire bonding. A third passive silicon layer is stack-bonded to the third die using D-DAF. A fourth die is stack-bonded to the third passive layer using D-DAF. The fourth die is coupled to the metal frame using wire bonding.

In method (B), die attachment (DA) paste application and curing are repeated for multi-layer thin die stack applications. The DA paste is applied to a first die, and a second die is disposed on the DA paste and solidified to the first die. The second die is coupled to the metal frame using wire bonding. DA paste is applied to the second die, and a third die is disposed on the DA paste and solidified to the second die. The third die is coupled to the metal frame using wire bonding. The DA paste is applied to the third die, and a fourth die is disposed on the DA paste and solidified to the third die. The fourth die is coupled to the metal frame using wire bonding.

In method (C), a die attach film (DAF) is cut and pressed to a bottom die, and a top die is then placed and heat compressed onto the DAF. For example, a DAF is pressed onto a first die, and a second die is thermally compressed onto the DAF. The second die is coupled to the metal frame using wire bonding. Similarly, a DAF is pressed to the second die and a third die is thermally compressed onto the DAF. The third die is coupled to the metal frame using wire bonding. A DAF is pressed onto the third die and a fourth die is heat compressed onto the DAF. The fourth die is coupled to the metal frame using wire bonding.

In method (D), the film-on-wire (FOW) employs a die attach film with wire penetrating capabilities that allows same or similar sized wire bond dies to be stacked directly on top of each other without the need for passive silicon spacers. A second die is stacked and bonded to the first die. The second die is coupled to the metal frame using over-wire bonding. A third die is stacked and bonded to the first die. The third die is coupled to the metal frame using over-wire bonding. A fourth die is stacked and bonded to the first die. The fourth die is coupled to the metal frame using over-wire bonding.

After completing the above steps, in each method (a) to (d), wafer molding and post-molding curing (PMC) are performed. Subsequently, ball planting and single graining are performed.

"Die Attach Adhesives for 3D Same-Sized Dies Stacked Packages" by TOH CH et al., pages 1538 to 1543 of the 58th Electronic Components and Technology Conference (ECTC2008), Florida, USA (May 27-30, 2008) Additional details of the die attachment technology described above are provided in "The entire contents of this document are expressly incorporated by reference into this application."

Figure 16 is a schematic side view of a multi-chip module 1600. The multi-chip module 1600 includes a TR chip 1602, an amplifier chip 1604 and a beamformer vertically integrated on a substrate 1614 in a vertical stacking configuration. device chip 1606. The multi-chip module may be fabricated using any suitable technique illustrated in Figures 12-15. Those skilled in the art will recognize that the specific order of die stacking may vary in other embodiments. A first spacer layer 1608 and a second spacer layer 1610 are provided to separate the wafers 1602, 1604, 1606. Each die is coupled to a metal frame (eg, a lead frame) 1612 . In some exemplary embodiments, heat transfer and heat dissipation mechanisms can be provided in multi-chip modules to maintain high temperature reliability and stress, and eliminate block failures. Other components of Figure 16 have been described with reference to Figures 12 and 14 .

In this exemplary embodiment, each multi-chip module can handle complete transmit, receive, TGC amplification and beamforming operations for a large number of channels (eg, 32 channels). By vertically integrating three silicon dies into a single multi-chip module, the required space and footprint of the printed circuit board can be further reduced. Multiple multi-chip modules can be placed on a single ultrasonic engine circuit board to further increase the number of channels while minimizing package size and footprint. For example, the 128-channel ultrasonic engine circuit board 108 can be fabricated within an exemplary planar dimension of about 10 cm by about 10 cm, which is a significant improvement over the space requirements of conventional ultrasonic circuits. In preferred embodiments, a single circuit board containing an ultrasonic engine of one or more multi-chip modules may have 16 to 128 channels. In some embodiments, a single circuit board containing an ultrasonic engine of one or more multi-chip modules may have 16, 32, 64, 128 channels, etc.

FIG. 17 provides an illustrative embodiment of an ultrasound engine 108 (ie, front-end ultrasound special circuit system) and an illustrative computer motherboard 106 (ie, host computer) as a single-board complete ultrasound system. A detailed schematic block diagram of an embodiment. An exemplary single-panel ultrasound system illustrated in Figure 17 may have exemplary planar dimensions of approximately 25 cm by approximately 18 cm, although other dimensions may exist. The single-board complete ultrasound system of Figure 17 can be implemented in the ultrasound device illustrated in Figures 1, 2A, 2B, and 9A, and can be used to perform the tasks shown in Figures 3-8, 9B, and 10 The operation of drawing.

The ultrasound engine 108 includes a probe connector 114 to facilitate connection of at least one ultrasound probe/transducer. In the ultrasonic engine 108, a TR module, an amplifier module, and a beamformer module can be vertically stacked to form a multi-chip module as shown in Figure 16, thereby integrating the overall structure of the ultrasonic engine 108. Package size and footprint are minimized. The ultrasonic engine 108 may include a first multi-chip module 1710 and a second multi-chip module 1712 that each include a TR vertically integrated into a stacked configuration as shown in Figure 16 chip, an ultrasonic pulser and receiver, an amplifier chip including a temporal gain control amplifier, and a sample data beamformer chip. The first multi-chip module 1710 and the second multi-chip module 1712 may be vertically stacked on each other to further minimize the area required on the circuit board. Alternatively, the first multi-chip module 1710 and the second multi-chip module 1712 can be placed horizontally on the circuit board. In an exemplary embodiment, the TR chip, amplifier chip, and beamformer chip are each a 32-channel chip, and each multi-chip module 1710, 1712 has 32 channels. Those skilled in the art will recognize that the exemplary ultrasonic engine 108 may include, but is not limited to, one, two, three, four, five, six, seven, or eight multi-chip modules. Note that in a preferred embodiment, the system may be configured with a first beamformer located in the transducer housing and a second beamformer located in the tablet housing.

ASIC and multi-chip module configurations enable the implementation of a complete 128-channel ultrasound system on a small, single board the size of a tablet computer format. For example, an exemplary 128-channel ultrasonic engine 108 can be accommodated within exemplary planar dimensions of about 10 cm by about 10 cm, which is a significant improvement over the space requirements of conventional ultrasound circuits. An exemplary 128-channel ultrasonic engine 108 may also be accommodated within an exemplary area of approximately 100 ^cm2 .

The ultrasound engine 108 also includes a clock generation complex programmable logic device (CPLD) 1714 for generating timing clocks for performing an ultrasound scan using the transducer array. The ultrasound engine 108 includes an analog-to-digital converter (ADC) 1716 for converting analog ultrasound signals received from the transducer array into digital RF shaped beams. The ultrasonic engine 108 also includes one or more delay profile and waveform generator field programmable gate arrays (FPGAs) 1718 for management. The delay profile is received and a transmission waveform is generated. The ultrasound engine 108 includes a memory 1720 for storing delay profiles for ultrasound scanning. An exemplary memory 1720 may be a single DDR3 memory chip. The ultrasound engine 108 includes a scan sequence control field programmable gate array (FPGA) 1722 configured to manage ultrasound scan sequences, transmit/receive timing, and to and from memory 1720 Distributed storage/retrieval, buffering of the digital RF data stream and movement of the digital RF data stream to the computer motherboard 106 through a high-speed serial interface 112. The high-speed serial interface 112 includes a FireWire or other serial or parallel bus interface between the computer motherboard 106 and the ultrasonic engine 108 . Ultrasonic engine 108 includes a communications chipset 1118 (eg, a FireWire chipset) for establishing and maintaining communications link 112.

A power module 1724 is provided to power the ultrasonic engine 108, manage a battery charging environment and perform power management operations. The power module 1724 can generate regulated low-noise power for the ultrasound circuit system and can generate high voltage for the ultrasound transmission pulser in the TR module.

The computer motherboard 106 includes a core computer readable memory 1122 for storing data and/or computer executable instructions for performing ultrasound imaging operations. Memory 1122 forms the computer's main memory and can store approximately 4 Gb of DDR3 memory in an exemplary embodiment. Memory 1122 may include a solid state drive (SSD) for storing an operating system, computer-executable instructions, programs, and image data. An exemplary SSD may have a capacity of approximately 128 GB.

The computer motherboard 106 also includes a microprocessor 1124, which is used to execute computer-executable instructions stored in the core computer-readable memory 1122 to perform ultrasound imaging processing operations. Exemplary operations include, but are not limited to, down conversion, scan conversion, Doppler processing, color flow processing, power Doppler processing, spectral Doppler processing, and post-signal processing. An exemplary microprocessor 1124 may be an off-the-shelf computer processor, such as an Intel Core-i5 processor. Another exemplary microprocessor 1124 may be a digital signal processor (DSP) type processor, such as the DaVinci ^™ processor from Texas Instruments.

The computer motherboard 106 includes an input/output (I/O) and graphics chipset 1704 that includes a coprocessor configured to control the I/O. and graphics peripherals (such as USB ports, video display ports, etc.). Computer motherboard 106 includes a wireless network adapter 1702 configured to provide a wireless network connection. An exemplary adapter 1702 supports the 802.11g and 802.11n standards. The computer motherboard 106 includes a display controller 1126 configured to interface the computer motherboard 106 to the display 104 . Computer motherboard 106 includes a communications chipset 1120 (eg, a FireWire chipset or interface) configured to provide a fast data communication between computer motherboard 106 and ultrasound engine 108 . An exemplary communications chipset 1120 may be an IEEE 1394b 800 Mbit/s interface. Other serial or parallel interfaces 1706 may be provided instead, such as USB3, Thunder-Bolt, PCIe, etc. A power module 1708 is provided to power the computer motherboard 106, manage a battery charging environment and perform power management operations.

An exemplary computer motherboard 106 may fit within exemplary planar dimensions of about 12 cm by about 10 cm. An exemplary computer motherboard 106 may be accommodated within an exemplary area of approximately 120 cm ² .

Figure 18 is a perspective view of an exemplary mobile ultrasound system 100 provided in accordance with an exemplary embodiment. The system 100 includes a housing 102 in one of the tablet computer form factors illustrated in Figure 18, but may be in any other suitable form factor. An exemplary housing 102 may have a thickness less than 2 cm and preferably between 0.5 cm and 1.5 cm. A front panel of the housing 102 contains a multi-touch LCD touch screen display 104 configured to recognize and distinguish one or more multi-touch and/or Or touch simultaneously. The surface of display 104 may be touched using one or more of a user's finger, a user's hand, or an optional stylus 1802 . The housing 102 includes one or more I/O port connectors 116. The I/O port connectors 116 may include, but are not limited to, one or more USB connectors, one or more SD cards, one or more network mini display port and a DC power input. The embodiment of the housing 102 in Figure 18 may also be configured in a handheld form factor having dimensions of 150 mm × 100 mm × 15 mm (a volume of 225,000 ^mm3 ) or less. Housing 102 may have a weight of less than 200 g. Optionally, the cabling between the transducer array and the display housing may include the interface circuitry 1020 described herein. For example, interface circuitry 1020 may include beamforming circuitry and/or A/D circuitry in a box suspended from the tablet. Separate connectors 1025, 1027 can be used to connect the suspension box to the transducer probe cable. Connector 1027 may include probe identification circuitry as described herein. Unit 102 may include a camera, a microphone, and a speaker as well as wireless telephone circuitry for voice and data communications and voice-activated software that may be used to control the ultrasound imaging operations described herein.

Housing 102 contains or is coupled to a probe connector 114 that facilitates connection of at least one ultrasound probe/transducer 150 . Ultrasonic probe 150 includes a transducer housing that includes one or more transducer arrays 152 . Ultrasonic probe 150 may be coupled to probe connector 114 using a housing connector 1804 disposed along a flexible cable 1806 . Those skilled in the art will recognize that any other suitable mechanism may be used to couple the ultrasonic probe 150 to the housing 102, such as an interface housing that includes means for performing ultrasound, such as beamforming. Circuit system for specific operation of sound waves. Other exemplary embodiments of ultrasound systems are described in detail in WO 03/079038 A2, filed on March 11, 2003, entitled "Ultrasound Probe with Integrated Electronics", the entire contents of which are expressly incorporated herein by reference. . Preferred embodiments may employ a wireless connection between the handheld transducer probe 150 and the display housing. Beamformer electronics may be incorporated into the probe housing 150 to enable beamforming of a sub-array of one of the ID or 2D transducer arrays described herein. The display housing may be sized to fit in the palm of a user's hand and may include wireless network connectivity to a public access network, such as the Internet.

Figure 19 illustrates an exemplary view of the main graphical user interface (GUI) 1900 presented on the touch screen display 104 of the mobile ultrasound system 100 of Figure 18. When the ultrasound system 100 is started, the main GUI 1900 may be displayed. To assist a user in navigating the main GUI 1900, the GUI may be considered to include four exemplary workspaces: a menu bar 1902, an image display window 1904, an image control bar 1906, and a toolbar 1908. Additional GUI components may be provided on the main GUI 1900 to, for example, enable a user to close, resize, and exit the GUI and/or windows within the GUI.

Menu bar 1902 enables a user to select ultrasound data, images and/or videos for display in image display window 1904 . For example, menu bar 1902 may include a GUI component for selecting one or more files in a patient folder directory and an image folder directory. The image display window 1904 displays ultrasound data, images and/or videos, and optionally provides patient information. Toolbar 1908 provides functionality associated with an image display or video display, which functionality includes, but is not limited to: a save button for saving the current image and/or video to a file; a save loop button, It saves a maximum allowed number of previous frames as a frame loop; a print button for printing the current image; a freeze image button for freezing an image; a playback toolbar for controlling a frame Loop playback modes, etc. Exemplary GUI functionality that may be provided in the main GUI 1900 is described in detail in WO 03/079038 A2, filed March 11, 2003, the entire contents of which is expressly incorporated by reference. This case is for reference only.

Image control column 1906 includes touch controls operable by touch and touch gestures that a user applies directly to the surface of display 104 . Exemplary touch controls may include, but are not limited to, a 2D touch control 408, a gain touch control 410, a color touch control 412, a storage device touch control 414, a split touch control 416, a PW imaging touch control 418, a beam steering touch control 420, an annotation touch control 422, a dynamic range operation touch control 424, a Teravision ^TM touch control 426, a picture operation touch control 428, and a needle guide touch Control 428. These exemplary touch controls are described in detail in conjunction with Figures 4a-4c.

20A illustrates an illustrative embodiment of an exemplary medical ultrasound imaging device 2000 implemented in a tablet form factor in accordance with the present invention. The tablet may have dimensions of 12.5" × 1.25" × 8.75" or 31.7 cm × 3.175 cm × 22.22 cm, but it may also have any other suitable form factor with a volume less than 2500 ^cm3 and a weight less than 8 pounds. As shown in the figure As shown in 20, the medical ultrasound imaging equipment 2000 includes a housing 2030 and a touch screen display 2010, which can display ultrasound images and ultrasound data 2040, and the ultrasound control 2020 is configured to be controlled by a touch screen Display 2010 controls. Housing 2030 may have a front panel 2060 and a rear panel 2070. Touch screen display 2010 forms front panel 2060 and includes a multi-touch LCD touch screen. The screen can recognize and distinguish one or more multi-touch or simultaneous touches by the user on the touch screen display 2010. The touch screen display 2010 can have a capacitive multi-touch and AVAH LCD screen. For example , capacitive multi-touch and AVAH LCD screens allow a user to view images from multiple angles without losing resolution. In another embodiment, the user can use a stylus to input on the touch screen Information. The tablet computer may include an integrated foldable stand that allows a user to rotate the stand from a storage device position that matches the external dimensions of the tablet computer so that the device lies flat on the rear panel, or Alternatively, the user can rotate the stand so that the tablet stands in an upright position at one of a plurality of tilt angles relative to a support surface.

Capacitive touch screen modules include an insulator (eg, glass) coated with a transparent conductor (such as indium tin oxide). The manufacturing process may include a bonding process between glass, x-sensor film, y-sensor film, and a liquid crystal material. The tablet is configured to allow a user to perform multi-touch gestures, such as pinching and pinching, while wearing a dry glove or a wet glove. The surface of the screen registers the electrical conductors in contact with the screen. Contact distorts the screen's electrostatic field, causing a measurable change in capacitance. A processor then interprets the changes in the electrostatic field. Increased response levels are achieved by reducing layers and using "hot chamber" technology to produce touch screens. "Hot chamber" technology removes several layers by placing capacitors inside the display. The application of "hot room" technology reduces the visual distance between the user's finger and the touch screen target, thereby forming a more targeted contact with one of the displayed content and increasing the responsiveness to clicks and gestures.

Figure 20A illustrates a tablet computer system 2000 having a port 2080 that receives a card 2082 with a SIM circuit 2084 mounted thereon.

Figure 21 illustrates a preferred truck system according to a modular ultrasound imaging system of the present invention. The truck system 2100 uses a base assembly 2122 that includes a socket for receiving a tablet computer. Truck configuration 2100 is configured to dock a tablet 2104 including a touch screen display 2102 to a truck 2108 which may include a full operator console 2124. After docking the tablet 2104 to the truck mount 2108, the system forms a fully featured rolling system. The fully featured rolling system may include an adjustable height device 2106, a gel holder 2110 and a storage bin 2114, wheels 2116, a thermal probe holder 2120, and an operator console 2124. The control device may include a keyboard 2112 on the operator console 2124. The operator console 2124 may also be equipped with other peripheral devices, such as a printer or a video interface or other control devices.

Figure 22 illustrates a preferred truck system for use with a modular ultrasound imaging system in accordance with the present invention, in an embodiment. The truck system 2200 may be configured with a vertical support member 2212 coupled to a horizontal support member 2028. An accessory connector 2018 having a location for an accessory accessory 2014 may be configured to connect to the vertical support member 2212 . A 3-port probe MUX connection device 2016 can also be configured to connect to a tablet. A storage bin 2224 may be configured to attach to the vertical support member 2212 via a storage bin attachment mechanism 2222. The truck system may also include a rope management system 2226 configured to attach to the vertical support members. The truck assembly 2200 includes a support beam 2212 mounted on a base 2228 having wheels 2232 and a battery 2230 that provides power for extended operations of the tablet computer. The assembly may also include an accessory holder 2224 mounted with the height adjustment device 2226. Retainers 2210, 2218 may be mounted on the beam 2212 or mounted on the console panel 2214. The multiport probe multiplexer 2216 is connected to the tablet computer to connect with several transducer probes simultaneously, and the user can select the several transducer probes sequentially using the displayed virtual switch. A mobile touch gesture, such as a three-finger flick on the displayed image or touching a displayed virtual button or icon, can switch between connected probes.

Figure 23A illustrates a preferred truck mounting system for a modular ultrasound imaging system in accordance with the present invention. Configuration 2300 shows tablet computer 2302 coupled to docking station 2304. Docking station 2304 is attached to attachment mechanism 2306. Attachment mechanism 2306 may include a hinge component 2308 that allows the user to tilt the display into a user-desired position. Attachment mechanism 2306 attaches to vertical member 2312. A tablet computer 2302 as described herein may be mounted on a base docking unit 2304 that is mounted to a mounting assembly 2306 on top of the beam 2212. Base unit 2304 includes a cradle 2310, electrical connectors 2305, and a port 2307 that connects system 2302 to battery 2230 and multiplexer device 2216.

Figure 23B illustrates a SIM card 2084 inserted into a card installation system in unit 2304.

Figure 24 illustrates a preferred truck system 2400 modular ultrasound imaging system in which a tablet computer 2402 is connected to a mounting assembly 2406 having a connector 2404 in accordance with the present invention. Configuration 2400 depicts tablet computer 2402 coupled to vertical support member 2408 via attachment mechanism 2404 without plug element 2304 . Attachment mechanism 2404 may include a hinge 2406 for display adjustment.

Figures 25A and 25B illustrate a multifunctional docking station. Figure 25A illustrates a docking station 2502 and a tablet computer 2504 having a base assembly 2506 mated to the docking station 2502. Tablet computer 2504 and docking station 2502 may be electrically connected. Tablet 2504 may be released from docking station 2502 by engaging tablet 2504 with release mechanism 2508. Docking station 2502 may contain a transducer port 2512 for connecting a transducer probe 2510. Docking station 2502 may contain three USB 3.0 ports, a LAN port, a headphone jack, and a power connector for charging. Figure 25B illustrates a side view of a tablet computer 2504 and a docking station 2502 having a stand in accordance with a preferred embodiment of the present invention. The docking station may include an adjustable bracket/handle 2526. The adjustable stand/handle 2526 tilts for a variety of viewing angles. Adjustable stand/handle 2526 flips up for transportation purposes. The side view also illustrates a transducer port 2512 and a transducer probe connector 2510.

Figure 26 illustrates a 2D imaging operating mode of a modular ultrasound imaging system in accordance with the present invention. The touch screen of tablet 2504 can display images obtained by a two-dimensional transducer probe using a 256 digital beamformer channel. 2D image window 2602 illustrates a 2D image scan 2604. Two-dimensional images can be obtained using flexible frequency scanning 2606, with control parameters represented on the tablet.

Figure 27 illustrates a motion operating mode of a modular ultrasound imaging system in accordance with the present invention. The touch screen display of the tablet computer 2700 can display images obtained through a motion operation mode. The touch screen display of tablet computer 2700 can display two-dimensional 2706 and motion mode imaging 2708 simultaneously. The touch screen display of the tablet computer 2700 can display a two-dimensional image window 2704, and the two-dimensional image window 2704 has a two-dimensional image 2706. The flexible frequency control 2702 using the graphical user interface display can be used to adjust the frequency from 2 MHz to 12 MHz.

Figure 28 illustrates a color Doppler operating mode of a modular ultrasound imaging system in accordance with the present invention. The touch screen display of the tablet computer 2800 displays images obtained by the color Doppler mode of operation. A two-dimensional image window 2806 serves as the primary display. Color-coded information 2808 is overlaid on the two-dimensional image 2810. Ultrasound-based imaging of red blood cells is derived from the received echo of the transmitted signal. The main characteristics of the echo signal are frequency and amplitude. The amplitude depends on the amount of moving blood within the volume sampled by the ultrasound beam. Scan quality can be controlled through the monitor by adjusting a high frame rate or high resolution. Higher frequencies can result from rapid blood flow and can be shown in light colors, while lower frequencies are shown in dark colors. Flexible frequency control 2804 and color Doppler scan information 2802 can be displayed on the tablet computer display 2800.

Figure 29 illustrates a pulse wave Doppler mode of operation of a modular ultrasound imaging system in accordance with the present invention. The touch screen display of Tablet PC 2900 can display images obtained by pulse wave Doppler operation mode. Pulsed wave Doppler scanning generates a series of pulses that are used to analyze the movement of blood flow in a small area along a desired ultrasonic cursor, called a sample volume or sample gate 2912. The tablet display 2900 may display a two-dimensional image 2902 with the sample volume/sample gate 2012 overlaid in the two-dimensional image 2902 . The tablet display 2900 may use a hybrid operating mode 2906 to display a two-dimensional image 2902 and a time/Doppler shift 2910. If an appropriate angle between the beam and blood flow is known, the time/Doppler shift 2910 can be converted into velocity and blood flow. The gray shading 2908 in the time/Doppler shift 2910 may represent signal strength. The thickness of the spectral signal can indicate laminar or turbulent flow. Tablet computer display 2900 may depict adjustable frequency control 2904.

Figure 30 illustrates a three-way scan operation mode of a modular ultrasound imaging system in accordance with the present invention. Tablet display 3000 may include a 2D window 3002 capable of displaying 2D images alone or in combination with color Doppler or directional Doppler features. The touch screen display of Tablet PC 3000 can display images obtained by color Doppler operation mode. A two-dimensional image window 3002 is used as the main display. Color-coded information 3004 is overlaid 3006 on the two-dimensional image 3016. Pulsed wave Doppler features can be used alone or in combination with two-dimensional imaging or color Doppler imaging. Tablet computer display 3000 may include a pulsed wave Doppler scan represented by a sample volume/sample gate 3008 that is overlaid on a 2D image 3016, alone or in combination, or color coded. Stack 3006. Tablet computer display 3000 may depict a split screen representing time/Doppler shift 3012. If an appropriate angle between the beam and the blood flow is known, the time/Doppler shift 3012 can be converted into velocity and blood flow. The gray shading 3014 in the time/Doppler shift 3012 may represent signal strength. The thickness of the spectral signal can indicate laminar or turbulent flow. Tablet computer display 3000 may also illustrate flexible frequency control 3010.

Figure 31 illustrates a GUI main screen interface 3100 in a user operating mode of a modular ultrasound imaging system according to the present invention. When the ultrasound system is started, a screen interface 3100 in a user operation mode may be displayed. To assist a user in navigating the GUI home screen 3100, the home screen may be considered to include three exemplary workspaces: a menu bar 3104, an image display window 3102, and an image control bar 3106. Additional GUI components may be provided on the main GUI home screen 3100 to enable a user to close, resize, and exit the GUI home screen and/or windows within the GUI home screen.

The menu bar 3104 enables the user to select ultrasound data, images and/or videos for display in the image display window 3102 . The menu bar may contain components for selecting one or more files in a patient folder directory and an image folder directory.

Image control column 3106 includes touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to, a depth control touch control 3108, a 2D gain touch control 3110, a full screen touch control 3112, a text touch control 3114, a split screen touch control 3116, a ENV touch control 3118, a CD touch control 3120, a PWD touch control 3122, a freeze touch control 3124, a save touch control 3126 and an optimization touch control 3128.

Figure 32 illustrates a GUI menu screen interface 3200 in a user operating mode of a modular ultrasound imaging system according to the present invention. When the menu bar 3204 triggers the menu selection mode to initiate operation of the ultrasound system, the screen interface 3200 in a user operation mode may be displayed. To assist a user in navigating the GUI main screen 3100, the main screen may be considered to include three exemplary workspaces: a menu bar 3204, an image display window 3202, and an image control bar 3220. Additional GUI components may be provided on the main GUI menu screen 3200 to allow a user to close, resize, scroll the image 3130, and exit the GUI menu screen and/or windows within the GUI menu screen (for example).

Menu bar 3204 enables the user to select ultrasound data, images 3218 and/or video for display in image display window 3202. Menu bar 3204 may include touch control components for selecting one or more files in a patient folder directory and an image folder directory. Shown in an expanded format 3206, the menu bar may include exemplary touch controls such as a patient touch control 3208, a default touch control 3210, a review touch control 3212, a report touch control 3214, and a settings Touch control3216.

Image control column 3220 includes touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to, depth control touch control 3222, a 2D gain touch control 3224, a full screen touch control 3226, a text touch control 3228, a split screen touch control 3230, a pin Visual ENV touch control 3232, a CD touch control 3234, a PWD touch control 3236, a freeze touch control 3238, a storage touch control 3240 and an optimization touch control 3242.

Figure 33 illustrates a GUI patient information screen interface 3300 in a user operating mode for a modular ultrasound imaging system in accordance with the present invention. When the ultrasound system is started, when the menu bar 3302 triggers the patient selection mode, a screen interface in a user operation mode 3300 may be displayed. To assist a user in navigating the GUI patient information screen 3300, the patient information screen may be viewed as containing five exemplary work areas: a new patient touch screen control 3304, a new study touch screen control 3306, and a study list touch screen Screen control 3308, a work list touch screen control 3310 and an edit touch screen control 3312. Within each touch screen control, 3314, 3316 other information entry fields are available. For example, patient information section 3314 and study information section 3316 may be used to record data.

Within patient information screen 3300, image control column 3318 contains touch controls operable by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to, accept study touch control 3320, rigorous study touch control 3322, print touch control 3324, print preview touch control 3326, cancel touch control 3328, a two-dimensional touch control Control 3330, freeze touch control 3332 and a save touch control 3334.

Figure 34 illustrates a GUI patient information screen interface 3400 in a user operating mode for a modular ultrasound imaging system in accordance with the present invention. When the menu bar 3402 triggers the default selection mode 3404, a user operation mode screen interface 3400 may be displayed when the ultrasound system is started.

Within default screen 3400, image control bar 3408 includes touch controls that can be operated by touch and touch gestures directly applied by the user to the surface of the display. Exemplary touch controls may include, but are not limited to: a save settings touch control 3410, a delete touch control 3412, a CD touch control 3414, a PWD touch control 3416, a freeze touch control 3418, and a save touch control. 3420 and an optimized touch control 3422.

Figure 35 illustrates a GUI review screen interface 3500 in a user operating mode for a modular ultrasound imaging system in accordance with the present invention. When the select menu 3502 triggers the default expansion review 3504 and the selection mode 3404, when the ultrasound system is started, a user operation mode screen interface 3500 may be displayed.

Within review screen 3500, image control bar 3516 includes touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to: a thumbnail setting touch control 3518, a sync touch control 3520, a selection touch control 3522, a previous image touch control 3524, a next image touch control 3526, a two dimensional image touch control 3528, a pause image touch control 3530 and a save image touch control 3532.

An image display window 3506 may allow the user to review images in a plurality of formats. Image display window 3506 may allow a user to view images 3508, 3510, 3512, 3514 in combinations or subgroups, or to view any image 3508, 3510, 3512, 3514 individually. Image display window 3506 can be configured to display up to four images 3508, 3510, 3512, 3514 for simultaneous viewing.

Figure 36 illustrates a GUI reporting screen interface in a user operating mode of a modular ultrasound imaging system according to the present invention. When the optional list 3602 triggers the report expansion review 3604, a user operation mode screen interface 3600 may be displayed when the ultrasound system is activated. Monitor screen 3606 contains ultrasound report information 3626. Users can use the work order section within Ultrasound Report 3626 to enter comments, patient information, and study information.

Within report screen 3600, image control bar 3608 includes touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to: a save touch control 3610, a save new file touch control 3612, a print touch control 3614, a print preview touch control 3616, a close study touch control 3618, A two-dimensional image touch control 3620, a freeze image touch control 3622 and a save image touch control 3624.

Figure 37A illustrates a GUI setup screen interface in a user operating mode of a modular ultrasound imaging system according to the present invention. When the optional list 3702 triggers the report expansion review 3704, a user operation mode screen interface 3700 may be displayed when the ultrasound system is activated.

Within the settings expansion screen 3704, the settings control bar 3744 includes touch controls that can be operated by touch and touch gestures directly applied by the user to the surface of the display. Exemplary touch controls may include, but are not limited to: a general touch control 3706, a display touch control 3708, a measure touch control 3710, an annotation touch control 3712, a print touch control 3714, a save/get touch control 3714. touch control 3716, a DICOM touch control 3718, an export touch control 3720 and a research information image touch control 3722. The touch controls may include a display screen that allows the user to enter configuration information. For example, general touch control 3706 includes a configuration screen 3724 where the user can enter configuration information. Additionally, the general touch control 3706 contains a section that allows the user to configure the soft key docking locations 3726. Figure 37B illustrates soft key control 3752 with a right-side alignment. Figure 37B further illustrates that activating soft key control arrow 3750 will change the key alignment to the opposite side (in this case, left) alignment. Figure 37C illustrates left alignment of soft key control 3762. The user can initiate a direction change using soft key control arrow 3760 to change the position to right alignment.

Within review screen 3700, image control bar 3728 includes touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to, a thumbnail setting touch control 3730, a synchronization touch control 3732, a selection touch control 3734, a previous image touch control 3736, a next image touch control 3738, a 2D Image touch control 3740 and a pause image touch control 3742.

Figure 38 illustrates a GUI setup screen interface in a user operating mode of a modular ultrasound imaging system according to the present invention. When the optional list 3802 triggers the report expansion review 3804, a user operating mode screen interface 3800 may be displayed when the ultrasound system is activated.

Within settings expansion screen 3804, settings control bar 3844 includes touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to: a plurality of icons, such as a general touch control 3806, a display touch control 3808, a measure touch control 3810, an annotation touch control 3812, a print touch control 3814, A store/retrieve touch control 3816, a DICOM touch control 3818, an export touch control 3820 and a research information image touch control 3822. Touch controls may include a display screen that allows user input to store/retrieve information. For example, the save/get touch control 3816 includes a configuration screen 3802 where the user can enter configuration information. The user can activate a virtual keyboard, thereby allowing the user to enter alphanumeric characters in different touch-activated fields. In addition, the save/retrieve touch control 3802 contains a section that allows the user to retrieve 3804 retroactively. When the user enables the save function, the system is preset to save the expected screen loop. If the user enables retrospective capture, the save function can retroactively collect frame loops.

Within settings screen 3800, image control bar 3828 contains touch controls that can be operated by touch and touch gestures applied directly by the user to the surface of the display. Exemplary touch controls may include, but are not limited to: a thumbnail setting touch control 3830, a synchronization touch control 3832, a selection touch control 3834, a previous image touch control 3836, a next image touch control 3838, two dimensional image touch control 3840 and a pause image touch control 3842.

Figures 39A and 39B illustrate an XY biplanar probe consisting of two one-dimensional multi-element arrays. The arrays may be configured with one array on top of another array, with the polarization axes of each array aligned in the same direction. The elevation axes of the two arrays may be at right angles or orthogonal to each other. For example, exemplary embodiments may employ a transducer assembly such as that set forth in U.S. Patent No. 7,066,887, the entire contents of which is incorporated herein by reference, or the French Vernon of Tours Cedex Transducers sold. Array orientation represented by configuration 3900 is illustrated in Figure 39A. The polarization axes 3908 of both arrays point toward the z-axis 3906. The elevation axis of the bottom array points in the y direction 3902 and the elevation axis of the top array points in the x direction 3904.

Figure 39B further illustrates an image shown in a one-dimensional multi-element array forming configuration 3912. A one-dimensional array of an elevation axis 3910 in a y direction 3902 forms an ultrasonic image 3914 on the x-axis 3904 and z-axis 3906 planes. The one-dimensional array of the elevation axis 3910 in the x direction 3904 forms an ultrasonic image 3914 on the y axis 3902 and the z axis 3906. A one-dimensional transducer array with an elevation axis 3910 along a y-axis 3902 and a polarization axis 3908 along a z-axis 3906 will form an ultrasound image 3914 along the x 3904 and z 3906 planes. An alternative embodiment illustrated in Figure 39C shows a one-dimensional transducer array with an elevation axis 3920 on an x-axis 904 and a polarization axis 3922 in the z-axis 3906 direction. The ultrasonic image 3924 is formed on the y 3902 and z 3906 planes.

Figure 40 illustrates the operation of a pair of planar image forming xy probes in which a high voltage is applied to array 4012 to form an image. High voltage drive pulses 4006, 4008, 4010 may be applied to the bottom array 4004 with a y-axis elevation angle. This application allows generation of transmission pulses used to form the received image in the XZ plane while maintaining the elements of top array 4002 at a ground level. These probes enable a 3D imaging mode using simpler electronics than a fully 2D transducer array. A touch screen activated user interface, as described herein, may employ on-screen icons and gestures to initiate 3D imaging operations. These imaging operations can be enhanced by software running on the tablet data processor, which processes the image data into 3D ultrasound images. The image processing software may employ filter smoothing and/or interpolation operations known in the art. Beam steering can also be used to achieve 3D imaging operations. A preferred embodiment uses a plurality of 1D sub-array transducers configured for biplane imaging.

Figure 41 illustrates the operation of a pair of planar image forming xy probes. Figure 41 illustrates an array 4110 to which a high voltage is applied for forming an image. High voltage pulses 4102, 4104, 4106 can be applied to the top array 4112 with an elevation angle in the x-axis, thereby generating transmission pulses used to form the received image in the yz plane, while keeping the elements of the bottom array 4108 grounded. This embodiment may also utilize orthogonal ID transducer arrays using sub-array beamforming operations as described herein.

Figure 42 illustrates the circuit requirements for a pair of planar image forming xy probes. Receive beamforming requirements are shown for a pair of planar probes. A connection is made with the receiving electronic device 4202. The elements of the selected bottom array 4204 and the selected top array 4208 are then connected to share a channel to the receiving electronics 4202. A two-to-one multiplexer circuit can be integrated on the high voltage drivers 4206, 4210. A two-to-one multiplexer circuit can be integrated into the high voltage drivers 4206, 4212. One receive beam is formed for each transmit beam. A dual-plane system requires a total of 256 transmission beams, of which 128 are used to form an XZ plane image and another 128 are used to form a YZ plane image. A multi-receive beamforming technique can be used to increase the frame rate. An ultrasound system with dual receive beam capability for each transmit beam provides a system that can form two receive beams. The biplane probe only requires a total of 128 transmission beams to form two orthogonal plane images, of which 64 transmission beams are used to form an XZ plane image, and the other 64 transmission beams are used to form a YZ plane image. Similarly, for an ultrasound system with a quadruple or 4 receive beam capability, the probe requires 64 transmit beams to form two orthogonal plane images.

Figures 43A-43B illustrate one application for simultaneous bi-plane evaluation. The ability to measure LV mechanical dyssynchrony with echocardiography may help identify patients who are more likely to benefit from cardiac resynchronization therapy. The LV parameters that need to be quantified are Ts-(transverse septum), Ts-SD, Ts-peak, etc. Ts-(transverse septum) can be measured on a 2D apical four-chamber echo image, while Ts-SD, Ts-peak (medial), and Ts-onset can be obtained on two separate parasternal short-axis views. (medial), Ts-peak (basal), Ts-onset (basal), with 6 segments each at the mitral valve level and at the mastoid muscle level, giving a total of 12 segments. 43A-43B illustrate an xy probe that provides apical four-chamber 4304 and apical two-chamber 4302 images that are to be viewed simultaneously.

Figures 44A-44B illustrate the extraction fraction probe measurement technique. Biplane probes provide EF measurements because visualization of two orthogonal planes ensures an on-axis view. Automatic boundary detection algorithms provide quantitative echo results to select implantable responders and guide AV delay parameter setting. As shown in Figure 44A, the XY probe acquires real-time simultaneous images from two orthogonal planes and images 4402, 4404 are displayed on a split screen. A manual contour tracing or automated border tracing technique can be used to trace the endocardial border at both end-systole and end-diastole, from which the EF can be calculated. The LV areas in the apical 2CH 4402 map and the apical 4CH 4404 map, A1 and A2 were measured at end-diastole and end-systole respectively. Use formula Calculate left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV). And by Calculate the winning percentage.

In the medical ultrasound industry, almost every ultrasound system can perform harmonic imaging, but this is done by using the second harmonic, or _fo , where _fo is the fundamental frequency. Preferred embodiments of the present invention use higher harmonics (ie, _3fo , _4fo , 5fo _, etc.) for ultrasound imaging. Harmonics higher than the second provide substantially improved image quality and spatial resolution. The advantages of higher harmonics include improved spatial resolution, minimization of clutter, and image quality with clear contrast between different tissue structures and sharper edge definition. This technology is based on the harmonic frequencies produced when an ultrasound wave propagates through tissue. The generation of harmonic frequencies is related to wave attenuation due to nonlinear sound wave propagation in tissues, which results in the appearance of harmonic frequencies that do not exist in the transmitted waves. The requirements for achieving this superharmonic imaging are: 1) low-noise linear bandwidth amplifiers; 2) high voltage linear transmitters; 3) wide bandwidth transducers; and 4) advanced signal processing.

Due to the nonlinearity of sound waves propagating through tissue, the waveform gradually attenuates and results in the appearance of harmonic waveforms that were not present in the original transmitted wave. The Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation can be used to theoretically calculate the nonlinear propagation of ultrasound in a tissue-like medium. For example, see "Nonlinear propagation applied to the improvement of resolution in Diagnostic medical ultrasound" by B. Ward, AC Baker and VF Humphrey, J. Acoust. Soc. Am., Vol. 101, pp. 143-163, 1997, above The entire contents of the document are incorporated into this case for reference. The calculation is based on finite difference approximation and is performed in the time and frequency domains. The KZK equation incorporates the combined effects of beam diffraction, energy dissipation due to medium attenuation, and waveform distortion. As shown in "Harmonic Ultrasonic Field of Medical Phased Arrays: Simulations and Measurements" by A. Bouakaz, CT Lancee and N. de Jong in 2003 IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, Volume 50, Pages 730 to 735, Both the diffraction term and the nonlinearity term are solved in the time domain, and the attenuation is explained in the frequency domain. The entire contents of the above-mentioned documents are incorporated into this case for reference. The calculated sound pressure levels ² at the fundamental, second and third harmonic frequencies in the tissue at the focal length are shown as a function of lateral distance in mm in Figure 45.

The calculation is based on a 3-cycle Gaussian pulse in which one of the fundamental frequencies of the transmitted waveform is 1.7 MHz. The second harmonic component is extracted using a bandpass filter with a flat response between low and high cutoff frequencies of 2.75 MHz and 4.02 MHz respectively. A bandpass filter is used to extract superharmonic components with a flat frequency response between 4.35 MHz and 9.35 MHz. The distributions have been scaled to have an on-axis amplitude of 0 dB. It can be seen from Figure 45 that the generation of superharmonic components is essentially limited to the strongest part of the fundamental wave beam, even more than the second harmonic profile. This has the beneficial effect that the superharmonic beamwidth is much narrower than the second harmonic beamwidth. It was found that the beam width at superharmonic frequency is half of the beam width of the transmitted fundamental wave, while the second harmonic beam width is only 30% narrower. As shown in Figure 45, for a fundamental beamwidth of 5.3 mm near the focus and 3.5 mm at the second harmonic, the superharmonic component has a beamwidth less than 2.6 mm. Figure 46 shows the normalized axial beam profile at the fundamental frequency, the second harmonic frequency and the third harmonic frequency. It is important to note that the third harmonic generated is proportional to the product of the amplitude of the fundamental wave and the amplitude of the second harmonic component. Therefore, the third harmonic is mainly generated in the focus area, where the fundamental frequency and the second harmonic frequency reach their highest levels. This has the beneficial effect that the superharmonic beamwidth is much narrower than the second harmonic beamwidth. Furthermore, since the superharmonic energy is essentially concentrated in the central portion of the beam, this represents a disproportionate reduction in side lobe energy. This property gives superharmonic technology the advantage of greatly removing off-axis echoes from scatterers located at the edge of the beam. Obviously this property is extremely beneficial for diagnosis, since most imaging artifacts and aberrations may be caused by the interaction of the ultrasound beam with side lobes at the edges of the beam profile.

Since different tissue structures produce different superharmonic responses and the superharmonic beam has the characteristic of a pencil beam profile with minimal side lobes, superharmonic imaging can provide a significantly better image between different tissue types and with better edge detection. Advantages of clearer and more contrasting images. Superharmonics can better suppress reverberation and artifacts, especially those that appear at the edges of the beam. Using superharmonics, lateral resolution and axial resolution can be improved.

A high-resolution phantom, the GAMMEX 404GS, can be used to evaluate the spatial resolution of the system. The size (diameter) of the reflector embedded in the 404GS Phantom is 100 um. First, a 15 MHz transmission waveform is used to generate the 404GS 15 MHz fundamental phantom image. Figure 47 shows the A-mode curve of the fundamental image, which also includes the 15 MHz transmitted waveform and the 15 MHz received A-mode waveform.

Use the FWHM plot of the 15 MHz image to indicate the spatial resolution of the 100 um pin phantom image. Figure 48 shows the half-maximum (FWHM) plots of a phantom A-mode image, a 15 MHz received fundamental wave image, and a 15 MHz transmitted waveform.

The following table lists the GAMMAX 404GS phantom measurement results and full width at half maximum (FWHM) spatial resolution comparison of fundamental, second harmonic and superharmonic images:

Due to the inhomogeneous nature of tissues in a body, it is well known that the echo signals received from the reflection of sound waves in the tissues have extremely high non-linearity. The nonlinear response of the tissue body leads to an increase in the width of the transmit-receive main beam and the level of side lobes, which in turn significantly reduces the lateral and contrast resolution of tissue ultrasound imaging. Yet another approach, referred to herein as tissue high-frequency imaging (THI) or tissue hybrid imaging (TMI) or superharmonic imaging, uses the nonlinear response of propagating waves in tissue, thereby minimizing these defocusing effects. . In medical ultrasound imaging, harmonic imaging is required where the transmitted waveform is a fundamental frequency F ₀ and the received signal of interest is a higher harmonic, typically the second harmonic (2F ₀ ) Or the third harmonic (3F ₀ ). The superharmonic image mode combines all higher harmonics (>=3f ₀ ). The harmonic signal of concern is generated by the image target in the body, and the harmonics in the transmitted waveform are not within the scope of concern. Therefore, it is crucial to suppress harmonics in the transmitted waveform.

Describes an ultrasonic pulser with one of three conventional square wave cycles. The spectrum of this waveform has a third harmonic component at about -4 dB below the fundamental frequency. There is a higher third harmonic component in the conventional square wave. Therefore, the conventional square wave is not suitable for realizing high-order harmonic imaging. Transmission waveform.

Figure 51A and Figure 51B illustrate a square wave and a spectrum of the square waveform. The spectrum has a third harmonic component and a higher third harmonic component at about -4 dB below the fundamental frequency; therefore, the square wave is not suitable for use as Realize the transmission waveform of high-order harmonic imaging.

The preferred embodiment herein uses a modified square wave by reducing the pulse high time and pulse low time to two-thirds of a conventional square wave. This modified waveform has a third harmonic component that is lower than that of a conventional square wave and approximates a pure sine wave. See, for example, Figure 52, which illustrates a two-thirds waveform. Figure 53 illustrates a third square waveform and a spectrum of a sine wave. This modified waveform has a lower third harmonic component than that of a conventional square wave and approximates a pure sine wave. This method utilizes two continuous transmission waveforms to image the first ultrasonic pulse and the second ultrasonic pulse alternately transmitted into the tissue. The two ultrasonic pulses are two-thirds square waveforms, and the difference between the first ultrasonic pulse and the second ultrasonic pulse is that the transmission waveform is inverted. The received superharmonic echo signals produced by these pulses are measured and combined by adding the echo signals produced by each of the ultrasonic transmission pulses.

An ultrasound imaging system includes a wideband amplifier having Noise base, bandwidth >22 MHz, two-thirds of high voltage under 4.5 MHz transmission waveform, pulse cancellation, and reception of one of the third harmonic, fourth harmonic and fifth harmonic frequencies waveform.

A comparison of fundamental wave imaging and superharmonic imaging is shown in Figure 54A and Figure 54B. Due to the nature of different tissue structures (such as fat, muscle, tumor cells) causing different distortions in sound wave propagation (that is, different tissue structures causing different attenuation of sound waves), harmonic images can distinguish different tissues better than fundamental wave images. structure. As can be seen in Figures 54A and 54B, superharmonic images provide significantly clearer and sharper contrast between different structures, ie, imaging properties. The superharmonic image is generated by transmitting two-thirds of the modified waveform at 4.5 MHz using pulse cancellation technology and consists of the third, fourth and fifth harmonics.

Due to the nonlinear nature of sound waves as they propagate through tissue, the waveform gradually attenuates and results in harmonic waveforms that were not present in the original transmitted wave. The nonlinear propagation of ultrasound in a tissue-like medium can be theoretically calculated using the Khokhlov-Zabolotskaya-Kuznetsov or KZK equations. The calculation is based on finite difference approximation and is performed in the time and frequency domains. The KZK equation incorporates the combined effects of beam diffraction, energy dissipation due to medium attenuation, and waveform distortion. Both the diffraction and nonlinearity terms are solved in the time domain, while attenuation is accounted for in the frequency domain. Most ultrasound systems can perform harmonic imaging, but this harmonic imaging is all performed using the second harmonic 2f _o , where f _o is the fundamental frequency. However, using higher harmonics higher than the second harmonic (ie, 3f _o , 4f _o , 5f _o , ...) can significantly improve image quality and spatial resolution. The advantages of higher harmonics are: improved spatial resolution, minimization of clutter, and image quality with clear contrast between different tissue structures and sharper boundary/edge definition. As can be seen from the soft tissue ultrasound images in Figures 54A and 54B, the visual anatomy and pathological information provided by superharmonic images can provide clinicians with additional information to help clinicians make diagnostic decisions regarding interventional procedures.

In addition to visual information, this article describes a technique that can provide quantitative diagnostic information of the tissue being imaged. U.S. Patent 5,361,767 has developed a tissue characterization technology based on ultrasound images. This tissue characterization technology based on ultrasound images can be used to non-invasively measure the absorption coefficients of different types of tissues in imaging, that is, a non-invasive ultrasound Imaging technology can be used to provide quantitative tissue characterization as well as anatomical and pathological diagnostic information of the tissue being imaged. The entire content of this U.S. patent is incorporated into this case for reference. The method has been tested on about 190 patients with breast abnormalities. The results indicate that patients with breast abnormalities can be summarized as having the following characteristics. • Normal breast tissue is in the range of 0.3 to 0.6 dB/Cm/MHz (depending on age and menstrual cycle); • Cancer in a range of 0.9 to 1.2 dB/Cm/MHz (depending on cancer type); • Fibroids in a range of 2.25 to 4.5 dB/Cm/MHz (depending on the type of fibrous tissue formation) • Cysts close to 0 dB/Cm/MHz

A superharmonic image-guided frequency tissue characterization process is described below. Once a superharmonic tissue image is acquired and a pathological region of interest (ROI) is identified on the image, the operator will draw a pathological region of interest through the ROI. Line 5490, see Figure 54C.

The ultrasound system automatically transmits a positive single pulse transmission waveform at f ₁ along the line of interest. The shape of the echo returned after envelope detection has two peaks, which correspond to the reflected waves from the front boundary and the rear boundary of the area of interest. The distance between the boundaries is shown in Figure 54D, where

Next, repeat the same procedure, but transmit a negative single-pulse transmission waveform at _f2 along the line of interest. Figure 54E shows the echo returned after envelope detection. Two of the peaks correspond to reflections from the front boundary and the rear boundary of the area of interest. The distance between the boundaries is the same, where: (1)

The absorption coefficient is a linear function of frequency α=kf. Next, the absorption coefficient between boundaries can be expressed as: (2)

In the case where there are N parallel lines along the region of interest, the software automatically repeats this process N times and then calculates an average k value based on measurements based on the N parallel lines 5492 (Fig. 54F). (3)

The software reports the N measured absorption coefficient values corresponding to the tissue representation along the N line of interest. Additionally, the software reports the average k _avg value, where k _avg (4)

In summary, one of the noninvasive ultrasound imaging techniques that can be used to provide clinicians with quantitative pathological tissue diagnostic information has been described.

Available in "Nonlinear propagation applied to the improvement of resolution in Diagnostic medical ultrasound" by B. Ward, A. C. Baker and V.F. Humphrey, J. Acoust. Soc. Am. 1997, Vol. 101, pp. 143-163 and also in 2003 Find out about ultrasound in "Harmonic Ultrasonic Field of Medical Phased Arrays: Simulations and Measurements" by A. Bouakaz, C.T. Lancee and N. de Jong in the IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, Volume 50, Pages 730 to 735 Additional details of the harmonic properties of imaging. These publications, in their entirety, are incorporated by reference.

It is important to note that breast ultrasound imaging is very operator dependent. A simple tool with software monitoring is proposed to guide a sonographer in performing a breast scan manually so that the scan completely covers the entire breast area without missing any area and is reproducible. A breast ultrasound transducer can be approximately 50 mm wide. During the scan, the operator manually moves the transducer in a linear direction covering approximately 50 mm × 200 mm breast area and then moves the probe to the starting point, offset the probe by approximately 50 mm in a medial lateral position , repeat the linear scan again. The imaging process is repeated until the entire breast area is covered. Acoustically clear hydrogel pads can be used to ensure total breast area is covered and the process is reproducible. As can be seen in Figure 55A, the hydrogel pad is marked with four overlapping rectangles with transducer placement and scan direction indications. Each rectangle is 50 mm wide and 200 mm long, with a central dot for nipple alignment. The scan is performed from head to toe, with parallel freehand scans covering the entire breast. In this example, four parallel overlapping scans cover the entire breast area.

Figure 55A shows a hydrogel pad marked with scanning direction and probe placement. The transducer was placed at the top of the first rectangle and moved to the bottom by hand. Then, move the probe to the start point of the second rectangle and repeat manually or by an automated controller. It is important that the freehand movements during scanning are slow enough to capture the ultrasound frames as a stream of images each spaced a sub-millimeter apart. The system will track the timing from the beginning of each scan sequence and provide a "warning beep" if the movement is too fast.

A transducer design with a 1D imaging array embedded between two motion guide arrays mounted in a direction normal to the central imaging array is shown in Figure 55B. This illustration illustrates a linear imaging array 5101 embedded between two vertical arrays 5102 for motion guidance. The linear array can be embedded between two smaller transducer arrays positioned normal to the central array. The number of elements of the central imaging array may be 128, 192 or 256. Each of the side arrays may have elements in the range of 16, 24 to 32, etc. The side array can be used to monitor the rate of freehand movement to ensure that the operator is using a constant rate and that the rate is slow enough to produce a stream of ultrasound frames that can be captured as a stream of images each spaced approximately 1 mm or less apart. . Arrays can also be used to ensure that the scanning system moves forward in a straight line. When the movement is too fast or the velocity is changing or the probe moves in a circular motion, the software sends a warning signal to the operator to adjust the movement.

Figure 55C illustrates an imaging sequence 5200 using position tracking of a transducer probe. Sequence 5200 includes positioning a transducer probe coupled to a movable ultrasound imaging device relative to a region of interest to be scanned (step 5202). Sequence 5200 includes the operation of activating an imaging process using a touch screen icon, menu, or keyboard input (step 5204). Sequence 5200 includes monitoring movement of the transducer probe during ultrasound imaging of a region of interest (step 5206). Sequence 5200 includes using a touch screen feature or sound waves to signal an operator controlling the movement of the transducer probe to adjust the movement of the transducer probe to guide imaging of the region of interest (step 5208). Sequence 5200 optionally includes activating an automated machine learning program operating on a processor of the mobile ultrasound imaging device to perform a computational diagnostic procedure (step 5210). Sequence 5200 includes displaying a diagnostic image or value on the display (step 5212).

Artificial intelligence (AI) and augmented reality (AR) transform medical ultrasound. Medical ultrasound applications using AI and AR can solve key issues that affect patient outcomes in many diagnostic and treatment applications. The problems posed by ultrasound imaging are solved by deep learning, which takes years to train deep learning to learn how to read ultrasound images. Clinical research has been reported on using deep learning AI algorithms to automatically detect tumor areas and detect heart disease, thereby assisting medical diagnosis with high sensitivity and specificity. Augmented reality (AR) integrates optical visual video and ultrasound images to provide surgeons with real-time image guidance to improve the recognition and enhanced visualization of anatomical structures during surgical procedures. The ultrasound system used for image acquisition can use a computer system with a processing capacity of 1000 GFLOP (giga floating point operations per second) or above to implement the mathematical calculations proposed by the deep learning algorithm, or to fuse/superimpose an ultrasound image on An anatomical feature is calculated on a user's optical view. AI and/or AR can greatly enhance or expand ultrasound imaging applications. Computationally enhanced ultrasound systems that can acquire real-time ultrasound images and can also perform the massive computations forced by their algorithms can advance clinical care in cancer treatment and diagnosis of cancer and heart disease. Preferred embodiments of the ultrasound system provide improved integration of portability, reliability, speed, ease of use, and affordability of the ultrasound system with computing power for advanced imaging.

Ultrasound (US) imaging has been widely used to diagnose and detect cancer, heart disease, etc. A drawback of using these diagnostic techniques for cancer detection is that manual diagnosis of each image pattern by a trained radiologist consumes a large amount of time. Although experienced doctors can manually locate tumor areas in a US image, it is still highly desirable to use algorithms that automatically detect tumor areas to assist medical diagnosis. Automated classifiers substantially upgrade diagnostic procedures in terms of accuracy and time requirements by automatically distinguishing between benign and malignant patterns. Neural networks (NN) play an important role in this, for example in breast and prostate cancer detection applications.

Pulse-coupled neural network (PCNN) is a biologically inspired type of neural network. It is a simplified model of the cat visual cortex with local connections to other neurons. PCNN can extract edge, segmentation and texture information from images. Efficient manipulation of different types of data requires only slight changes in PCNN parameters. This is an advantage over published image processing algorithms, which usually require information about the target before they can work. An accurate boundary detection algorithm of the prostate in ultrasound images can be obtained to assist radiologists in making a diagnosis. In order to increase the contrast of ultrasound prostate images, PCNN with a median filter is first used to adjust the intensity value of the original image. Thereafter, the PCNN segmentation algorithm can be executed to detect the boundaries of the image. Combining strength adjustment and segmentation reduces PCNN sensitivity to various PCNN parameter settings. The optimal choice of PCNN parameters can be difficult and may vary even for the same problem. The results show that compared with other machine learning techniques including Fuzzy C-mean and Fuzzy Type-II, the overall boundary detection overlap accuracy provided by the adopted PCNN method is high.

In particular, ultrasound (US) imaging has been widely used to diagnose breast cancer. Although experienced doctors can manually locate the tumor area in a US image, it is still highly desirable to develop algorithms for automatically detecting tumor areas to assist medical diagnosis. Peng Jiang, Jinliang Peng, Guoquan Zhang, Erkang Cheng, Vasileios Megalooikonomou, and Haibin Ling have developed an algorithm for automatically detecting breast tumors in US images: "Learning-based Automatic Breast Tumor detection and Segmentation in Ultrasound Images". The entire contents of the document are incorporated into this case for reference. The tumor detection procedure is formulated as a one-two-step learning problem: bounding boxes for tumor localization and accurate boundary delineation. Specifically, an exemplary method uses an AdaBoost classifier based on Harr-like features to detect a preliminary set of tumor regions. The initially detected tumor areas are further screened using a support vector machine (SVM) using quantitative intensity features. Finally, a random walk segmentation algorithm is performed on the US image to capture the boundaries of each detected tumor area. The preferred method was evaluated based on a dataset of 112 breast US images, including 80 histologically confirmed diseased patients and 32 normal patients. The data set contains one image per patient and the patients are between 31 and 75 years old. These measurements demonstrate that the proposed algorithm can automatically detect breast tumors as well as their locations and boundaries.

Rheumatic heart disease (RHD) is the most common heart disease among young people under the age of 25. Rheumatic heart disease often presents in childhood as strep throat and can progress into severe heart damage that kills or debilitates teenagers and young adults and makes pregnancy dangerous.

Although nearly eradicated in Europe and North America, the disease remains common in Africa, the Middle East, Central and South Asia, the South Pacific, and in poor areas of developed countries. RHD affects 33 million people worldwide. Although RHD can be diagnosed through ultrasound images, these ultrasound images are highly dependent on the user. Typically, it requires an experienced sonographer to obtain diagnostic quality ultrasound images. By using GPU-accelerated deep learning software to train a system to provide diagnostic ultrasound images, it would be beneficial for general practitioners to use the ultrasound system to diagnose RHD using an AI-based deep learning algorithm.

One computational neural network model with fully connected artificial neural nodes is shown in Figure 56A. The model includes L layers, and there are K nodes in each hidden layer. The output of each node in the lower layer is fully connected to the corresponding node in the upper layer with a trainable connection weight.

As can be seen in Figure 56A, each node is a two-dimensional image, where (i, j) represents the position of the pixel element; N _{l , k} (i, j) represents the k-th position of layer l (i, j ) pixel value; W _{l ,k} ^k' (i,j) represents the (i,j)-th element at the k-th position in the l layer and (i,j) at the k'-th position in the l+1 upper layer Connection weights between elements. The upper layer can be calculated by summing the product of the connection weight W _lk of each corresponding node at the lower layer and the output value N _l,k (i,j) of each node in the lower l layer. Pixel values N _{l+1 ,k'} (i,j) at k' positions, where i=1, 2,...,I; j=1, 2,...,J (5)

In this example, assume that the image size of each of the neural nodes in the hidden layer is (1000, 1000), that is, i=1000, j=1000, and there are 500 nodes in each hidden layer ,k=500. It can directly calculate the mathematical operations that need to be performed to calculate the value of the node on the upper layer based on the input from the lower layer, that is, 1 × 10 ⁹ floating point operations. For a neural network with 1000 layers (i.e., l = 1000), the total number of calculations required is 1 × 10 ¹² floating point operations, that is, when conducting clinical evaluation of RHD in developing countries, A processor with 1000GFLOP is used to calculate the required data using this deep learning artificial neural network. In addition to the ultrasound system, clinicians can carry 76 high-end Linux laptops with Nvidia GPUs capable of over 1,000 GFLOPs. Preferred embodiments of the present application include a tablet ultrasound system as described herein, in which a graphics processing unit is integrated into the tablet or removable system housing and connected via a bus or other high speed/data rate connection to the central processing unit of the ultrasound system.

A neural network consists of units (neurons) arranged in several layers, which convert input vectors into certain outputs. Each unit accepts an input, applies a (usually non-linear) function to the input, and then passes the output to the next layer. Typically, networks are defined as feedforward: a unit feeds its output to all units on the next layer, but not to previous layers. Weights are applied to the signals passed from one unit to another, and these weights are tuned during the training phase to adapt a neural network to the specific problem faced. This is the learning stage. The goal of neural network pattern recognition is to group observed input patterns into one of a set of known categories. The backpropagation classifier is one of the most intensively studied NN classifiers (NNC) and has been applied to problems such as face, character and speech recognition and signal prediction. Radial basis function (RBF) classifiers effectively generalize in high-dimensional spaces and provide low error rates, and their training time is much shorter than that of backpropagation classifiers. In addition, the RBF classifier forms a smooth decision region with good performance and performs well when there is little training data. Next, the real-time implementation of a backpropagation algorithm and an RBF algorithm is described. In addition, the back propagation and RBF training algorithms are explained.

Backpropagation is a method widely used in artificial neural networks for remote sensing image classification. It is used to calculate the error contribution of each neuron after processing a batch of data (image recognition, multiple images). In the context of machine learning, backpropagation is often used by gradient descent optimization algorithms to adjust the weights of neurons by calculating the gradient of the loss function. This technique is sometimes called error backpropagation because errors are calculated at the output and spread back through the network layer.

Backpropagation requires that the desired output is known for each input value. It is therefore considered a supervised learning method (although it is used in some unsupervised networks, such as autoencoders). Backpropagation is also a generalization of the delta rule to multi-layer feedforward networks, achieved by using chain rules to iteratively calculate the gradient of each layer. It is closely related to the Gauss–Newton algorithm and is part of the ongoing research on neural backpropagation. Backpropagation can be used with any gradient-based optimizer, such as L-BFGS or truncated Newton.

Backpropagation neural networks were developed by Rumelhart et al. as a solution to the problem of training multi-layer perceptrons. Backpropagation is often used to train deep neural networks, a term used to describe neural networks with more than one hidden layer. Research has shown that neural network models used for supervised classification of remotely sensed images greatly improve the accuracy of image classification because neural network classifiers can study discontinuous non-linear classification models. In addition, the neural network model has good robustness and adaptability and can solve problems under specific conditions. Finally, the neural network can combine the analysis of multiple parameters (such as shape, spectrum, texture, etc.) of the remote sensing image to extract potential information.

The backpropagation training algorithm is an iterative gradient descent method designed to minimize the mean square error between the actual output and the desired output of a multi-layer feedforward. The algorithm starts with a network with random weights. Training vectors are repeatedly applied to the network, and the weights are adjusted after each training vector according to a set of equations specified by the algorithm until the weights converge and the error function is reduced to an acceptable value.

Next, the calculation algorithm is reviewed. As ^indicated in Figure 56B, _xi represents the input vector, _wijh represents the connection weight between the input ^layer and the hidden layer, and _wijo represents the connection weight between the hidden layer and the output layer. In addition, u _j = f(y _j ) represents the excitation of the hidden layer, where is the dot product output, and v _j = is the j-th element of the actual output pattern generated by the network. In both cases, f(.) is the nonlinear activation function of a node. In the weight update stage, the update amounts of weights w _ij ^o (t) and w _ij ^h (t) are given by the following formulas: (6) and (7) where t is a time index. The difference term is specified by the following equation: (8) (9)

In equation (8), T _j is the j-th component of the target output pattern. Therefore, the implementation of backpropagation training rules involves two stages. During the first phase, the input is presented and propagated forward through the network to calculate the output values u _j and v _j . During the second phase, starting at the output node, the error term is propagated backward to nodes in the lower layer and the weights are adjusted accordingly.

An RBF classifier has an architecture very similar to that of a three-layer feedforward network. Figure 56B shows an RBF classifier where the connection between the input layer and the hidden layer has unit weight and therefore does not have to be trained. Nodes in the hidden layer, called basis function (BF) nodes, may have a Gaussian impulse nonlinearity specified by a specific mean vector µ _i and variation vector σ _i ² , where i=1, 2,...,F, And F is the number of BF nodes. Given an N-dimensional input vector X, each BF node i outputs a tensor value y _i that reflects the BF excitation caused by the input: (10) where h is a proportional constant of the variation, x _k is the k-th component of the input vector X = [x ₁ , x ₂ ,..., x _N ], and µ _ik and σ _k ² are basis function nodes respectively The mean vector of i and the k-th component of the variation vector. Inputs close to the center of the radial BF (in the Euclidean sense) form a higher excitation, while inputs far from the center form a low excitation. Since each output node of the RBF network forms a linear combination of BF node excitations, the network connection between the middle layer and the output layer is linear: (11) where z _j is the output of the j-th output node, y _i is the excitation of the i-th BF node, w _ij is the weight connecting the i-th BF node to the j-th output node, and w _oj is the The deviation or threshold value of j output nodes. This bias is caused by the weight associated with a BF node that has a constant unit output regardless of input (in this case, BF node i = 0). An unknown input vector X is classified as belonging to the class associated with the output node j having the maximum output z _j .

It is important to note that in equation (10), RBF(0) is chosen as a Gaussian function. In general, if the first derivative of a function is completely monotonic, the function can be used as a radial basis function. The following gives a series of functions that can actually be used for classification (12) in .

An iterative gradient descent method can be used to train the weights W _ij in the linear network to minimize the mean square error between the actual output and the desired output of an RBF network. To illustrate this approach _, let the actual RBF classifier _output for a given input vector =0, and j = I,…,M (13) and M is the number of categories. In equation (13), d _j is the j-th component of the desired target output pattern. Define the optimal weight as the weight that minimizes the squared error of the net output. (14) Minimum error can be achieved by choosing weight changes in the opposite direction of the gradient of this error function, thus performing a gradient descent of the error function. that is: (15) Next (16) The algorithm starts with a network with random weights. Training vectors are repeatedly applied to the network and the weights are adjusted according to equation (16) after each training vector until the weights converge and the error function is reduced to an acceptable value.

Next, the calculation algorithm is reviewed. As indicated in the network structure shown in Figure 56B, _Xi represents the input vector, and _wij represents the connection weight between the hidden BF node and the output layer. Therefore, the implementation plan of RBF training rules involves two stages. During the first phase, the input is presented and propagated forward through the network to calculate the output values y _i and z _j . During the second phase, the weights are adjusted according to equation (16). This process is repeated until the weights converge and the error term reaches an acceptable value.

Conventional laparoscopy provides a planar representation of the three-dimensional (3D) surgical field and cannot visualize internal structures located beneath the surface of visible organs. Due to the deformable nature of soft tissue organs, real-time fusion of computed tomography (CT) and magnetic resonance (MR) images with laparoscopic views is difficult. Taking advantage of emerging camera technology, a real-time stereoscopic augmented reality (AR) system has been developed to perform laparoscopic surgery by merging real-time laparoscopic ultrasound (LUS) with stereoscopic video. The system performs two important visual cues: (1) true depth perception, allowing for a better understanding of the 3D spatial relationships between anatomical structures, and (2) visualization of key internal structures and a more comprehensive visualization of the surgical area. Using laparoscopic ultrasonography (LUS) can be challenging for both novice and experienced sonographers. Laparoscopic cameras have made significant improvements in image quality in recent years as high-definition (HD) cameras are now integrated into laparoscopic systems. However, conventional laparoscopes are monocular and can only provide a single camera view. Therefore, the resulting display is a planar representation of the three-dimensional (3D) surgical field and does not provide the surgeon with a good understanding of the 3D spatial relationships between anatomical structures. In addition, despite the rich surface texture, laparoscopic video does not provide information about the internal structures located beneath the surface of the visible organ. Good depth perception and knowledge of internal structures are both critical to the safety and effectiveness of laparoscopic procedures and to improving surgical outcomes.

Laparoscopic augmented reality (AR) is a method of overlaying laparoscopic ultrasound video onto optical video to provide enhanced intraoperative visualization, such as Xin Kang, Mahdi Azizian, Emmanuel Wilson, Kyle Wu, Aaron D.Martin , "Stereoscopic augmented reality for laparoscopic surgery" by Timothy D. Kane, Craig A. Peters, Kevin Cleary, Raj Shekhar, Surg Endosc (2014) 28:2227–2235 and Xinyang Liu, Sukryool Kang, William Plishker. George Zaki. "Laparoscopic stereoscopic augmented reality: toward a clinically viable, electromagnetic tracking solution" by Timothy D. Kane and Raj Shekhar; J. Med. Imag.3(4),045001 (2016), doi:10.1117/1.JMI.3.4. 045001, the entire contents of both of these public cases are incorporated into this case for reference.

Intraoperative imaging has the advantage of providing real-time updates of the surgical field and enabling AR rendering of moving and deformable organs located in the abdomen, chest, and pelvis. A clinically feasible laparoscopic AR system based on EM tracking can be used. The performance of the EM-AR system has been rigorously verified, with clinically acceptable registration accuracy and visualization delay.

The inventive system shown in Figure 58A can perform the process illustrated in Figure 57, wherein a laparoscopic transducer probe 4950 having an EM sensor 4952 can be operated using a touch screen as described herein. Come activate 4902. The 4904 device can be optionally calibrated for a specific imaging application and can capture 4906 optical and ultrasound images simultaneously or sequentially. Images can be presented in split-screen format or merged (overlaid) into video format 4908. A neural network can be used to process the 4910 data to generate diagnostic data. The system includes a core processor and memory 4954. The core processor may include one of the Nvidia graphics processor units previously described herein, which may be programmed or configured to function as a neural network. road. One or more neural networks can be configured for discrete learning algorithms that are consistent with the use of an ultrasound laparoscope for individual anatomy (such as heart, lung, kidney, gastrointestinal imaging) The probe is associated with the imaging protocol. Probe 4950 may include an imaging camera, such as a CMOS or CCD imaging device. Alternatively, an imaging catheter or probe can be used to generate imaging data directly connected to the mobile ultrasound system.

The embodiment of Figure 58B includes a graphics processor 4956, such as a Nuidia Quadro P3000 graphics card including a 6GB video memory. This graphics processor is configured to perform the machine learning methods described herein, such as may be purchased from Bay Labs, Inc. of San Francisco, California and as described in U.S. patent application US2018/0153505 filed on December 4, 2017. The entire contents of this U.S. patent application for the software product described are hereby incorporated by reference.

A large number of mathematical calculations are required to overlay or map a laparoscopic ultrasound video onto an optical video. Let p _us = [xy 0 1] represent LUS, a point in the laparoscopic ultrasound image coordinates, where the z coordinate system is 0. Let p _Lap ^u represent the point corresponding to p _us in the undistorted laparoscopic optical video image. If T _A ^B is denoted as a 4x4 transformation matrix from the coordinate system of A to the coordinate system of B, then the relationship between p _us and p _Lap ^u can be expressed by the following equation. (17) Among them, US refers to the laparoscopic ultrasound image; EMS _us refers to the sensor attached to the laparoscopic ultrasound probe; EMT refers to the EM tracking system; EMS _Lap refers to the 3D optical field of view attached to The sensor; the lens refers to the camera lens in the 3D range; I ₃ is the unit matrix of size 3; and K is the camera matrix. T _us ^EMSus can be obtained from ultrasound calibration; T _EMSus ^EMT and T _EMT ^EMSLap can be obtained from tracking data; T _EMSLap ^lens can be obtained from hand-eye calibration; and K can be obtained from camera calibration. P _lap ^us can be distorted using lens distortion coefficients also obtained from camera calibration.

The computational requirements for augmented reality imaging using composite ultrasound and optical video images are directly calculated by mapping a point in the laparoscopic ultrasound image to a corresponding point in the laparoscopic optical video image based on equation (17). Let the camera matrix size be (500,500) pixels and the ultrasound image size be (500,500) pixels. According to equation (17), the total number of calculations required is approximately 1x10 ¹² floating point operations, or 1000GFLOPs, where the graphics processor is used to provide the solution in real time.

In addition to the ultrasound system used to acquire laparoscopic ultrasound images, a laptop (Precision M4800, Dell; 4-core 2.9 GHz Intel CPU) to implement the fusion of optical imaging and ultrasonic imaging. However, one of the better designs described in this article uses a computationally enhanced ultrasound system. In addition to Intel processor CPUs, the system can be incorporated into a multi-core GPU that can provide processing capabilities of more than 1000 GFLOP to adapt to the computing requirements of the AI and AR applications illustrated above.

The preferred embodiments described herein provide a flexible system for processing ultrasound data. As shown in Figure 58C, the system can process beamformed image data transmitted from the beamforming engine 5402 to the processor 5406 via the bus 5404. The processor 5406 runs a number of ultrasound processes including scan conversion and Doppler processing. Software operation 5405. The selected imaging mode selected by the user via voice command or keyboard at the touch screen interface defines the data and images 5408 transmitted to the display.

When the user selects an imaging mode that requires more complex computing or imaging processing capabilities, the processor 5406 will access the machine learning and/or image processing applications 5410 described herein, as shown in Figure 58D. This may include optional options for processing RF data generated by the transducer, which may also be transferred from engine 5402 to processor 5410 via bus 5404. Ultrasound application 5405 may utilize RF data or data formatted as bitmap image data for processing by processing application 5410 , which transmits the required data to graphics processing unit 5420 . Processor 5420 may utilize memory 5422 to store data for further processing or transmission back to CPU application 5410 before storing the display or wired/wireless transmission to a network.

Figure 58E shows an image of a circuit board layout of a tablet computer configuration in which the processor 5406 and the graphics processing unit 5420 are mounted on a single circuit board. Tablet computers can have a display diameter in the range of 8 to 16 inches, where all operations can be actuated by touch operations. Alternatively, the tablet may display a touch-activated icon for voice activation, which may be operated via an external keyboard or remotely via a wired or wireless connection over a network.

Figure 59 illustrates the use of a shared memory to provide communication with an external application. In a tablet or other removable ultrasound device utilizing a shared memory as described herein, stored data may be accessed by multiple different applications on the same or different processors. Additional details regarding shared memory operation in ultrasound devices can be found in U.S. Patent No. 9,402,601 and U.S. Published Application No. 2004/015079, filed March 11, 2003, both of which All contents are incorporated into this case for reference. Shared memory 5920 may be accessed using one of the control circuits 5960 in a tablet or laptop computer, which sends data packets to the tablet or portable ultrasound system running remotely or as described herein. A third-party application 5940 runs inside the device and receives data packets. Shared memory 5920 can be used to use a third-party application to transfer individual image frames or streaming video for processing, which processing can include machine learning or augmented reality operations. Figure 60A illustrates a distributed processor system or GPU 4954 integrated into a tablet or laptop ultrasound system. A plurality of core processors 6020 can be connected to a plurality of GPUs 6040 and a shared memory 6050 via a bus 6060. Tablet computer devices employing touch screen actuation of ultrasound imaging operations may include a touch actuation menu of operations performed by a graphics processor. For example, a software program available from Bay Labs, Inc. may be opened via a touch-activated icon or menu list on the tablet's touch screen. An exemplary program for use with an imaging procedure may be the EchoMD Auto EF product available from Bay Labs, Inc., which is used to automatically select images or videos from an echocardiographic study and also perform automated extraction. Fractional truncation.

Shown in Figure 60B is a screenshot of a Bay Labs, Inc. software engine displayed on a touch screen display of a tablet computer, in which a plurality of graphical visual indicators 7002, 7004 enable a system operator to control the system based on a horizontal bar. The size adjusts the position and/or movement of a probe, and the horizontal bar provides feedback by indicating to the user the effectiveness of manual manipulation of the probe. Another product is available from DIA Imaging Analysis, Ltd (Be’er Sheva, Israel), such as the LVIVO EF fractionation evaluation tool for use with the bimodal transducer probe described in this article.

Other quantitative features include thyroid cancer detection methods available from AmCad Biomed Corporation in Taipei, Taiwan. Such methods are described in U.S. Patent No. 8,948,474 and also in "Quantitative analysis of echogenicity for patients with thyroid nodules" by Wu et al., Nature Scientific Reports, V6:35632; DOI 10.1038/srep v 35632, October 2016 , the entire contents of this U.S. patent are incorporated into this case for reference.

An example of a machine learning technology according to the present invention is as follows: 1. Obtain ultrasound image data: I(x) 2. Place a certain bounding box around each area of interest on the image to mark this data, thus forming A training data set. 3. For each image and for each map, form a set of features based on its sobel gradient: g _o (I(x)) 4. Use these gradients to use Haar wavelets and an AdaBoost algorithm to detect lesions Or distinguish between other target tissues of interest and normal tissues. Haar wavelet is the integral difference of features around an image position. AdaBoost works by selecting a set of Haar wavelets that best distinguish lesions or other selected and unselected regions by minimizing the empirical error based on a training data set and by optimally combining these wavelets with a set of threshold values. a set of weights. More precisely, the AdaBoost learning function: (18) where h _t (x) is a weak classifier and corresponds to: (19) 5. Use f(x) for detecting lesions in the selected image.

The systems and methods presented herein may include one or more programmable processing units having associated executable instructions stored on one or more computer readable media, RAM, ROM, hard drive and/or hardware. In exemplary embodiments, hardware, firmware, and/or executable code may be provided, for example, as upgrade modules for use with the processing systems described herein. For example, hardware may include components and/or logic circuitry for executing embodiments taught herein as a computing program, such as to control one or more ultrasound imaging sequences.

Contains a display and a processing unit to transmit calculated/processed data, such as topographic 2D or 3D image data. In an exemplary embodiment, a display and/or computing device is used to visualize the derived ultrasound imaging information relative to a conventional two-dimensional image overlay, as described herein. In an exemplary embodiment, the display may be a three-dimensional display that facilitates visualizing imaging information.

The actual software code or control hardware that may be used to implement some of the embodiments of the invention is not intended to limit the scope of such embodiments. For example, certain aspects of the embodiments set forth herein may be implemented in code using any suitable programming language type, such as assembly coding, C, C#, or C++, using, for example, conventional or object-oriented programming techniques. . This code is stored or preserved on one or more suitable non-transitory computer-readable media of any type, such as magnetic storage device media or optical storage device media.

In addition to the above, an exemplary mobile ultrasound system suitable for use by embodiments of the present invention and shown in Figure IB is now further described. It should be understood that the descriptions of the illustrative systems set forth below are intended to illustrate and explain features of the systems and are not intended to be limiting. It will also be understood that modifications to the illustrative systems described below that are consistent with the description contained herein are deemed to be within the scope of the present invention.

Exemplary mobile ultrasound systems produce high-resolution images intended for use by qualified physicians performing analysis by ultrasound imaging or body fluid flow. Specific clinical applications and examination types include but are not limited to: fetus, abdomen, surgery (abdomen, organs and blood vessels), pediatrics, small organs (thyroid, breast, testicles); neonatal and adult skull; transrectal, transvaginal, muscle Bones (common and superficial); Heart (adults &children); Peripheral blood vessels.

Typically, ultrasound is primarily an operator-dependent imaging technology. Image quality and the ability to make a correct diagnosis based on the scan depend on the precise image adjustments and appropriate control settings applied during the examination. An exemplary mobile ultrasound system provides tools to improve or optimize image quality during patient scans in all imaging modalities. This system incorporates one of the graphics processing units previously described herein, for example, but not limiting, as illustrated in Figures 9A-9F and Figures 46-60B.

Mobile ultrasound systems are available in versions with different feature levels.

The following table lists the scan modes included with each version.

The mobile ultrasound system can use 256 digital beamforming channels to achieve two-dimensional digital imaging. This imaging mode achieves excellent image uniformity, tissue contrast resolution and maneuverability at frequencies from 2 MHz to 12 MHz. High channel count supports true phased arrays and high component count imaging probes. The 2D scan data is displayed in the 2D imaging window.

The movable ultrasound system can simultaneously achieve two-dimensional (2D mode) imaging and M-mode imaging. This combination is valuable for efficient assessment of mobile structures. M mode can be used to determine the movement pattern of objects within the ultrasonic beam. This mode can be used to view heart movement patterns. M mode displays scan data of anatomical structures in a 2D imaging window and motion scans in a time series window.

Color Doppler mode is used to detect presence, direction and relative blood flow velocity by assigning color code information to these parameters. Plots color on a region of interest (ROI) overlaid on a 2D image. Non-reverse flow toward the probe is assigned a red shading, and flow away from the probe display is shown in blue shading. The average Doppler shift is then displayed against a grayscale scan of one of the structures. Ultrasound-based imaging of all forms of red blood cells is derived from the received echoes of the transmitted signal. The main characteristics of this echo signal are its frequency and its amplitude (or power). The frequency shift is determined by the movement of red blood cells relative to the probe - blood flow toward the probe produces a higher frequency signal than blood flow away from the probe. The amplitude depends on the amount of blood moved within the volume sampled by the ultrasound beam. A high frame rate or high resolution can be used to control scan quality. Higher frequencies resulting from rapid blood flow are shown in lighter colors, and lower frequencies are shown in darker colors. For example, the proximal carotid artery is often shown in bright red and orange because blood flow is toward the probe and the frequency (velocity) of blood flow in this artery is relatively high. In contrast, blood flow in the jugular vein appears blue because it flows away from the probe. Display color Doppler scan data in the 2D imaging window.

A pulse wave Doppler (PWD) scan generates a series of pulses that are used to study the movement of blood flow along a desired scan vector in a small area, called the sample volume or sample gate.

The X-axis in the chart represents time, and the Y-axis represents Doppler shift. If an appropriate angle between the sonicated beam and the blood flow is known, the frequency shift between successive ultrasound pulses caused primarily by moving red blood cells can be converted into velocity and blood flow. Gray shading in the spectrum display indicates signal strength. The thickness of the spectral signal indicates laminar or turbulent flow (laminar flow usually displays a narrow frequency band of blood flow information). In a mobile ultrasound system, pulse wave Doppler and 2D are displayed together in a mixed mode display. This combination enables a user of the system to monitor the exact location of the sample volume on a 2D image in the 2D imaging window while simultaneously acquiring pulse wave Doppler data in the time series window.

In 2D scanning, the field lines allow a user to adjust the ultrasound cursor position, the two parallel lines (similar) allow the user to adjust the sample volume (SV) size and depth, and the line crossing the above lines allows the user to adjust the correction angle .

A continuous wave Doppler scan displays all velocities present over the entire length of the ultrasonic cursor. This mode is used for imaging extremely high velocities, such as those caused by a leaking heart valve. Regarding pulse wave Doppler scanning, the X-axis of the graph represents time, and the Y-axis represents Doppler frequency shift.

Triple scan mode combines simultaneous Doppler imaging or non-simultaneous Doppler imaging (color Doppler) with pulsed wave Doppler imaging to view arterial or venous velocity and blood flow data. The triple scan mode allows a user to perform range gate blood flow assessments. Tertiary applications include vascular research, phlebology, peripartum and radiology. The lower three-dimensional image in Figure 61 shows the larger shadow vein.

The exemplary mobile ultrasound system may also include an optional image optimization package that sharpens images. The removable ultrasound system can be configured with a needle guide for tissue biopsy, fluid aspiration, amniocentesis and catheter placement. The system can also be incorporated into other manufacturers' cryoablation (or targeted ablation) products and brachytherapy products. The mobile ultrasound system scans the anatomy or blood vessels for size, location and patency and provides guide lines between which the needle will appear. For biopsy and vascular puncture applications, a needle guide set guides the needle to the appropriate location for percutaneous vascular puncture and nerve block. The needle guide allows a user to guide the needle to the center of a blood vessel or tissue mass, thereby helping to avoid adjacent vital tissue. A user can see the anatomy in real time before, during and after the procedure, and images and frame loops can be saved for future reference.

For cryoablation or brachytherapy applications, the system may include an insertion template and a stepper or stabilizer. The companies providing these systems define the process for these applications. The system software displays inserted grids and pins during the scan to demonstrate process progress.

A user can use the needle guide in the following modes: 2D mode; Color Doppler; M mode (movement mode). The movable ultrasound system consists of a probe, an electronic device envelope and system software. In the exemplary movable ultrasound system, all probes can be used in all scan modes.

When a user starts the system software, the imaging window is displayed. The imaging window can contain a 2D window above the time series window (if the scan mode is selected to produce a time series window). The 2D view window is displayed in all scan modes; the time series view window is only displayed when scanning in M mode, PWD mode, CWD mode or triplex mode. If a control, button, key, or menu is grayed out, it indicates that the function is not available for the current situation. The imaging screen may include a status bar in the lower corner.

The status bar displays indicators including network connectivity when the computer is connected to a network. If there is no connection, a red System Power displays the remaining power of the system battery and whether the AC power supply is connected. In the illustration, the battery is fully charged and the system is connected to an AC power source. As the battery discharges, the green band disappears from right to left. When the battery is almost completely discharged, a single red band appears at the left end of the indicator. When the battery is partially discharged and the AC power supply is connected, a yellow glowing ball appears on the battery icon. When the battery is fully charged and the AC power supply is connected, a power plug icon will appear below the battery icon. The imaging window contains a text display showing information about the current scan. The image control settings displayed vary based on scan mode and other factors.

As depicted in Figure 62, an exemplary display may include a mechanical index, thermal index, reference column type, image control settings: graph/persistence/scan frequency//2D gain/dynamic range, a depth setting, frame rate , scan mode, PRF settings, wall filter settings, color frequency and focus. In the exemplary mobile ultrasound system, the 2D gain is initially shown to be 50. This is not an absolute value; the actual gain varies from preset to preset, but is always shown as 50 initially. When a user changes the gain using the gain knob, the displayed value increases or decreases. When the cardiac exam type is selected, the depth gauge and focus indicator are located on the ultrasound cursor, as shown in the imaging window image.

A user can view a saved study in the review window. When reviewing a saved study, a user can add annotations and measurements in the same manner as on the imaging window.

The exemplary mobile ultrasound system includes a console 6310 shown in Figure 63 that contains controls 6320 for configuring and operating the mobile ultrasound system. 1: Power button 13: Color mode key 2: Baseline key 14: 2D mode key 3: Standard key 15: CW mode key 4: Page turning key 16: Gain/active control 5: Not assigned 17: Clear key 6: Operation keys 18: Calculation keys 7: Split key 19: Caliper key 8: Focus key 20: Select key 9: Depth key 21: Cursor key 10: Main body mark key 22: M mode key 11: Text keys 23: Zoom control 12: PW mode key 24: Update key

The console contains a numeric keyboard, a set of system keys, TGC sliders, soft key controls and numerous controls for ultrasound imaging functions. The numbered ultrasound imaging controls in the exemplary console perform the following functions: 1. Power: start the system and shut down. 2. Baseline: Change the Doppler baseline in PW, CW and color Doppler modes. Pressing the top of the key moves the baseline up, and pressing the bottom of the key moves the baseline down. 3. Scale: Change the velocity scale (by changing the PRF) in PW, CW and Color Doppler modes. Pressing the top of the key increases the PRF, and pressing the bottom of the key decreases the PRF. 4. Page turning: Change the displayed set of functional soft keys. 5. This key may not be assigned. 6. Control: In 2D, Color Doppler or PWD mode, this key controls the ultrasonic signal. Press the left end of the key to operate left, and press the right end to operate right. 7. Split: Press the left end of the key to open the split screen when the left screen is active, or enable the screen when the split screen is turned on. With the right screen active, press the right end of the key to open split screen or enable the right screen. Press the end of the key corresponding to the active screen to exit split screen. 8. Focus: Change the depth of signal focus. Pressing the top of the key moves the focus up, and pressing the bottom of the key moves the focus down. 9. Depth: Change the total image depth. Pressing the top of the key moves the image depth up, and pressing the bottom of the key moves the image depth down. 10. Subject Marker: Insert subject mark in the scan. 11. Text: Enable text entries and annotations during scanning. 12. PW: Enter and exit pulse wave Doppler mode. 13. Color: Enter and exit color Doppler mode. 14. 2D: Enter 2D mode. 15. CW: Enter and exit continuous wave Doppler mode. 16. Gain/Active: Turn the knob to change the gain. Pressing the active button toggles between active scan modes and the softkeys associated with those modes. 17. Clear: Erase the currently selected annotation or measurement. 18. Calculation: Open the calculation menu. 19. Caliper: Start general measurement. Press this key to repeatedly cycle through the available calculations. 20.Select: Select a trackball function. The selected function is highlighted in blue above the softkey display. 21. Cursor: Select and show or deselect and hide the ultrasonic cursor. 22. M mode: Enter and exit M mode. 23. Zoom: Press to enter ROI square zoom or exit zoom mode. Move to quick zoom 24. Update: Turn on and off the update of 2D images in PWD and CW modes. 25. Left input: select and deselect items. When the window screen is activated, the left input key acts as the left button on a mouse. 26. Trackball: Control the movement of cursors, ROI and other features. 27. Right input: Open the context menu. When the window screen is activated, the right input key acts as the right button on a mouse. 28. Freeze: Freeze and unfreeze scans. 29. Save: Save a single frame image. 30. Record: Store for one cycle.

On the top left side of the console is a set of system keys that control which windows are launched. It includes: Patient - opens the patient window, Preset - opens the default menu, Review - opens the review window, Report - opens the report window, End Study - closes the current study, Probe - opens the imaging window, Setup - opens the settings window.

The keys directly below the keyboard control the functions of the softkeys displayed across the bottom of the imaging window. Softkey functionality depends on the connected probe, the scan mode selected, and whether the scan is active or frozen. The following illustrations show examples of soft keys when the image is active and frozen. The softkeys displayed by the system depend on the connected probe, selected scan mode, and selected exam. The display viewed by a user may differ from the illustrations displayed.

It will be appreciated that in some embodiments, console controls may be provided via a touch screen display rather than being configured as a separate physical housing.

The system can include an ECG module, an ECG guide set - 10 electrode settings, a foot switch (Kinessis FS20A-USB-UL), a medical grade printer and one or more transducer probes. The exemplary mobile ultrasound system complies with Standard for Real-Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment (UD3-98). UD3-98)). When the relevant output index is below 1.0, the index value is not displayed.

When operating in any mode in which the freeze function is disabled, the window displays the acoustic output index associated with the currently active probe and operating mode. Minimizing the index value displayed in real time allows implementation of the ALARA principle (exposing the patient to ultrasound energy as low as reasonably achievable).

In the exemplary mobile ultrasound system, to select a scan mode, a user presses the appropriate key on the console: For 2D, press the 2D key; for M mode, press the M mode key; for color Doppler, press the color key; for pulse wave Doppler, press the PW key; for continuous wave Doppler, press the CW key.

In the exemplary mobile ultrasound system, to perform an ultrasound examination in 2D mode, color Doppler mode, or M mode, the user completes these steps: 1 Load or form patient information. 2 Press the console key for the desired scan mode: 3 Press the Preset button and select a preset from the preset menu. The system software loads the default image control settings optimized for the selected default and connected probe. A user can now use the probe to perform an ultrasound examination. Refer to the appropriate clinical examination process being performed by a user. 4 If necessary, use the soft keys to adjust the image controls. 5 Press the Freeze key. Change softkey controls to allow printing, measurement, and other functions.

To perform a check in pulsed wave Doppler mode, a user can complete these exemplary steps: 1 Make a check in 2D mode, 2 Press the PW key on the console. 3 Move the range gate to the appropriate position and press the left input key on the console. 4 Use the soft keys to adjust any image control settings as needed. 5 Press the Freeze key. Softkey controls change to allow printing, measurement, and other functions.

To perform a check in three-worker mode, a user can complete these illustrative steps: 1 Perform a check in Color Doppler mode (scan without freezing). 2 Press the PW key on the console. The software turns on the triple mode. 3 Move the range gate to the appropriate position and press the left input key on the console. 4 Use the soft keys to adjust any image control settings as needed. 5 Press the Freeze key. Change softkey controls to allow printing, measurement, and other functions.

When a user switches to triple mode, both the original 2D scanning mode and the PWD mode are valid. This depends on whether the option is set to simultaneous mode.

Record real-time images through the frame and temporarily store the real-time images on the computer. Depending on the mode selected by a user, the system records a certain number of frames. For example, 2D mode allows a user to capture up to 10 seconds in a frame loop.

Pulse wave Doppler (including triplex) and M-mode scans only save a single frame of the 2D image, and a user cannot save cycles of these scan modes.

When a user freezes a live image during a scan, all movement hovers within the imaging window. Freeze frames can be saved as a single image file or as an image loop. For M mode, PWD and triple mode, the software saves time series data and a single 2D image.

A user can unfreeze the frame and return to the live image display at any time. If a user presses the freeze key without saving the image or while the image is looping, the user loses the temporarily saved frame.

To freeze the displayed image while performing an ultrasound scan, a user presses the freeze key. When a scan is frozen, a freeze icon appears on the imaging screen directly above the left soft key. A user can then use the gain knob or keyboard arrow keys to move around the frame acquired during the scan.

To start a new scan, a user presses the freeze key again. If a user does not save the frozen image or loop, starting a real-time image scan will erase the frame data. Before a user obtains new scanned data, the user saves or prints any desired images.

Reviewing an image loop is useful for focusing images during brief segments of a scan session. When a user freezes an image, a user can use the gain knob to go through the cycle frame by frame to find a specific frame. A user can also do this by turning the Gain knob until the desired frame is displayed and pressing the Save key while viewing a saved loop.

To save the entire cycle, a user does not need to select a different frame. When a user presses the save key, all retrieved frames are saved in the loop.

To view a loop, the user freezes the image and presses the play soft key. The playback soft key label changes and is paused. Play continuously in a loop until a user presses the freeze key or pause soft key. A user can track the number of frames and the current frame in the progress bar at the bottom of the imaging window.

In 2D and color modes, the system can acquire loops prospectively or retroactively. Prospective retrieval captures a cycle of real-time scan data after the capture command, while retrospective retrieval saves a cycle of frozen scans.

During live imaging, pressing the Store key instructs the system to acquire and save a cycle of scans after a key click. Displays the loop in a thumbnail window to the side of the main screen. The default length of the loop is 3 seconds, but this can be adjusted, for example, by setting the Get Length section of the Save/Get window to be between 1 and 10 seconds.

When the beat option button on the Save/Acquire tab of the Settings window is selected and the system detects an ECG signal, the number of cycles acquired is the number of heartbeats. A default can be 2 ticks, but this can also be adjusted, such as between 1 and 10 ticks in the acquisition length section. If no ECG signal is detected, even if the Bounce option button is selected, the acquired loops will be of the length set in the Time field. A user can apply an R-wave delay in the acquisition length section. A user can also enable a beep to sound when retrieval is complete. As such, the default format of the loops retrieved is .dcm, however, they can be saved in any other available format. A user can use the Export Index tab on the settings window to select a different file format.

When a user is viewing a frozen image or a live image, a user can use the zoom tool to zoom in on a region of the 2D image. In the time series view, a user cannot use the zoom tool. To zoom in on the middle part of the image, the user: 1 Press the Gain knob until Zoom is selected in the Gain knob menu. 2 Turn the gain knob to zoom in or out to a size desired by the user. To zoom away from an area in the middle of the image:

To zoom into an area away from the center of the image, the user: 1 Press the Compression and Amplification switch soft key. 2. Use the trackball to move the zoom box to an area that the user desires to be larger, and press the left enter key. 3 Use the Gain knob to zoom in or out on the area.

In the exemplary mobile ultrasound system, in M-mode spectrum mode, a user can make the 2D display larger relative to the time series display, and vice versa.

To resize the scanning monitor: 1. Press the Set key. 2. Click the Monitor Index tab. To make the time series display larger and the 2D imaging display smaller, click the S/L option button in the M Mode Format or Spectral Format area. To make the 2D display larger and the time-series imaging display smaller, click the L/S option button in the M-Mode Format or Spectral Format area. 3. Click OK to apply the changes. Note: This selection applies whenever a user uses a default that was selected when a user made changes. When a user uses a different default, the selection does not apply unless a user also makes changes in that default.

In the exemplary mobile ultrasound system, an optional image optimization package sharpens images produced by the mobile ultrasound system. When the mobile ultrasound system is started, the default configuration starts the software. To change this so that the system boots up with the optimization software turned off, a user can make the following default: Set the TV Level softkey control to 0. The number of optimized software levels is between 0 and 3. 0 setting does not apply image processing. The larger the number, the more processing is applied to the image. To adjust the optimization level, while performing live imaging, a user can press the TV Level soft key until the desired level is set.

The View Options section of the General Index tab on the Settings window enables a user to add or delete several guides on a scanned image. These guides provide details about patient, probe, and image control settings.

The system software enables a user to split the imaging screen into two sections to view two current scans of a patient. A user can acquire one scan of the patient, choose to split the screen, and then acquire another scan from a different angle or position. Split screen mode works together with 2D scanning mode (2D and Color Doppler).

When a user enters split-screen mode, the system software copies the current settings of the image control window to the new screen. A user can then apply any image control setting independently of any screen. A user can activate or freeze screens (only one screen can be active at a time), and a user can use any of the tools and menus on either screen. Additionally, a user can scan in different modes on each screen. For example, a user can acquire a 2D scan, enter split screen mode, and then acquire a color Doppler scan on the second screen. The figure below shows an example of a split screen.

The active screen has cyan columns at the top and bottom. To activate other screens, a user performs one of these actions: Move the arrow cursor to the desired screen and press the left enter key.

Press the toggle screen soft key. To exit split-screen mode, use any of these methods: Press the 2D key. Choose a different check Select M mode, PWD or triple scan mode Press the Split soft key

When a user exits split-screen mode by pressing the Split softkey, the system software saves the data captured by the active screen (the screen with cyan lines at the top and bottom) and discards the data captured by the other screen.

Text mode allows a user to add text and labels to an image using soft keys.

Softkey controls available in text mode include: Lateralize places the text on the left or right side of the image. Press the Lateralization softkey to cycle between left, right, and no text. Position opens a menu of subject locations or increments a list of subject locations. If a menu is open, you can click on the appropriate item to place it on the image. Annotation opens a menu of names for different anatomical structures, or increments a list of anatomy. If a menu is open, click on the appropriate item to place it on the image. "Briefing" opens a menu of patient briefings or increments a list of patient briefings. If a menu is open, click on the appropriate item to place it on the image. "Subject Mark" opens the subject mark menu. "New Text" starts a new line of text at the original position. "Text Clear" deletes all text from the image (including manually typed text and arrows) "Original" moves the text cursor or selected text to the original position of the text. "Arrow" places an arrow at the original position of the text, or if there is no text on the image, places the arrow in the middle of the last line of text. "Set original position" sets the original position of the text. Move the text cursor to the desired position and press the "Set Home Position" soft key.

To enter text mode, press the text key. The system software places a text cursor (I-beam) on the imaging screen. The trackball is used to move the text cursor to a location where the user desires new text and type the text, or use any of the mode soft keys. When the text is complete, press the left enter key. If a user adds custom text using the Annotation Index tab of the Settings window, the text appears in the softkey list to which it was added.

A user can also add predetermined text using soft keys. This allows a user to add a label and information that the user needs frequently without having to type it every time. 1 Press the text key on the console, or press the space bar on the keyboard. 2 Press one of the soft keys for the predetermined text: Lateralization places words on the left or right side of the image. Press the Lateralization softkey to cycle between left, right, and no text. Position opens a menu of subject locations or increments a list of subject locations. If a menu is open, click on the appropriate item to place it on the image. Anatomy opens a menu of names for one of the different anatomical structures, or increments a list of anatomical structures. If a menu is open, click on the appropriate item to place it on the image. "Briefing" opens a patient briefing menu, or increments a patient briefing list. If a menu is open, click on the appropriate item to place it on the image. Use one of the Place soft keys to select an item to place it on the image.

A user can place two types of arrows on a frozen image: marker arrows and text arrows. The default is to mark the arrow. A user can place as many arrows on an image as the user desires. Marker arrows are short, hollow arrows that indicate a point on the image. When a user places an arrow (see procedure below), the arrow is green. When the arrow is green, a user can use the trackball to move the arrow. A user can click on an arrow to make a selection for the arrow. When an arrow is selected, a user can move the arrow with the trackball and rotate the arrow by pressing the "Select" key and then move the trackball. To place a marker arrow on an image, complete these steps: 1 Press the "Arrow" soft key. 2 Use the trackball to move the arrow to a desired location 3 is the rotation arrow, press the "Select" key and move the trackball. 4. To place another arrow on the image, press the Arrow soft key. 5 Press the Left Enter key to set the arrow and exit text mode.

A text arrow is a dashed arrow that the user can draw from the text to a point on the scanned anatomy. A user can also add an arrow without adding text. To use text arrows, a user must make a selection in the Settings/Annotations window.

After placing text on an image, a user can easily move it to any location within the image display. To move text, click on the text, move it to a new location, and press the Left Enter key. If an arrow is attached to text, the origin of the arrow will also move.

A user can add an icon to a 2D image that identifies the scanned anatomy. Subject Marking in the Annotation menu opens a window containing several views of the anatomy based on the current examination. To add a subject mark to an image, a user completes these steps: 1 Press the text key. 2 Press the Body Mark soft key. A subject marker is displayed on the image. 3. If a user's desired mark is not displayed, press the "Next Mark" or "Previous Mark" soft key. If another marker is available, the first travel marker is replaced. 4. When a user's desired mark is displayed, press the "Left Enter" key.

To change body tags, complete these steps: 1 Click the body mark. The marker turns green and the soft key changes to Body Mark Settings. 2 Press the Next Mark or Previous Mark soft key. 3. When a mark desired by the user is displayed, press the "Left Enter" key.

A user can move the subject marker to any location on the image. To move the subject marker, complete these steps: 1 Click on the subject marker to select it. 2 Press the Marker Position soft key. 3 Use the trackball to move the subject marker. 4 When the marker is at a user desired location, press the Left Enter key twice.

A user can move the orange probe indicator to any position on the icon to more accurately indicate the scanned anatomy.

To move the orange marker, complete these steps: 1 Click the body mark. The text display above the soft key changes to show that the probe position is selected. 2 Use the trackball to move the probe pointer to the desired location on the body mark. 3. When the mark is at a position desired by the user, press the "Left Enter" key.

To rotate the probe pointer to more positions, complete these steps: 1 Move the viewport pointer above the body marker. The pointer changes to point at the hand. 2 Press the Select key to highlight the probe orientation in the line above the softkey display. 3 Use the trackball to rotate the probe pointer to the desired profile on the body mark. 4 Press the Left Enter Key to lock the pointer in place.

A set of softkey controls below the imaging window displays the currently available imaging controls. keys on the console or use a touch screen display to operate the soft keys. When a user selects a scan mode, the software configures the soft keys for that mode. The controls displayed vary depending on the probe connected and based on other selections. Press the left and right arrow keys on the left side of the console to change the display of other controls available in the selected mode.

To change a setting, use the toggle key on the console. Each toggle key controls the setting of one of the soft keys at the bottom of the imaging window. The position of the key group corresponds to the position of the buttons on the screen - the leftmost key controls the settings of the leftmost softkey, etc.

Figure 64 illustrates soft keys 6420, showing one example of available 2D image controls. A user can adjust these image controls only during live scanning. When a user freezes a scan, the system software replaces the softkeys with a different set to print the scanned image and perform annotations and measurements on the scanned image.

The softkey display depends on the connected probe, the selected scan mode, and the selected exam. A user can adjust the following 2D image controls during real-time scanning: Frequency, Scan Depth, Depth of Focus, Gain, Temporal Gain Compensation (TGC), Image Format, Omni Beam, Left/Right and Up/Down Inversion, Colorization, Durability, imaging, needle guide, dynamic range, software optimization control.

When a user selects a test, the system software sets the appropriate frequency for that test. A user can select an alternative frequency to better suit a particular situation. Typically, a higher transmission frequency achieves better 2D resolution, while a lower frequency achieves optimal penetration. Use the Frequency softkey to select high, medium, or low frequencies. The exact frequency varies depending on the probe connected. Each frequency has several other parameters associated with it, depending on the type of examination. The selected frequency is displayed as a character string as H, M or L in the information on the right side of the imaging window. In the following example, select Medium Frequency.

The "Depth" key adjusts the field of view. A user can increase the depth to view larger or deeper structures. A user can reduce the depth to magnify the display of structures near the skin line, or not display unwanted areas at the bottom of the window. When a user selects an exam type, the system software enters a preset depth value for the specific exam type and probe. To set the scan depth, use the "Depth" key. After adjusting the depth, a user may wish to adjust the gain, temporal gain compensation (TGC) curve, and focus control settings. A user can view a depth gauge on the image by selecting Depth Gauge on the General tab of the Settings window.

Focus optimizes the image by increasing the resolution of a specific area. Figure 65 shows the depth gauge along the right side of the image. A colored triangle on the depth scale indicates depth of focus. This indicator is only visible if a user is displaying a depth gauge. Also displays depth as text in the scanned information area. When a user selects an exam type, the software updates the focus value to a default value for the specific exam type, probe, and frequency. In 2D mode, a user can set up to four depths of focus using the "Focus Zone" soft key. In all other modes, a user can set only one focus depth. When a user uses more than one depth of focus, a user can select a focus depth distribution.

To set the depth of focus, a user uses the "focus" key. To set multiple depths of focus in 2D, a user completes these steps: 1. Use the "Focus Zone" soft key to select the desired number of focus zones. 2. Use the "Focus Range" soft key to select one of the focus zone distributions.

The distribution is shown by the intervals between depth indicators on the depth scale. The actual spacing of the depth of focus depends on the number and depth of selected points. Increasing the number of focus zones reduces frame speed.

2D gain allows a user to increase or decrease the magnification of the returned echo, which increases or decreases the amount of echo information displayed in an image. If enough echo information is generated, adjusting the gain can brighten or darken the image. When a user adjusts the gain, the system software increases or decreases the overall gain while maintaining the shape of the TGC curve. When a user selects a preset, the system software sets the gain to a default value for the specific preset and probe. To increase or decrease gain, the user turns the gain knob to the right or left.

Scanning tissue at greater depths causes the returned signal to attenuate. The TGC slider adjusts the amplification of the returned signal to correct for attenuation. The TGC balances the image to equalize the brightness of the echoes from the near field to the far field. When a user changes depth, loads a new exam type, selects a different frequency, or adjusts gain settings, the system software re-adjusts TGC settings.

TGC slider column spacing is proportional to depth. The TGC curve on the video display represents the TGC setting and appears when a user moves one of the sliders. Each slider controls a point on the curve. A user can individually adjust the TGC sliders as needed. A user drags a slider to the left to decrease the gain, or to the right to increase the gain. To show or hide the TGC curve, press the "Settings" button, then click on the General index tab and select "Show", "Hide" or "Timeout" in the TGC box. Select Show to always show the curve, or Hide to always hide the curve. If a user selects "Timeout" (the default setting), the curve is primarily displayed when a user launches the application or adjusts an individual TGC slider.

When using a linear probe, the "Image Format" softkey allows a user to select an image format of Rectangle or Trap. Omni allows electronic steering of ultrasound beams to acquire scans of an ROI from several directions. Omni works with linear and curved linear array probes. When the Omni is turned on, the code OM is displayed in the scan information display and the focus mark on the depth scale changes. To turn the Omni Beam on or off, press the Omni Beam soft key.

Persistence refers to the averaging of live images or image frames in a loop. When the persistence rate is high, the image is less scattered and smoother. However, increasing the persistence rate can produce a blurry image if tissue moves while a user freezes the image. When persistence is low, the opposite occurs.

To change the frame average, a user presses the "Persistent" soft key to select a value from 0 to 7. A setting of 0 means 0% durability and 7 means 100% durability. Persistence settings appear on the screen as one character in the information text string.

Image controls allow a user to choose how to distribute gray levels across an image. Each graph highlights certain regions of the signal amplitude range. This feature is useful for taking a closer look at certain anatomical features and for detecting subtle pathologies. The effects of user map selections are represented by the reference column to the left of the depth scale on the image.

The Needle Guide softkey is only available when a probe that supports biopsies or other medical procedures is connected. To display a needle guide, use the softkey to open the needle guide and select the correct needle guide (if more than one guide is available). Depending on the connected probe, a user may only see one needle guide option. If the probe's cradle supports more than one angle or depth, an option is displayed for each supported angle or depth. To toggle the needle guide between "On" and "Off", press the "Needle Guide" soft key. If more than one needle guide is available, press the Guide Type softkey to select a different guide. To toggle the target indicator between On and Off, press the Target softkey. Use the trackball to set target depth. The distance from the probe to the target is displayed in the upper left corner of the imaging window.

The "Dynamic Range" soft key controls the range of sound wave levels displayed in the image. The range of sound wave levels will affect the contrast of the image. A number on the soft key indicates the amount of compression: from 0 to 100. Use the Dynamic Range softkey to adjust the dynamic range. A setting of 0 achieves maximum contrast, and 100 achieves minimum contrast. To enable or disable software image enhancement optimization, use the TV Level softkey. A user can use the soft keys to set the level to "Off", "1", "2" or "3".

Choose Tissue Doppler Imaging (TDI) to optimize image control of imaged tissue motion. Control settings change with the selected scan mode. Control values can be adjusted and preset independently of non-TDI settings. When the image is frozen, TDI is disabled. TDI only works with 4V2A probes. To apply tissue Doppler imaging, press the TDI soft key while in 2D mode.

The transmitted ultrasound signal generates harmonics (signals with frequencies that are multiples of the frequency of the transmitted signal) in the tissue. Tissue harmonic imaging processes a returned harmonic signal to enhance the displayed image. The harmonics used in THI are twice the frequency of the transmitted signal. THI is only available when connecting a 4V2A or 5C2A transducer. When a different type of transducer is connected, the THI button is not displayed. THI is most effective at mid-range depths. THI is not helpful for shallow scans and deep scans. THI is disabled when the scanning depth is 4 cm or greater. To turn THI on or off, click the THI button in 2D mode.

When a user selects M mode, the system software applies a set of default image settings and changes the available softkey controls. When a user freezes a scan, the system software replaces the imaging softkey controls with controls for measuring characteristics of the M-mode image and for checking frames and playing the loop.

When M mode is selected, the system software automatically selects the ultrasonic cursor and moves the trackball to control the cursor position. Pressing the Left Enter key deselects the cursor and locks it in place. Press the "Cursor" key to select the ultrasonic cursor.

The active button control in the center of the gain knob displays the imaging control group for active mode. In M mode, this group of imaging controls is used for 2D mode and M mode control. The name of the currently selected control group is displayed in blue above the soft key. To select a different control group, press the "Action" button. In M mode, the gain knob can be used to control the 2D gain control.

The "Scan Rate" soft key sets how quickly the timeline scans across the time series window. To set the scan rate, a user presses the "Scan Rate" soft key to select "Slow", "Medium" or "Fast". The tick marks in the time series view are denser or sparser depending on the rate. Each large tick mark represents 1 second.

To move the ultrasonic cursor, a user presses the "cursor" key to select the ultrasonic cursor and then uses the trackball to move it to a new position. When the cursor is at a position desired by the user, press the "Left Enter" key. When the ultrasonic cursor is selected, it turns green. When locked in place, the ultrasonic cursor returns to its normal color.

Enabling the Dissection M mode using the Dissection softkey allows a user to move the scan line both rotationally and vertically. When a user selects Pulse Wave Doppler, the system software applies a set of default image settings and changes the available softkey controls. When a user freezes a pulse wave scan, the system software replaces the imaging soft key controls with controls for measuring the characteristics of the PWD image and for checking the frame and playing the loop.

The active button control in the center of the gain knob displays the imaging control group for active mode. In PWD mode, this group of imaging controls is used for the control of 2D mode and spectrum mode. The currently selected control group is displayed in blue above the soft keys. To select a different control group, press the "Action" button. When the pulse wave Doppler mode is selected, the special trackball responds to the PWD mode. The system software automatically selects the ultrasonic cursor and sample volume gate (SVG), and moves the trackball to control the positions of the ultrasonic cursor and SVG. Press the "Left Enter" key to set the ultrasonic cursor and SVG to the appropriate position. While in PWD mode, press the Cursor key to select the ultrasonic cursor and SVG.

The system software enables a user to select the sweep rate for spectral Doppler mode. A slow rate shows more waveforms over time, but with less detail. A medium speed is suitable for normal use. Fast rates show fewer waveforms over time, but more detail. The space between the ticks along the top of the time series view indicates the sweep rate. Each larger tick represents 1 second. When an image is frozen, a user cannot change settings. The "Scan Rate" soft key sets how quickly the timeline scans across the time series window. To set the sweep rate, press the Sweep Rate soft key to select Slow, Medium, or Fast.

The time series window displays blood flow velocity in cm/s or kHz. A user can change units at any time as long as the cursor angle is 70° or less. To change the speed display unit, press the "Output Unit" soft key. Press the soft key to switch between cm/s and kHz.

The pulse repetition frequency defines the displayed speed range, which is displayed as a scale. The maximum value of PRF (in Hz) depends on the location of the specific probe and sample volume. The PRF should be set high enough to prevent overlap and low enough to adequately detect slow blood flow. It may be desirable to vary the PRF based on blood flow rate during an examination, or when a pathology is present. Frequency overlap occurs when a user is observing more than half the sample rate. If the blood moves faster than the pulse repetition rate, the waveform on the display will overlap with or become tangled around the baseline. A user can change this setting only when viewing a live image and not when an image is frozen. The system software can automatically change the PRF value when a user moves the area of interest to ensure that the maximum PRF value does not exceed its limit. To adjust the PRF value, use the "Scale" key. The velocity (cm/s) scale on the left side of the time series window changes in response to the scale setting, and the PRF value is displayed in the scan properties display. The increment value for each click is based on the current range. For example, if the scale setting is 4000, then each time a user presses the up or down soft key, the system software adds or subtracts 500 Hz from that value until the selected value is in a lower or higher range. . Increasing the PRF will also increase the thermal index (TI) value. Only in triple scanning, the PRF value is related to the setting in 2D mode (Color Doppler). If a user changes the PRF value for one mode, the system software also changes the PRF value for the other modes. This depends on whether a user is scanning in simultaneous mode or non-simultaneous mode, which is controlled by the "Update" key.

Doppler systems use a wall filter (high-pass frequency filter) to remove low-frequency, high-intensity signals (called clutter) from the display. Tissue motion or rapid movement of the probe can cause clutter. Increasing the wall filter setting will reduce the display of velocity tissue motion. Decreasing the wall filter setting reveals more information but shows more wall tissue motion.

Use a one-wall filter setting that is high enough to remove clutter but low enough to display information near the baseline. To adjust the wall filter value, use the Filter softkey. The wall filter range is between 1% and 25% of the PRF, so changing the PRF using the "Scale" key will also change the range of the wall filter and the "Filter" soft key changes the increment of its setting. The increment value for each click is based on the current range. For example, if the wall filter range is 1000 Hz, then each time a user clicks the "Filter" soft key, the system software adds or subtracts 100 Hz from the filter value.

When using spectral Doppler, the user should be aware of the Doppler flow angle (the angle between the axis of the ultrasound beam and the blood flow plane). When the ultrasound beam is perpendicular to the blood flow (flow angle is 90°), a missing or chaotic color pattern is still displayed even when the blood flow is normal. A sufficient Doppler flow angle is required to obtain useful spectral Doppler information. In most cases, the closer the Doppler beam is to parallel to the blood flow (the lower the flow angle), the better the signal received. Angle less than 60° provides the best quality spectral Doppler. Electronic steering can be used when the blood flow is at an adverse angle to the Doppler beam. However, it is also often necessary to compress one or the other end of the probe to improve the Doppler flow angle. Electronic steering can be used with flat linear array probes (4V2A and 15L4). Curved probes cannot be electronically steered, and depending on the clinical situation may require a user to press down on one corner of a probe to obtain an adequate blood flow angle. The control angle does not directly affect the calibration of the speed scale. To select a different control angle, the user presses the "operate" key to obtain the desired angle. A user can use this control while viewing a live image. When an image is frozen, a user cannot change settings.

To obtain accurate speed, a user must maintain the Doppler angle at or below 60°. It is often necessary to press one or the other end of the probe to improve the Doppler flow angle. In mobile ultrasound systems, the velocity display in centimeters per second is only shown in the correction angle range between +70° and –70°. At angles greater than 70°, the velocity calculation error is too large and the velocity scale is converted into frequency (in kHz) independently of the correction angle. The blood flow direction indicator remains displayed on the window for reference. To adjust the correction angle, press the CA soft key to increase or decrease the angle. The angle setting is displayed to the right of the depth scale in the Image Information section of the imaging window. To set the correction angle to 0° or 60°, press the "CA+/□□60" soft key or the "Steer 0" soft key. The "CA+/□□60" soft key switches the correction angle between –60° and +60° and the "Steer 0" soft key sets the angle to 0°.

A user can invert the pulsed Doppler waveform. A zero baseline across the width of the spectrum display separates the Doppler scales. Data above the baseline is classified as positive flow. Data below the baseline is classified as reverse flow. When the waveform is inverted, retrograde flow is shown above the baseline and forward flow is below the baseline. To invert the waveform, the user presses the "Invert" soft key. A user can use this control only when viewing a live image. While an image is frozen, a user does not change this setting.

To adjust the ultrasonic cursor in the 2D image display, press the Cursor key, use the trackball to move the cursor, and press the Left Enter key to lock the cursor in place.

The sample volume size control adjusts the size of the Doppler zone being detected. The lower the value, the narrower the sample size used when calculating blood flow velocity. The sample volume is displayed as two parallel lines along the ultrasound cursor. The distance between the two parallel lines is the sample volume size in millimeters. To adjust the sample volume (SV) size, press the "SV Size" soft key. "SV Size" is displayed on the softkey and in the image information area to the right of the depth scale on the imaging window. A user can set a value from 0.5 to 20 mm (in 0.5 mm increments).

To adjust the position of the sample volume, use the Cursor keys to select it and then use the trackball or touch pad to move it to the desired position. Press the Left Enter key to anchor it.

A user can use this control only when viewing a live image. While an image is frozen, a user cannot adjust the sample volume. Modifying the depth position of the sample volume will affect the thermal index (TI) value.

The sample volume indicator allows a user to start a scan in a 2D scan mode, set the sample volume position, and switch to spectral Doppler mode. The sample volume is locked in place. When scanning in CD mode, the process switches to triplex mode (if enabled by a user's permission). To position the sample volume in the 2D viewport, press the Cursor key and use the trackball to set the gate position.

The PW gain setting (not the 2D gain setting) will increase or decrease the amplification of the returned signal (real-time or playback) of the time series display. The gain should be adjusted so that the spectral waveform is clear, but not so high that it shrinks the window fill or produces other artifacts. To adjust PWD gain, use the gain knob. Make sure the spectrum is displayed above the soft key display. A user can adjust the gain for a live image being played or a saved loop. A user cannot adjust the gain of frozen images or paused loops.

Noise suppression controls the suppression of low-level return signals. Increasing suppression darkens the image background. A number on the soft key indicates the noise suppression level. To adjust noise suppression, use the Suppression softkey. A number on the soft key indicates the noise suppression level.

The "Update" button allows a user to select whether to continue scanning the anatomy (displayed in the 2D window) while acquiring spectral Doppler scan data (displayed in the time series window). When Update is selected, the key lights blue and the system software continuously updates the 2D scan while acquiring spectral Doppler data. When no selection is made, the key lights white and the system software freezes the 2D data while acquiring spectral Doppler data. The default setting for this key (continuous scan of 2D and spectral Doppler data) is selected in most exams. When a user deselects the "Update" button (but does not freeze scanning), a user cannot adjust some of the 2D image controls. To toggle the 2D window between active and frozen, press the Update key.

When a user selects a color mode, the system software displays soft keys and a gain knob menu for the color mode. The active button control in the center of the gain knob displays the imaging control group for active mode. In color mode, the imaging control group is used in 2D mode and color mode. When color mode is selected, the system software automatically selects the ROI position (ROI Pos) and moves the trackball to change the position. Click the select button above the trackball to change the ROI size control; and roll the trackball to shrink or expand the ROI. When the ROI is in the correct position and the correct size, click the "Left Enter" key to set the ROI. Press the cursor keys to select the ultrasonic cursor, and the trackball controls the cursor position.

The size of the scan area (also called the region of interest or ROI) is one of the primary controls that affects frame rate. The smaller the scanning area, the faster the frame rate. The larger the scanning area, the slower the frame rate. A user can move the scan area by pressing the Select key, moving the ROI to a new location, and pressing the "Left Enter" key to anchor it. Pressing the select key twice selects the ROI size and enables a user to resize and shape the ROI using a trackball or through touch actuation as shown in Figure 67. While the image is frozen, a user cannot move or resize the ROI. To move the area of interest, complete the following steps: 1 Press the select key to select ROI. The cursor disappears and the ROI Pos display appears blue above the soft keys. 2 Use the trackball to move the ROI. 3 Press the "Left Input" key.

To resize the area of interest, complete the following steps: 1. Press the select key twice to select ROI. The cursor disappears, the ROI shape changes to a dotted line, and the ROI size display appears in blue above the soft keys. 2. Use the trackball to resize the ROI.

As a user moves the area of interest, the system software can automatically adjust the PRF value to ensure that the maximum PRF does not exceed the new depth. The pulse repetition frequency defines the displayed speed range, which is displayed as a scale. The maximum value of PRF (in kHz) depends on the specific probe and the location of the area of interest. The PRF should be set high enough to prevent overlapping and low enough to adequately detect low blood flow. It may be desirable to vary the PRF based on blood flow rate during an examination, or when a condition is present. Frequency overlap occurs when a user is observing more than half the sample rate. If the blood moves faster than the pulse repetition rate, the Doppler image will overlap with or become tangled around the baseline. If the PRF is set too high, the low-frequency shift caused by low-speed blood flow cannot be displayed. As the PRF increases, the maximum Doppler that can be displayed without frequency overlap also increases. A user can use this control only when viewing a live image. While an image is frozen, a user cannot change the PRF.

To adjust the PRF value, use the scale keys. The increment value for each click is based on the current range. For example, if the PRF setting is 4.0 kHz, then each time a user clicks the right or left arrow, the system software adds or subtracts 500 Hz from that value until the selected value is in a lower or higher range So far. Increasing the PRF will also increase the thermal index (TI) value.

In Color Doppler, a user can flip the color levels. Typically, red is assigned a positive frequency shift (blood flow toward the probe) and blue is assigned a negative frequency shift (blood flow away from the probe). This color assignment can be reversed by pressing the "Invert" softkey. Blood flow toward the probe is always assigned the color of the upper half of the color column, and blood flow away from the probe is assigned the color of the lower half of the color column. When a user presses the flip soft key, the colors of the color Doppler reference column and the scanned data in the area of interest are flipped.

For example, when scanning the internal carotid artery (ICA), inversion may be used. Normally, the blood flow in this vessel is away from the probe. If flipping is enabled, ICA blood flow is shown shaded red. The color column displays shades of blue on the top half and shades of red on the bottom.

Doppler systems use a wall filter (high-pass frequency filter) to remove unwanted low-frequency, high-intensity signals (also known as clutter) from the display. Tissue motion or rapidly moving probes can cause clutter. Increasing the wall filter setting will reduce the display of low velocity tissue motion. Lowering the wall filter settings will reveal more information. However, more mural tissue motion was also shown. The wall filter setting should be set high enough to ensure that color Doppler flicker artifacts caused by tissue or wall motion are not shown, but low enough to show low blood flow. If the wall filter is set too high, slower blood flow will not be visible. When scanning in color Doppler mode, set the wall filter higher for applications where there is significant tissue motion or in cases where the probe is moving rapidly. For small sections or cases with slow blood flow but not much tissue movement, set the wall filter setting lower. Use a wall filter setting that is high enough to remove clutter but low enough to reveal Doppler information near the baseline. To adjust the wall filter value, use the Filter softkey. The current value is displayed on the softkey and in the image information area of the imaging window (as a number after "WF"). The wall filter range is from 1% of the scale value to 50% of the scale value.

The color gain can be increased to correct for an insufficient color fill within a vessel and the color gain can be decreased to correct for an unacceptable amount of color outside of a vessel. A user can adjust the color gain to increase or decrease the amplification of the returned signal as it is played or displayed. There is no indicator for color gain similar to 2D gain in the scan properties list. To change color gain, turn the gain knob to the left (decrease) or right (increase).

Image color priority defines the amount of color displayed on clear echoes and helps localize color within the vessel wall. Color priority affects the degree to which color information covers 2D information. If the user must see more blood flow in one of the areas of significant 2D brightness, increase the color priority. To better control the display of intravascular blood flow, the color priority is lowered. If the color priority is set to zero, no color is displayed. To change color priority, use the Priority softkey. The current color priority setting is shown on the soft key display.

The color persistence setting determines the amount of averaging between frames. Increased persistence allows blood flow to be permanently displayed on 2D images. Reducing persistence allows for better detection of short duration jets and provides a basis for better flow/no flow assessment. Adjusting color persistence also produces better rendering of vessel outlines. To change color persistence, use the Persistence softkey. The current color persistence setting is shown on the soft key display.

Color baseline adjustments are usually not required. Baseline refers to the zero baseline within the color Doppler image. To adjust the baseline, the baseline is moved down to show more positive flow (forward) and up to show more negative flow (reverse). This adjustment can be used to prevent overlap in either direction. To move the color baseline, use the baseline keys. The current setting of the baseline is displayed on the Color Doppler Reference Bar. A user can see the effects of changes a user makes to the color reference column. If the column is not visible, select Setup > General > Reference Bar to add it to the image display.

The Plot softkey selects one of five color plots to display color Doppler data. A user can configure the color map independently for each exam by selecting an exam and then selecting a color map. When a user selects a different exam, the system software loads a color map for the selected exam. Colormaps are designated A through E. Some images use more colors than others, and some images appear with smoother gradients than others. To select a color map, use the Map softkey. The current image letter is shown in the soft key display.

The triple scanning mode combines pulse wave Doppler scanning and color Doppler scanning. To start triple scanning, select Color Doppler mode and press the PW key on the console. Only in triple scanning, the PRF value is related to the 2D mode (color Doppler) setting. If a user changes the PRF value in one mode, the system software also changes the PRF value in other modes. This depends on whether a user is scanning in simultaneous or non-simultaneous mode, which is controlled by the Update Console key. To adjust the image control of the 3D scan, first adjust the image control of the 2D scan mode, then go to the color Doppler window and press the cursor key to select the PWD ultrasound cursor and sample volume position. When scanning in 3D mode, some 2D image controls cannot be adjusted, so a user must adjust the image controls in 2D mode. A user can adjust these image controls only during live scanning. When a user freezes a scan, the system software replaces the soft keys with a different set to print the scanned image and make annotations and measurements on the scanned image. The application adds the PWD time series viewport to the 2D image.

When scanning in triplex mode, a user can move the area of interest, resize it, or move the range gate. To move the area of interest, complete the following steps: 1 Press the select key to select ROI. 2 Use the trackball to move the ROI. 3 Press the left input key.

When performing triple scanning, the PW soft key can be used. The image information display shows two PRF values in triplex mode. The system software sets the color PRF to an integral fraction of the PWD PRF (1/2, 1/3, 1/4, etc.). If a user changes the PRF value in one mode, the system software also changes other PRF settings. A user can set wall filters independently for 2D scans and PWD scans. The active button control in the center of the gain knob displays the imaging control group for active mode. In the three-mode mode, the imaging control group is used for the control of 2D mode, spectrum mode and color mode. The currently selected control group is displayed in blue above the soft key. To select a different control group, press the Action button.

Measurements accompanying ultrasound images complement other clinical procedures available to the attending physician. The accuracy of the measurements is determined by the system software and by appropriate use of medical protocols. When a user freezes a scan, the system software changes the set of available softkey controls and enables the Caliper key. Press the Caliper button to enable measurement control. Press the Caliper key repeatedly to cycle through distance, trace, and ellipse measurement options. When a user saves an image, all measurements are saved with the image.

When using split screen mode, one user can also measure two screens. To obtain a complete set of measurements, a user usually must acquire multiple scans. A user can perform as many scans and measurements as their research needs without losing any measurements. Measurements continue in the imaging window until a user selects a different exam, selects a different scan mode, loads a different patient, presses the Delete soft key, or presses the Clear All soft key.

The default location for displaying measurement results in the exemplary movable ultrasound system is the upper left portion of the image. To move the results to the bottom of the image, press the Results softkey (enabled when a measurement tool is active). A user can also change the default position to the bottom of the image using the Result Display Position option button on the Setup/Measurement window.

When a user selects an inspection default, the system software makes one of the default settings for available measurements. Default settings may vary between supported probes. A user can also add custom measurements to the available list.

The system loads a user-selected default custom set of measurements. Use the calculation keys to select a measurement. To select a measurement type, press the Calculate key and click on the desired measurement.

When a user freezes a 2D scan, the system software displays soft keys and a gain knob menu to measure, print, and playback loops in 2D mode. The measurement function in the 2D window allows measuring distances; measuring ellipse circumferences and areas; tracing areas on the image; splitting the screen for measurement; Typically, a user selects what he or she wishes to measure from a measurement menu. If a user selects a specific measurement, such as area, only softkeys that work with the measurement are available.

To measure a distance in a 2D viewport, a user completes the following steps: 1 If the image is active, press the Freeze key. The image freezes and the soft key controls change. 2 Press the "Caliper" key. 3. To accurately measure a detailed area, use the zoom function to enlarge an area of the 2D scan. 4 Press the "Caliper" key. 5. Click a position where the user wants to start measurement, move the target cursor, and click a position where the user wants to end measurement. 6 The system software displays the results in the upper left corner of the 2D window.

If a user does not see the measurement value, the user presses the Set button and then selects General > Measurement Value. To take more than one measurement of the same type on an image, press the appropriate softkey again and make additional measurements. When using the Caliper key to take a series of 2D measurements, a user can activate the caliper by checking the Activate Caliper box on the Setup Measurements window. When the box is checked, a new caliper cursor appears when the user sets the end point of a caliper measurement. When a user ends the measurement, the user saves the image and then presses the freeze key to close the diameter measurement.

A user can use the Ellipse softkey or Trace softkey to measure a circle on the image shown in Figure 68. To measure an oval area, use the Ellipse softkey. To measure the area of an irregular shape, use the Trace softkey. To measure a small area, a user uses the zoom function before taking measurements.

To use the Ellipse tool to measure an elliptical area, complete the following steps: 1 If the image is active, press the Freeze key. The image freezes and the soft key controls change. 2 Press the "Caliper" key. 3 Press the Calculate key. The measurement menu opens. 4. Select the measurement type by clicking Measurement Type in the measurement menu. If a user selects Circle from the Measurement menu, the Ellipse tool is automatically launched. 5. Position the target cursor at an end of the area that the user wishes to measure and click on. 6. Move the target cursor to the other end of the desired area and click. The system software displays a green line and displays the circumference or area value at the top of the image. 7. To adjust the other axes of an ellipse, press the Select key to highlight the axis (above the softkey display), then use the trackball to adjust the width of the ellipse. 8. When the measurement is correct, press the "Left Enter" key to lock it. A user cannot change a measurement after locking. A user can now take another measurement without deleting a user-locked measurement. 9. To save the measurement, press the Save key. Save the image with all measurements.

The system software enables a user to measure an area by tracing the outline of any shape on an image and a tumor as shown in Figure 69. A user can also use the Ellipse tool to measure an area. A user can use the tracing tool to trace an irregular shape by tracing the outline and drawing a polygon by clicking on the corners of the shape. A user can also combine these methods to trace an area on the image.

To trace a shape: a. the user clicks to start measuring; and b. the user uses the trackball to drag the tracing cursor around the object the user wishes to trace. Then c. When a user's tracing is almost complete, the "Left Enter" key is pressed, and the software completes the cycle by drawing a straight line from the current cursor position to the starting point.

When a user presses the "Left Enter" key, the trace turns white and is no longer editable. Before a user clicks the "Left Enter" key, a user can reverse the trajectory of the cursor to delete portions of the trace. 5. To edit unfinished tracings: a. Press the Select key so that Erase is highlighted above the soft key display. b. Use the trackball to return from the most recent direction to the beginning to erase the unwanted parts of the trace. c. When all but all parts of the trace have been erased, press the "Select" key again so that "Draw" is highlighted above the soft key display. d. Use the trackball to complete the tracing. e. Press the "Left Enter" key to complete tracing.

When measuring in split-screen mode, all measurements are displayed in a single list, even if both screens contain measurements. A user can make a measurement on either screen or across two screens. In order to perform alternate measurements on split screens, a user must disable Return to Live Imaging: 1 Press the "Settings" button. 2 Click the Monitor Index tab. 3 Click on the toggle active screen to return to live imaging so that the blocks are not checked.

This allows a user to take a measurement on one screen, switch to another screen and take a measurement on that other screen, and then return to the first screen and take additional measurements. If you check the box in the Setup/Display window, return to the first screen to enable it and erase all measurements on that first screen. To take a measurement across the screen: 1 Deactivate returns to live imaging as explained above. 2 Freeze a scan on one screen. 3 Press the "Two-state thixotropic screen" soft key. 4 Freeze the previous scan on another screen. 5. Press the "Caliper" button repeatedly until a tool required by the user is displayed. 6 Click the start point of the measurement. 7 Click the end point of the measurement. 8 Press the "Left Input" key.

When a user freezes an M-mode scan, the system software displays softkeys and a gain knob menu for measuring, printing, and playing loops in M-mode.

In the time series window of an M-mode scan, a user can measure their heart rate (HR) and distance (including time distance [TD] and slope values). To take measurements in the M-mode time series view, complete the following steps: 1 Press the Freeze key. 2 Press the "Caliper" button until the measurement type required by the user is displayed. 3 Click the target cursor at a location where the user wants to start measurements. 4 Move the target cursor and click at the desired end position. Measurements are displayed in the upper left part of the time series window.

When a user freezes a pulse wave Doppler or triplex scan, the system software changes the soft keys to allow measurement, printing, and other functions.

A user can use the CA (Correction Angle) soft key and the 0/+-60 soft key to adjust the angle of the freeze scan. This function has the same effect as the correction angle on the PWD index label. If a user has added 2D measurements to the spectrum measurement settings, a user can perform 2D measurements in the spectrum Doppler imaging screen. To perform 2D measurements on the spectral Doppler imaging screen, press the Calculate key. Any 2D measurements that a user has added to the spectrum measurement group appear in the measurement menu in the upper right corner of the imaging screen.

A user can perform any of several cardiac measurements and then generate a report. The system software provides cardiac measurements for the 2D image display window, the M-mode time series window, and the PWD/CW time series window (see FIG. 70 ). When a user performs a measurement in the 2D image display window, the measurement value is displayed in the upper left portion of the window.

Medial thickness (IMT) measurement is used to diagnose atherosclerosis by measuring the thickness of the inner wall of an artery. To measure the inner wall of the carotid artery: 1. Connect a linear probe to the system. 2. In 2D mode, select the Carotid Arteries preset. 3. Scan the carotid arteries. 4. Freeze scan. 5. Press the "Calculate" key. The measurement menu appears. 6. Select IMT from the menu. A green square appears on the image. 7. Use the trackball to move the green square so that it covers both walls of the artery. If necessary, press the "Select" key to allow resizing of the box using the trackball. Pressing the Select key once allows horizontal resizing; pressing it twice allows vertical resizing. The width of the square is shown in the upper left part of the imaging window. If the monitor does not correctly trace the inner wall of the artery, press the Edit soft key and click on the appropriate location on the wall on the image. 8. Press the Wall softkey to select the front wall, rear wall, or both. The measurement is displayed in the upper left part of the imaging window.

The system software includes preset groups of commonly used measurements that can be used in the measurement menu when an image is frozen. A user can add or remove measurements from a group, and form or delete groups.

The following table lists the measurements that can be used in various scan modes. a. This calculation can be used in CW mode. The time series view must display a velocity range that includes 300 cm/s. Use the Scale softkey to do this. b. This calculation can be used in CW mode. The time series view must display a velocity range that includes 200 cm/s. Use the Scale softkey to do this.

Selecting an exam loads an optimized preset of image control settings in an open window or menu 7120, in which a user can select from a plurality of diagnostic imaging sequences 7140 that may be used for A body part, organ or region as shown based on the anatomy to be scanned (including the probe used and the scanning mode) as seen in Figure 71. These inspection presets also specify measurements suitable for inspection. A user can continue to use these optimized presets, or a user can adjust any of the image control settings as necessary for a specific patient and a specific exam. A user can create additional presets to store sets of image control settings for specific types of exams. Customized presets can minimize the number of settings a user must change each time a user performs a specific ultrasound examination.

The mobile ultrasound system comes with predefined presets for all supported probes. Although several probe models can support the same exam type, the default image control settings are unique to each probe model. One exam contains predetermined image control settings for high, medium, and low frequencies. When a user selects a frequency range on the console, the system software loads other check settings optimized for that frequency. When a user selects a different frequency, a user does not need to reload the default or load a different default; the system software automatically updates the settings for the selected frequency. The following table lists the preset checks available for each probe.

An exemplary mobile ultrasound system provides customized examination presets for scanning different anatomy. When a user selects a preset, the system software loads image control settings customized for that anatomy, selected scan mode, and attached probe. To select a preset, the user selects the preset from the default menu, highlights the preset by clicking on the preset, and then presses the left enter key. If a user does not see a default name corresponding to the type of study a user wants to perform, a user can create a custom default.

The system software only displays those tests supported by the connected probe. If a user creates any custom exams, the custom exams are displayed at the bottom of the exam menu.

In addition to using the provided exam presets, a user can also create custom presets. Custom defaults contain user-specific modifications to the default image control settings. A user can then load custom defaults and skip setting image control parameters. A user can customize any default to include user-specific control settings. A user cannot change the default settings of a system default. However, a user can edit a system default image control setting and then save it under a different name. To create a default or modify an existing custom default, a user completes these steps: 1 Select a system default or a custom default that has settings that are close to those a user wants to create. 2 Modify the image control settings as necessary. 3 Press the preset key. 4 Press the Save Settings soft key. The Save Settings window opens. It contains a list of presets with system presets at the top and custom presets at the bottom. 5. Enter one of the custom default names in the Name: field. The name can be up to 16 characters long. If a user is modifying an existing custom default, make sure their name is in the field. 6. Click Save. The system software saves the image control settings.

Whenever the current probe is connected to the computer, the new preset is now available. If a user connects a different probe, this new default is not available.

Images and loops are saved to the study directory in the appropriate patient folder. If the patient is not associated with a scan, the image or cycle cannot be saved. All images and cycles saved for a given patient on the same day are saved in the same study unless the New Study button in the patient window is clicked before saving a later image. A single study cannot contain images and loops saved on different dates. For split screen mode, a user can save a split screen image (as a single frame showing one of the two screens). A user can save split screen images as a loop file. When a user does this, the system software saves the active screen as an image loop and saves the other screens as a single frame.

To save an image or loop, complete these steps: 1. If viewing a live image, press the Freeze button. 2 To save an image, press the Save button. A user can also save an image by pressing F8 on the computer keyboard. 3 To save an image cycle, press the Save button while live imaging (not frozen). 4. To add a saved image or loop to the current study's report, place the cursor over the image or loop, press the right enter key, and select Add to Report. 5 To delete an image or loop, place the cursor over the image or loop, press the Enter key, and select Delete. If a user has not loaded patient information for an exam, a user cannot save the image or loop.

When a user saves an image or loop, a thumbnail of the image or loop appears in the area to the right of the imaging window. When more than 12 images or loops are included in a study, some images or loops will be hidden. To view the images or loops, click the scroll arrows at the bottom of the thumbnail area. To scroll up and back, click the scroll arrow at the top of the thumbnail area. To review a saved image or loop in the current study, double-click the image or loop thumbnail. It is displayed in the imaging window.

A user can find saved patient studies by using the Study List... button on the Patients window.

To find previously saved studies in the patient window: 1. Press the patient button. 2. In the patient window, click the Study List... button. The Study List window opens, displaying a list of one of the saved studies. 3. The default system displays all research. To find studies conducted on a specific day or within a specific date range, click the Study Dates menu and select Today, Last 7 Days, Last 30 Days, or Validity Range. If a user clicks on the validity range, a box opens from which the user can select a date range to display the study. 4. Find the desired study in the list and click on it to select it. 5. Press the Review button. The selected study loads in the imaging window.

A user can export studies and images to a CD, a DVD, a DICOM server, a USB drive, or another location on the network. When exporting a study, image, or cycle, the system creates a uniquely named subdirectory for each study, image, or cycle. A user can export an image as a JPEG, BMP or AVI format to a computer hard drive or an external disk drive. A user can also attach an image to an email message in one of these formats. The system software allows a user to export an image or loop to external media in any of these formats: AVI, bitmap, DICOM, JPEG. A user can send images and loop files via email or include them as graphics in other applications. If a user saves images using the JPEG format, the user should be aware of the effects of data compression. By default, the system software uses a lossy JPEG compression algorithm. After compression, some image data disappears. When viewed, compressed images reveal the finished product resulting from JPEG compression. These products can also show whether a user is viewing images on a medical viewing station, which allows a user to window and level the image. The amount of compression to be applied to an image cannot be selected or predicted. One scan can be compressed at a ratio of 10:1, and another scan can be compressed at a ratio of 5:1. Regardless of the amount of compression, medically important structures may be lost due to compression. In addition, compression can produce a finished product that appears on the image.

Exemplary mobile ultrasound systems may assist in performing medical procedures such as biopsies. To perform a biopsy, a user requires a probe, needle, needle guide set and bracket. Biometric features are available for use with selected probes. When all preliminary steps are completed and alignment has been recently verified by a user, a biologic examination is performed on the patient. The system software displays guide lines for specific probes, brackets, and needle gauges used during lifetime exams or other medical procedures.

The removable ultrasound system software provides two types of needle guides for use with different physical needle guides. A needle guide is only available when one of the probes supporting that guide is connected to the ultrasound system. If more than one needle guide can be used to connect the probe, a user must verify that the selected guide matches the hardware mounted on the probe. In-plane guides work with standard needle guide hardware. These guides are two parallel lines that indicate the path of the hand when using appropriate hardware. The lateral guide is a circle that indicates the depth achieved when using guide hardware that includes clips to set the angle and depth of insertion. To switch off the needle guide, press the lower needle guide softkey. If a user is using the transverse needle guide, the user may have to press the lower needle guide soft key several times.

The mobile ultrasound system provides an on-screen needle guide and utilizes a specific probe to provide enhanced imaging of the needle. If a user system is licensed for needle enhancement, the system brightens the needle image as seen in Figure 72 if all of the following conditions are met; 2D mode is selected; a probe is connected to the system; a patient profile is selected And press the N key on the console.

Pressing the N key will display a solid blue line and a diverging blue dotted line on the scan window. The solid blue line and the diverging blue dotted line mark the limit of needle enhancement. If the point of the needle becomes to exceed these limits, the portion of the needle image that exceeds the limit is not brightened. The dashed line is for steeper needle insertion. One of the softkeys labeled Lt/Rt toggles between a line angled from top left to bottom right and a line angled from top right to bottom. When needle enhancement is active, the legend ENV (for enhanced needle visualization) appears in the scan information area to the right of the imaging window.

To activate needle image enhancement, press the N key on the console.

To perform a lifetime inspection using the in-plane needle guide, complete these steps: 1 Start live imaging. 2 Press the Needle Guide soft key. The needle guide is displayed in the imaging window along with a warning message. The warning turns off and the system software displays the needle guide and target indicator. The guide wire shows a user where to insert the needle into the patient. The green target indicator can move within the guide line to the exact location of the biometric target. The distance to target value then shows exactly how deep the needle must be inserted to reach that target. The large scale lines on the guide lines are at intervals of 1 cm, and the distance between the guide lines is fixed at 1 cm. 4. If the green target indicator is not displayed in the boot, press the Target soft key. The system software adds a "distance to target" value on top of the image. 5. Use the trackball to move the target indicator to the correct depth. A user cannot move the target outside the guidance line. 6. Complete biologic exams following appropriate medical protocols. Target distance is measured in centimeters and is calculated as the distance from the bottom of the clip to the patient's skin (as indicated by the top of the needle guide) plus the distance from the skin line to the target (as indicated by the location of the green target indicator) as indicated). When a user inserts the needle, it should be located near the center of the guide wire. If the needle appears outside the line, it is verified that a user has selected the appropriate needle guide.

To perform a lifetime inspection using the transverse needle guide, complete these steps: 1. Start live imaging. 2. Press the needle guide soft key. The needle guide is displayed in the imaging window along with a warning message. 3 Click OK. 4 Press the Boot Type soft key. A transverse needle guide circle replaces the in-plane needle guide on the imaging viewport, and the Needle Guide softkey displays the guide's identification. 5. If the guide is not the correct guide for the clip (which a user attaches to the hardware guide), press the Guide Type softkey until the correct guide is displayed. 6. Complete biologic exams following appropriate medical protocols. To ensure that the probe and biometric accessory are accurately aligned and that the needle path is within stated specifications, a user should periodically perform a simulation test. To perform this test, a user must have an assembly holder, needle guide, and a sink. Use 2D to verify alignment without using the zoom tool. The needle guide is not shown in the scaled display.

To verify the alignment of the probe and biometric accessory, complete these steps: 1 If the needle guide is not visible, press the Needle Guide softkey. The Biopsy Guide appears in the imaging window. 2 Press the Guide Type softkey to select the needle guide to be used for testing. There may be only one guide available to the installed probe. 3 Assemble the bracket, needle guide clip and gauge insertion pin. 4 Insert the needle into the gauge insertion pin. 5 Place the needle in a sink, ensuring that a user does not touch the sides or bottom of the sink (this can bend the needle and produce an inaccurate reading). 6 Verify that the pin appears clearly between the two guide wires. 7 Remove the needle from the test tray and safely dispose of the needle. 8 Remove the biopsy holder from the probe.

The system's software enables a user to make small adjustments to the positioning of the needle guide (used in biopsies) and the insertion grid (used for cryoablation or brachytherapy). When a user receives the needle guides, they have been configured and tested for angle and depth. The angle is the number of degrees between the X-axis and the Y-axis (needle axis). The depth shown in millimeters is the point where the biopsy needle and guide line intersect the vertical centerline of the 2D image.

A user can make margin changes to the upper and lower limits of angle and depth on the needle guide error correction dialog box. Changes made by a user to these settings are visible in the needle guide and are saved by the system and used for all biopsies until a user changes the settings again. A user can change the values within the following ranges: Angle: –2° to 2° and Depth: –1 mm to 1 mm.

To change the needle guide error correction value for any probe except a biplane probe, complete these steps: 1 Press the Set key. 2 Click the Monitor Index tab. The settings display window opens. 3. In the Needle Guide section, click the Calibrate button. The Needle Guide Calibration dialog box opens. A user can click the Apply button to see the effects of the user's selections without closing the dialog box. Click the Preset button to reset the values to factory settings. 1 Next to the angle correction field, click the left arrow and the arrow to correct the angle by one or two degrees. 2 Next to the Depth Correction field, click the left and right arrows to enable a depth correction of + or -1 mm. 3 Click OK to save the user project and close the dialog box.

DICOM (Digital Imaging and Communications in Medicine) is a format formed by NEMA (National Electrical Manufacturers Association) to aid in the distribution and viewing of medical images such as ultrasound scans. If a user has the DICOM option installed on a user-movable ultrasound system, a user can: Send studies to a DICOM server where the studies can be used by other applications that support DICOM files and use the DICOM worklist to search patient study archives on the DICOM server and copy the patient information to the removable ultrasound system to identify the exam on the system for the correct patient.

When a user sends a study to a DICOM server, the system software saves the study in a temporary location on the user's computer. These studies are then sent to the server. To send a study to a DICOM server, complete these steps: 1 Load the study (if it was previously saved) or obtain and save a new scan. 2 Press the Export soft key. The export selection window opens. 3 In the Export Destination: section, make sure the DICOM Server option button is selected. 4 Click on the name of the study the user wants to send. 5 Click Export. The mobile ultrasound system application sends studies to a configured DICOM server.

When a user exports a study to a CD or DVD, a user has the option of including a viewer for the DICOM files on the disk. The DICOM worklist is a function of the portable ultrasound system software that connects to a DICOM server using a network service and generates a list of patient information groups that meet selected criteria. The worklist finds the patient record based on the parameter group in the Setup > DICOM > Query window.

To prepare for an ultrasound exam, the sonographer queries the worklist using parameters that contain patient information. This query reruns a worklist of all patient information groups that meet the criteria. The sonographer selects a patient's record on the work list, and the review automatically attaches to that patient's information (populating the patient information window with the selected patient's information). Technicians can also use worklists to obtain patient information from the DICOM server and apply the information to a current exam. There are two types of worklist queries available: automatic query and manual query.

The automatic query runs periodically when the ultrasound system is turned on and returns a list of patient information that matches the set of criteria in the query window as a broad query. For example, an automated query can be set up to return a list of ultrasound exams scheduled for the current date. The facility's schedule manager enters a patient's ultrasound examination into DICOM, and when the scheduled date arrives, the work list automatically queries to collect the patient information and adds it to the work list.

Manual queries can take two forms: broad queries and patient-based queries. A broad query searches all records on the DICOM server using the parameters selected in the options window. Extensive query is a default parameter group. It can be used as is, modified with different parameters, or applied to patient-based queries.

Patient-based queries search for records using a patient name, accession number, or patient ID. Can also be limited to parameters in a broad query.

A user can perform a broad query that searches all patient records and returns all sets of patient information that match the criteria, or a patient-specific query that searches for sets of information for a specific patient. A patient-specific query can use the same criteria as a broad query, returning only information that matches both the criteria in the broad query and certain data specific to the patient.

The checkbox controls whether toggling between split screens makes the active screen active. When the block is unchecked, the toggles between screens cause both to be frozen. Pressing the Freeze key makes the active window active. Switching to another screen and back causes both screens to freeze again. When a block is checked, toggling between windows makes the active window active, even if it was previously frozen using the Freeze key.

When it is selected, Spectral Doppler mode is usually turned on, updating both the time series display and the 2D display simultaneously. This is the default and is selected simultaneously on the settings display window. Selecting Non-Simultaneous will cause Spectral Doppler mode to be turned on while the 2D display is frozen. Regardless of which option button is selected, pressing the update key toggles the 2D display between active and frozen.

This section contains a checkbox to show or hide the target indicator and a button to open the needle guide calibration window. Needle guide calibration works exclusively with the Biopsy/Medical Procedures option.

These option buttons set the relative sizes of the 2D display and the time series display on the imaging window. S/L makes the 2D display half the height of the time series display Equal makes the 2D display the same height as the time series display L/S makes the 2D display twice the height of the time series display This selection displays the thermal index in the scan window. TIS is the soft tissue index; TIB is the bone index; TIC is the skull index.

When this box is checked, toggling from one split-screen view to another makes the selected view active. When the box is unchecked, the two views remain frozen when toggling from one to the other until the freeze key is pressed.

When a user presses the Setup button and then clicks on the Measurement Index tab, the Setup window allows the user to select which measurements appear on the menu accessed by the Calculate button on the frozen image. The Set Measurements window also contains controls for selecting the size of the measurement cursor, tables used in calculating obstetric measurements, and a port for sending measurements to another location. Volume calculation coefficient selection selects the standard PI/6 ellipsoid coefficient or a custom value. The default for custom selections is 0.479, another common value, but a user can enter any value.

According to various embodiments, handheld housings associated with the mobile or tablet ultrasound devices described herein may have compact exterior dimensions. For example, a handheld housing of a flat-panel ultrasound device may provide a touch screen display with a diagonal size ranging from 8 inches (~20 cm) to 18 inches (~46 cm). In some embodiments, the electronic components used to operate the ultrasound and computer are designed using a 3D panel architecture to achieve more compact placement of the components within a smaller sized housing.

Figure 73 illustrates a cross-sectional view of a tablet ultrasound device 2000' in which the tablet's motherboard 106' and ultrasound engine 108' are stacked vertically on top of each other rather than side by side, according to various embodiments. In other words, the motherboard 106' and the ultrasonic engine 108' are constructed and configured according to the three-dimensional system architecture. In some embodiments, the motherboard 106' and the ultrasonic engine 108' are connected using a board connector 7001. In some embodiments, board connector 7001 may provide at least partial mechanical support for motherboard 106' and/or ultrasonic engine 108'. In certain embodiments, electrical connections between components of motherboard 106' and components of ultrasonic engine 108' may pass through board connector 7001.

Figure 74 illustrates a schematic bottom view of the flat-panel ultrasound device 2000' with the housing and bottom portion of the ultrasound engine 108' removed. This view thus shows motherboard 106' turned upside down. The motherboard 106′ includes a processing unit 7002, a memory 7004, a board connector 7001, a data storage device 7006, a cooling fan 7008, a battery 7010 and a trusted platform module 7012. In preferred embodiments, memory 7004 may comprise a shared memory device mounted on a second circuit board (mounted above or below a first circuit board), or may comprise a plurality of stacked circuit layers. layer to provide a three-dimensional (3D) circuit device. In some embodiments, data storage device 7006 may include a solid-state drive storage device (ie, a disk storage device with no moving parts). In some embodiments, processing unit 7002 may contact heat dissipation tubes to remove excess heat from the vicinity of processing unit 7002. The motherboard 106' may interface with external devices such as transducer probes, data storage devices, or external displays as described above using connector 7014. In some embodiments, the motherboard 106' may include one or more connectors 7014 for use with communication standards such as Universal Serial Bus (USB 1.0/2.0/3.0, USB-C, Mini USB, Micro USB), Display port and mini-display port, Lightning, Thunderbolt, High Definition Multimedia Interface (HDMI) or other appropriate standard or protocol) interface with one or more external devices.

A trusted platform module (TPM) 7012 including an encryption and decryption circuit can interface with other motherboard 106' components (such as data storage device 7006, memory 7004, and display drive) to protect and encrypt data on the flat-panel ultrasound device 2000'. TPM 7012 can encrypt all data written to data storage device 7006 and memory 7004 in real time and can decrypt all data retrieved from data storage device 7006 and memory 7004 in real time. In some embodiments, TPM 7012 can encrypt one or more data fields in each data packet. By providing real-time encryption and decryption, TPM 7012 ensures that sensitive patient data is always encrypted in any storage device media on the device. Therefore, in the event that the flat-panel ultrasound device 2000' is lost, stolen, or decommissioned, the patient data cannot be simply extracted from the memory 7004 or data storage device 7006.

Figure 75 illustrates a schematic diagram of a display of a flat-panel ultrasound device 2000' in accordance with various embodiments set forth herein. In some embodiments, tablet ultrasound device 2000' may utilize a mode switching menu 7030 operable by touch controls. When the mode switching menu 7030 is activated by touch, the display provides various operating modes 7032 to the user. The mode switching menu 7030 allows a user to select from various modes 7032 to quickly switch the device among different imaging or image analysis modes. In some embodiments, operating modes 7032 may each be based on a different machine learning algorithm or other computer-aided diagnostic functionality.

In some embodiments, tablet ultrasound device 2000' can respond to voice commands. A voice indicator 7020 may appear on the display when device 2000' actively accepts voice commands or controls. The voice indicator 7020 can also be activated by touch to turn on or off the voice-activated operation. In these embodiments, the tablet ultrasound device 2000' may include a microphone to detect a user's voice embedded in the tablet casing. In other embodiments, the tablet ultrasound device 2000' may receive wired or wireless signals corresponding to voice commands received from an external source (e.g., a headset or a microphone worn or used by the user). In certain embodiments, voice commands may provide the most practical method of controlling and adjusting features of device 2000'. For example, a user in a magnetic resonance imaging suite may be able to use a transducer probe on the patient near the magnetic bore, but may not be able to place the tablet device housing near the magnetic bore. In this situation, when the flat-panel ultrasound device 2000' is located in a safe location away from the magnet, the user can use voice commands to remotely control functions on the flat-panel ultrasound device 2000' from a distance.

Voice can be used to operate many functions on the tablet ultrasound device 2000'. After voice activation, voice indicator 7020 may spin to life or, for example, change color or shape to indicate that a voice command has been received or acted upon. In various embodiments, a user can provide a voice command to the device that the device can then implement, for example, "increase gain," "decrease contrast," etc. In certain embodiments, device 2000' may contain a current value or change that will be implemented immediately upon activation by a voice command. For example, a command "increase gain" increases the gain on the image by a preset amount such as 10%.

The above devices and methods can be used with conventional ultrasound systems. Preferred embodiments are used in a touch screen actuated tablet display system as described herein. Touch-activated icons can be used so that gestures can be used to control the imaging process.

Note that the operations described in this article are purely illustrative and do not imply any specific order. Furthermore, operations may be used in any sequence and/or may be used in part, where appropriate. Illustrative flowcharts are provided herein for illustrative purposes and are non-limiting examples of methods. Those skilled in the art will recognize that the illustrative methods may include more or fewer steps than illustrated in the illustrative flowcharts, and the steps in the illustrative flowcharts may be performed in a different order than shown. steps.

In describing the illustrative embodiments, specific terminology is used for the sake of clarity. For purposes of explanation, each specific term is intended to include at least all technical and functional equivalents that operate in a similar manner to achieve a similar purpose. Additionally, in some instances in which a particular illustrative embodiment includes multiple system elements or method steps, a single element or step may be substituted for those elements or steps. Likewise, a single element or step may be replaced by multiple elements or steps that serve the same purpose. Additionally, where parameters of various properties are specified herein for exemplary embodiments, those parameters may be adjusted upwards or downwards by 1/20, 1/10, 1/5, 1/3, 1/2, etc. Etc. or adjust to rounded approximations, unless otherwise specified.

With the above embodiments in mind, it should be understood that these embodiments may employ various computer-implemented operations involving data transferred and stored in a computer system. These operations are those requiring physical manipulation of physical quantities. Usually, though not necessarily, these quantities take the form of electrical, magnetic, and/or optical signals capable of being stored, transmitted, combined, compared, and otherwise manipulated.

Furthermore, any of the operations set forth herein forming part of the illustrative embodiments are useful machine operations. Illustrative embodiments also relate to an apparatus or an apparatus for performing these operations. A device may be specially constructed for the required purposes, or it may include a general purpose computer that is selectively enabled or configured by a computer program stored in the computer. In particular, various general purpose machines employing one or more processors coupled to one or more computer readable media may be used with computer programs written in accordance with the teachings disclosed herein, or configured to perform the required Operation of one of the more special equipment can be more convenient.

The foregoing description has been directed to specific illustrative embodiments of the invention. It will be apparent, however, that other changes and modifications may be made to the illustrated embodiments, wherein some or all of their associated advantages are obtained. Furthermore, the processes, processes, and/or modules described herein may be implemented in hardware, software (embodied in a computer-readable medium having program instructions), firmware, or a combination thereof. For example, one or more of the functions described herein may be performed by a processor executing program instructions outside of a memory or other storage device.

Those skilled in the art will appreciate that modifications to the above-described systems and methods and variations in these systems and methods can be made without departing from the inventive concepts disclosed herein. Accordingly, the present invention should not be construed as limited except by the scope and spirit of the appended claims.

10‧‧‧Medical ultrasound imaging equipment 12‧‧‧Foldable display 14‧‧‧Keyboard control panel 16‧‧‧Handle 18‧‧‧Keyboard 100‧‧‧Medical ultrasound imaging equipment/equipment/mobile ultrasound system/system/ultrasound system/ 101‧‧‧Front panel 102‧‧‧Casing 103‧‧‧Rear panel 104‧‧‧Touch screen monitor/monitor/multi-touch LCD touch screen monitor/touch monitor 105‧‧‧Surface 106‧‧‧Computer motherboard 106’‧‧‧Motherboard 107‧‧‧Touch sensor/sensor 108‧‧‧Ultrasonic engine/128-channel ultrasonic engine circuit board/128-channel ultrasonic engine 108’‧‧‧Supersonic Engine 109‧‧‧Touch processor 110‧‧‧battery 112‧‧‧FireWire connection/link/high-speed serial interface/communication link 114‧‧‧Probe Connector/Connector 115‧‧‧Probe attachment/detachment lever 116‧‧‧I/O port connector 118‧‧‧Circuit system 119‧‧‧Case port 120‧‧‧SIM card/card 140‧‧‧System 150‧‧‧Transducer housing/probe/ultrasonic probe/transducer/transducer probe/probe housing 152‧‧‧Transducer element array/transducer array 154‧‧‧Probe identification circuit 302‧‧‧Click gesture 304‧‧‧Pinch gesture 306‧‧‧Flicking gesture 308‧‧‧Rotate gesture 310‧‧‧Double point gesture 312‧‧‧Expand gesture 314‧‧‧Flicking gesture 316‧‧‧Rotate gesture 318‧‧‧Drag gesture 320‧‧‧Press gesture 322‧‧‧Press and drag gestures 324‧‧‧Palm gesture 340‧‧‧Imaging operation 342‧‧‧Image processing operations 344‧‧‧Operation 346‧‧‧Operation 348‧‧‧Operation 350‧‧‧Operation 352‧‧‧Operation 402‧‧‧Subgroup 404‧‧‧Subgroup 406‧‧‧Subgroup 408‧‧‧Touch control/two-dimensional touch control 410‧‧‧Touch Control/Gain Touch Control 412‧‧‧Touch control/color touch control 414‧‧‧Touch control/storage device touch control 416‧‧‧Touch control/split touch control 418‧‧‧Touch control/PW imaging touch control 420‧‧‧Touch control 422‧‧‧Touch Control/Annotation Touch Control 424‧‧‧Touch Control/Dynamic Range Operation Touch Control 426‧‧‧Touch control/TeravisionTM touch control 428‧‧‧Touch control/image operation touch control 430‧‧‧Touch Control/Needle Guide Touch Control 428 502‧‧‧Liver 504‧‧‧Cystic lesions 506‧‧‧Virtual Window 508‧‧‧Finger 602‧‧‧Heart 604‧‧‧Endocardial border 606‧‧‧Left ventricle 607‧‧‧Cursor 608‧‧‧dashed line 610‧‧‧Finger 612‧‧‧Finger 702‧‧‧Liver 704‧‧‧Cystic lesions 706‧‧‧Virtual Window 707‧‧‧First Cursor 709‧‧‧Second Cursor 710‧‧‧Finger 712‧‧‧Finger 802‧‧‧Liver 804‧‧‧Cystic lesions 806‧‧‧Virtual Window 807‧‧‧First cursor/cursor 809‧‧‧Second Cursor 810‧‧‧Finger 811‧‧‧Connection cable 812‧‧‧Finger 900‧‧‧Software flow chart 902‧‧‧Transducer Management Module 904‧‧‧Operation 906‧‧‧Operation 908‧‧‧Operation 910‧‧‧Operation 912‧‧‧Operation 914‧‧‧Operation 916‧‧‧Operation 918‧‧‧Operation 920‧‧‧Operation 921‧‧‧Operation 922‧‧‧Operation 924‧‧‧Operation 926‧‧‧Operation 928‧‧‧Operation 930‧‧‧Steps 932‧‧‧Steps 934‧‧‧steps 936‧‧‧Steps 938‧‧‧steps 940‧‧‧Steps 942‧‧‧Steps 944‧‧‧Steps 946‧‧‧Steps 948‧‧‧Steps 950‧‧‧steps 952‧‧‧Steps 956‧‧‧Needle 958‧‧‧System 960‧‧‧Ultrasonic transducer element/transducer element 962‧‧‧Needle Guide 964‧‧‧Ultrasonic reflector disc/reflector disc 966‧‧‧Needle guide mounting bracket 968‧‧‧Transducer Array 970‧‧‧Ultrasonic imaging probe assembly 972‧‧‧Ultrasound 974‧‧‧Reflected ultrasound 976‧‧‧distance 978‧‧‧Linear ultrasonic acoustic array/ultrasonic imaging probe assembly 980‧‧‧Ultrasonic transducer array/transducer element 982‧‧‧Ultrasonic imaging probe assembly 984‧‧‧Ultrasonic transducer array 986‧‧‧System 1000‧‧‧Block Diagram 1010‧‧‧Host computer 1012‧‧‧USB Connectivity/Customized or USB3 Chipset 1014‧‧‧Microprocessor 1020‧‧‧Interface unit/interface circuit system 1022‧‧‧USB connection/customized USB3 chipset/USB3 chipset/customized or USB3 chipset 1024‧‧‧System Controller 1025‧‧‧Connector 1026‧‧‧Field Programmable Gate Array/Field Programmable Gate Array Digital Beamforming 1027‧‧‧Connector 1028‧‧‧A/D converter 1030‧‧‧A/D converter 1032‧‧‧Memory 1034‧‧‧DC-DC converter 1040‧‧‧Integrated ultrasonic probe/ultrasonic probe/transducer 1042‧‧‧Power supply 1044‧‧‧Controller 1046‧‧‧Memory 1048‧‧‧Multiplexer 1050‧‧‧Transmission Driver 1052‧‧‧Subarray/Aperture/Subarray Beamformer 1054‧‧‧Transmission driver 1056‧‧‧Multiplexer 1058‧‧‧Memory 1060‧‧‧Sub-array beamformer 1062‧‧‧One-dimensional transducer array 1064‧‧‧Image target 1066‧‧‧cable 1068‧‧‧cable 1075‧‧‧Device 1080‧‧‧Block Diagram 1082‧‧‧Host computer 1102‧‧‧Image target 1104‧‧‧Cable 1112‧‧‧FIFO buffer module 1114‧‧‧Memory 1116‧‧‧Beamformer Control Processor/System Controller 1118‧‧‧Communication Chipset 1120‧‧‧Communication Chipset 1122‧‧‧Core Computer Readable Memory/Memory/ 1124‧‧‧Beamformer Control Processor/Microprocessor 1126‧‧‧Monitor Controller 1200‧‧‧Circuit Board 1202‧‧‧HDI substrate/substrate 1204‧‧‧First Integrated Circuit Chip/ 1206‧‧‧First spacer layer 1208‧‧‧Second integrated circuit chip 1210‧‧‧Metal frame 1212‧‧‧Wiring 1214‧‧‧Wiring 1216‧‧‧Package 1302‧‧‧Steps 1304‧‧‧Steps 1306‧‧‧Steps 1308‧‧‧Steps 1310‧‧‧Steps 1312‧‧‧Steps 1600‧‧‧Multi-chip module 1602‧‧‧TR chip/chip 1604‧‧‧Amplifier chip/chip 1606‧‧‧Beamformer Chip/Chip 1608‧‧‧First spacer layer 1610‧‧‧Second spacer layer 1612‧‧‧Metal frame 1614‧‧‧Substrate 1702‧‧‧Wireless Network Adapter/Adapter 1704‧‧‧Input/Output (I/O) and Graphics Chipset 1706‧‧‧Serial or parallel interface 1708‧‧‧Power module 1710‧‧‧The first multi-chip module 1712‧‧‧The second multi-chip module 1714‧‧‧Clock generation complex programmable logic device 1716‧‧‧Analog to digital converter 1718‧‧‧Delay profile and waveform generator field programmable gate array 1720‧‧‧Memory 1722‧‧‧Scan sequence controlled field programmable gate array 1724‧‧‧Power module 1802‧‧‧Optional stylus 1804‧‧‧Shell Connector 1806‧‧‧Flexible Cable 1900‧‧‧Main GUI 1902‧‧‧Menu bar 1904‧‧‧Image display window 1906‧‧‧Image control column 1908‧‧‧Toolbar 2000‧‧‧Medical ultrasound imaging equipment/tablet computer system 2000’‧‧‧Flat-plate ultrasound device 2010‧‧‧Touch screen monitor 2020‧‧‧Ultrasonic Control 2030‧‧‧Casing 2040‧‧‧Ultrasound data 2060‧‧‧Front panel 2070‧‧‧Rear panel 2080‧‧‧Port 2082‧‧‧Card 2084‧‧‧SIM card/SIM circuit 2100‧‧‧Transport truck system/port truck configuration 2102‧‧‧Touch screen monitor 2104‧‧‧Tablet 2106‧‧‧Adjustable height device 2108‧‧‧Transportation truck/transportation truck bracket 2110‧‧‧Gel holder 2112‧‧‧Keyboard 2114‧‧‧Storage Box 2118‧‧‧Probe Connector 2120‧‧‧Thermal Probe Holder 2122‧‧‧Base assembly 2124‧‧‧Full operator console/operator console 2126‧‧‧Operator Console 2200‧‧‧Porter truck system/pallet truck assembly 2210‧‧‧Retainer 2212‧‧‧Vertical support parts/support beams/beams 2214‧‧‧Console Panel 2216‧‧‧Multi-port probe multiplexer/multiplexer device 2218‧‧‧Retainer 2222‧‧‧Storage box attachment mechanism 2224‧‧‧Storage box/accessory holder 2226‧‧‧Rope Management System/Height Adjustment Device 2228‧‧‧Base 2230‧‧‧Battery 2232‧‧‧wheel 2300‧‧‧Configuration 2302‧‧‧Tablet/System 2304‧‧‧Dock station/base plug unit/base unit/unit/plug element 2305‧‧‧Electrical Connector 2306‧‧‧Attachment mechanism/installation assembly 2307‧‧‧Port 2308‧‧‧Hinge parts 2310‧‧‧Shaking table 2312‧‧‧Vertical parts 2400‧‧‧Transport truck system/configuration 2402‧‧‧Tablet 2404‧‧‧Connector/Attachment Mechanism 2406‧‧‧Hinged parts 2408‧‧‧Vertical Support Parts 2502‧‧‧Dock station 2504‧‧‧Tablet 2506‧‧‧Base assembly 2508‧‧‧Release mechanism 2510‧‧‧Transducer Probe/Transducer Probe Connector 2512‧‧‧Transducer port 2602‧‧‧2D image window 2604‧‧‧2D image scanning 2606‧‧‧Flexible frequency scanning 2700‧‧‧Tablet 2702‧‧‧Flexible frequency control 2704‧‧‧2D image window 2706‧‧‧2D image 2708‧‧‧Motion mode imaging 2800‧‧‧Tablet/Tablet Monitor 2802‧‧‧Color Doppler Scan Information 2804‧‧‧Flexible frequency control 2806‧‧‧2D image window 2808‧‧‧Color coding information 2810‧‧‧2D image 2900‧‧‧Tablet PC Monitor 2902‧‧‧2D image 2904‧‧‧Adjustable frequency control 2906‧‧‧Hybrid operating mode 2908‧‧‧Shadows of gray 2910‧‧‧Time/Doppler frequency 2912‧‧‧Sample gate 3000‧‧‧Tablet PC Monitor/Tablet PC 3002‧‧‧2D Window/2D Image Window 3004‧‧‧Color coding information 3006‧‧‧Color code overlay 3008‧‧‧Sample volume/sample gate 3010‧‧‧Flexible frequency control 3012‧‧‧Time/Doppler shift 3016‧‧‧2D image 3100‧‧‧GUI Home Screen/Screen Interface/GUI Home Screen/Main GUI Home Screen 3102‧‧‧Image display window 3104‧‧‧Menu bar 3106‧‧‧Image control column 3108‧‧‧Depth Control Touch Control 3110‧‧‧2D gain touch control 3112‧‧‧Full screen touch control 3114‧‧‧Text touch control 3116‧‧‧Split screen touch control 3118‧‧‧ENV touch control 3120‧‧‧CD touch control 3122‧‧‧PWD touch control 3124‧‧‧Freeze touch control 3126‧‧‧Storage touch control 3128‧‧‧Optimized touch control 3130‧‧‧scrolling image 3200‧‧‧GUI Menu Screen/Screen Interface/Main GUI Menu Screen 3202‧‧‧Image display window 3204‧‧‧Menu bar 3206‧‧‧Expand format 3208‧‧‧Patient touch control 3210‧‧‧Default touch control 3212‧‧‧Review Touch Control 3214‧‧‧Report touch control 3216‧‧‧Set up touch control 3218‧‧‧image 3220‧‧‧Image control column 3224‧‧‧2D gain touch control 3226‧‧‧Full screen touch control 3228‧‧‧Text touch control 3230‧‧‧Split screen touch control 3232‧‧‧Needle Visual ENV Touch Control 3236‧‧‧PWD touch control 3238‧‧‧Freeze touch control 3240‧‧‧Storage touch control 3242‧‧‧Optimized touch control 3302‧‧‧Menu bar 3304‧‧‧New Patient Touch Screen Control 3306‧‧‧New research on touch screen control 3308‧‧‧Research List Touch Screen Control 3310‧‧‧Work List Touch Screen Control 3312‧‧‧Edit Touch Screen Controls 3314‧‧‧Patient information section 3316‧‧‧Research information section 3318‧‧‧Image control column 3320‧‧‧Research on touch control 3324‧‧‧Print touch control 3326‧‧‧Print preview touch control 3328‧‧‧Cancel touch control 3330‧‧‧2D touch control 3332‧‧‧Freeze touch control 3334‧‧‧Save touch control 3400‧‧‧GUI Patient Information Screen Interface/Default Screen 3402‧‧‧Menu bar 3404‧‧‧Default selection mode/selection mode 3408‧‧‧Image control column 3410‧‧‧Save settings touch control 3412‧‧‧Delete touch controls 3414‧‧‧CD touch control 3416‧‧‧PWD touch control 3418‧‧‧Freeze touch control 3420‧‧‧Storage touch control 3422‧‧‧Optimized touch control 3500‧‧‧GUI Review Screen/Screen/Screen 3502‧‧‧Menu bar 3504‧‧‧Default review 3506‧‧‧Image display window 3508‧‧‧image 3510‧‧‧image 3512‧‧‧image 3514‧‧‧image 3516‧‧‧Image control column 3518‧‧‧Thumbnail setting touch control 3520‧‧‧Synchronized touch control 3522‧‧‧Select touch control 3524‧‧‧Previous image touch control 3526‧‧‧Next image touch control 3528‧‧‧2D image touch control 3530‧‧‧Pause image touch control 3532‧‧‧Save image touch control 3600‧‧‧Screen Interface/Report Screen 3602‧‧‧Menu bar 3604‧‧‧Report begins review 3606‧‧‧Monitor screen 3608‧‧‧Image control column 3610‧‧‧Save touch control 3612‧‧‧Save new file touch control 3614‧‧‧Printing touch control 3616‧‧‧Print preview touch control 3618‧‧‧Carefully study touch control 3620‧‧‧2D image touch control 3622‧‧‧Freeze image touch control 3624‧‧‧Save image touch control 3700‧‧‧Screen Interface/Screen 3702‧‧‧Menu bar 3704‧‧‧Report begins review 3706‧‧‧General touch control 3708‧‧‧Display touch control 3710‧‧‧Measurement touch control 3712‧‧‧Annotation Touch Control 3714‧‧‧Print Touch Control 3716‧‧‧Save/Get Touch Controls 3718‧‧‧DICOM touch control 3720‧‧‧Export touch control 3722‧‧‧Research Information Image Touch Control 3724‧‧‧Configuration screen 3726‧‧‧Soft key plug-in position 3728‧‧‧Image control column 3730‧‧‧Thumbnail setting touch control 3732‧‧‧Synchronized touch control 3734‧‧‧Select touch control 3736‧‧‧Previous image touch control 3738‧‧‧Next image touch control 3740‧‧‧2D image touch control 3742‧‧‧Pause image touch control 3750‧‧‧Soft key control arrows 3752‧‧‧Soft key control 3760‧‧‧Soft key control arrows 3762‧‧‧Soft key control 3800‧‧‧Screen Interface/Settings Screen 3802‧‧‧Menu Bar/Save/Get Touch Control 3804‧‧‧Report expansion review/set expansion screen 3806‧‧‧General touch control 3808‧‧‧Display touch control 3810‧‧‧Measurement touch control 3812‧‧‧Annotation Touch Control 3814‧‧‧Printing touch control 3816‧‧‧Save/Get touch control 3818‧‧‧DICOM touch control 3820‧‧‧Export touch control 3822‧‧‧Research Information Image Touch Control 3828‧‧‧Image control column 3830‧‧‧Thumbnail setting touch control 3832‧‧‧Synchronized touch control 3834‧‧‧Select touch control 3836‧‧‧Previous image touch control 3838‧‧‧Next image touch control 3840‧‧‧2D image touch control 3842‧‧‧Pause image touch control 3900‧‧‧Configuration 3902‧‧‧y direction/y axis 3904‧‧‧x direction/x axis 3906‧‧‧z axis 3908‧‧‧Polarization axis 3910‧‧‧elevation axis 3912‧‧‧Configuration 3914‧‧‧Ultrasound images 3920‧‧‧elevation axis 3922‧‧‧Polarization axis 3924‧‧‧Ultrasound images 4002‧‧‧Top Array 4004‧‧‧Bottom Array 4006‧‧‧High voltage driving pulse 4008‧‧‧High voltage driving pulse 4010‧‧‧High voltage driving pulse 4012‧‧‧Array 4102‧‧‧High voltage pulse 4104‧‧‧High voltage pulse 4106‧‧‧High voltage pulse 4108‧‧‧Ground 4110‧‧‧Array 4112‧‧‧Top Array 4114‧‧‧Bottom Array 4202‧‧‧Receiving electronic device 4204‧‧‧Select bottom array 4206‧‧‧High voltage driver 4208‧‧‧Select top array 4210‧‧‧High Voltage Driver 4212‧‧‧High voltage driver 4302‧‧‧Apical two chambers 4304‧‧‧Apical four chambers 4402‧‧‧Image 4404‧‧‧Image 4900‧‧‧Operation 4902‧‧‧Operation 4904‧‧‧Operation 4906‧‧‧Operation 4908‧‧‧Operation 4910‧‧‧Operation 4950‧‧‧Laparoscopic transducer probe/probe 4952‧‧‧EM sensor 4954‧‧‧Distributed processor system/core processor and memory/distributed processor system or graphics processing unit 5101‧‧‧Linear Imaging Array 5102‧‧‧Vertical Array 5200‧‧‧sequence 5202‧‧‧Steps 5204‧‧‧Steps 5206‧‧‧Steps 5208‧‧‧Steps 5210‧‧‧Steps 5212‧‧‧Steps 5402‧‧‧Beamforming engine/engine 5404‧‧‧Bus 5405‧‧‧Ultrasound software operation/ultrasound application 5406‧‧‧Processor 5408‧‧‧Information and images 5410‧‧‧Machine learning and/or image processing applications/processors/processing applications/central processing unit applications 5420‧‧‧Graphics Processing Unit/Processor 5422‧‧‧Memory 5490‧‧‧Focused line 5492‧‧‧parallel lines 5920‧‧‧Shared memory 5940‧‧‧Third-party applications 5960‧‧‧Control circuit 6020‧‧‧Core Processor 6040‧‧‧Graphics Processing Unit 6050‧‧‧Shared memory 6060‧‧‧Bus 6310‧‧‧Console 6320‧‧‧Control 6420‧‧‧soft key 7001‧‧‧Board Connector 7002‧‧‧Graphic Visual Indicator/Processing Unit 7004‧‧‧Memory 7006‧‧‧Data storage device 7010‧‧‧Battery 7012‧‧‧Trusted Platform Module 7014‧‧‧Connector 7120‧‧‧Open window or menu 7140‧‧‧Diagnostic Imaging Sequence 7020‧‧‧Voice indicator 7030‧‧‧Mode switching menu 7032‧‧‧Operating mode

The above and other objects, aspects, features and advantages of illustrative embodiments will become apparent and better understood with reference to the following description taken in conjunction with the accompanying drawings, in which: 1A is a plan view of an exemplary medical ultrasound imaging device according to an exemplary embodiment of the present application; Figure 1B shows a battery-powered portable system with a keyboard control panel and a folding display; 2A and 2B are side views of a medical ultrasound imaging system according to a preferred embodiment of the present invention; 3AA-3AL illustrate exemplary single-point and multi-point gestures that may be used as user input to a medical ultrasound imaging system according to preferred embodiments of the present invention; 3B illustrates a process flow chart for operating a flat-panel ultrasound system according to a preferred embodiment of the present invention; Figures 3C-3K illustrate details of touch screen gestures used to adjust beamforming operations and display operations; 4A-4C illustrate several subsets of exemplary touch controls that may be implemented on a medical ultrasound imaging system in accordance with preferred embodiments of the present invention; 5A and 5B are illustrative illustrations of a liver with a cystic lesion on a touch screen display of a medical ultrasound imaging system according to a preferred embodiment of the present invention; Figures 5C and 5D are illustrative illustrations of liver and cystic lesions on the touch screen display of Figures 5A and 5B, the touch screen display including a virtual window corresponding to an enlarged portion of the liver; Figure 6A is an illustrative illustration of an apical four (4) chamber view of a heart on a touch screen display of a medical ultrasound imaging system; 6B-6E illustrate an exemplary manual tracing of an endocardial rim of the left ventricle of the heart on the touch screen display of FIG. 6A; Figures 7A-7C illustrate an exemplary measurement of the size of a cystic lesion on the liver within the virtual window of Figures 5C and 5D; Figures 8A to 8C illustrate an exemplary caliper measurement of a cystic lesion on the liver within the virtual window of Figures 5C and 5D; 9A illustrates one of a plurality of transducer arrays attached to a processor housing; Figure 9B shows a transducer attachment sequence according to one of the exemplary embodiments; 9C shows a perspective view of a needle sensing positioning system according to an exemplary embodiment; 9D shows a perspective view of a needle guide of an exemplary embodiment; 9E shows a perspective view of a needle sensing positioning system according to an exemplary embodiment; Figure 9F illustrates a system with a cellular communications card; Figure 10A shows one method of measuring heart wall motion; Figure 10B shows a schematic block diagram of an integrated ultrasonic probe according to an exemplary embodiment; Figure 10C shows a schematic block diagram of an integrated ultrasonic probe according to an exemplary embodiment; Figure 11 is an illustration of an exemplary embodiment of an ultrasound engine (ie, front-end ultrasound special circuit system) and an exemplary embodiment of a computer motherboard (ie, host computer) of the exemplary ultrasound device Detailed schematic block diagram; 12 illustrates a schematic side view of a circuit board including multi-chip modules assembled in a vertically stacked configuration; 13 is a flowchart of an illustrative method of fabricating a circuit board including a multi-chip module assembled into a vertically stacked configuration; Figure 14A is a schematic side view of a multi-die module containing four vertically stacked dies separated from each other by a passive silicon layer with a 2-in-1 diced die attach film (D-DAF). separate; separate 14B is a schematic side view of a multi-die module containing four vertically stacked dies separated from each other by a DA film adhesive used as an inter-die spacer; 14C is a schematic side view of a multi-die module containing four vertically stacked dies separated from each other by DA paste or film adhesive used as inter-die spacers; Figure 15 is a flow diagram of another exemplary method of performing inter-die stacking using (a) a passive silicon layer with a 2-in-1 diced die attach film (D-DAF), (b) DA paste, (c) thick DA film, and (d) over-the-wire (FOW) containing a 2-in-1 D-DAF; Figure 16 is a schematic side view of a multi-chip module including an ultrasonic transmission/reception IC chip, an amplifier IC chip and an ultrasonic beamformer IC vertically integrated into a vertical stack configuration wafer; 17 is a detailed schematic block diagram of an exemplary embodiment of an ultrasound engine (ie, front-end ultrasound special circuitry) and an exemplary embodiment of a computer motherboard (ie, host computer), The ultrasonic engine and the computer motherboard are configured as a single-board complete ultrasonic system; Figure 18 is a perspective view of an exemplary mobile ultrasound system provided in accordance with exemplary embodiments; 19 illustrates an exemplary view of a main graphical user interface (GUI) presented on a touch screen display of the exemplary mobile ultrasound system of FIG. 18; 20A and 20B are top views of a medical ultrasound imaging system according to another preferred embodiment of the present invention; Figure 21 illustrates a preferred truck system of a flat-panel ultrasonic system according to a preferred embodiment of the present invention; Figure 22 illustrates a preferred truck system of a modular ultrasound imaging system according to a preferred embodiment of the present invention; 23A and 23B illustrate a preferred truck system of a modular ultrasound imaging system according to a preferred embodiment of the present invention; Figure 24 illustrates a preferred truck system of a modular ultrasound imaging system according to a preferred embodiment of the present invention; 25A to 25B illustrate a multifunctional plug-in base of a flat-panel ultrasound device; Figure 26 illustrates a 2D imaging operating mode of a modular ultrasound imaging system according to the present invention; Figure 27 illustrates a motion operating mode of a modular ultrasound imaging system according to the present invention; Figure 28 illustrates a color Doppler operating mode of a modular ultrasound imaging system in accordance with the present invention; Figure 29 illustrates a pulse wave Doppler operating mode of a modular ultrasound imaging system in accordance with the present invention; Figure 30 illustrates a three-way scan operation mode of a modular ultrasound imaging system according to the present invention; Figure 31 illustrates a GUI main screen interface in a user operation mode of a modular ultrasound imaging system according to the present invention; Figure 32 illustrates a GUI menu screen interface in a user operation mode of a modular ultrasound imaging system according to the present invention; Figure 33 illustrates a GUI patient information screen interface in a user operating mode of a modular ultrasound imaging system according to the present invention; Figure 34 illustrates a GUI default screen interface in a user operation mode of a modular ultrasound imaging system according to the present invention; Figure 35 illustrates a GUI review screen interface in a user operating mode of a modular ultrasound imaging system according to the present invention; Figure 36 illustrates a GUI report screen interface in a user operation mode of a modular ultrasound imaging system according to the present invention; 37A to 37C illustrate a GUI setting display screen interface in a user operation mode of a modular ultrasound imaging system according to the present invention; Figure 38 illustrates a GUI setting storage/retrieval screen interface in a user operation mode of a modular ultrasound imaging system according to the present invention; 39A to 39C illustrate an XY biplane probe according to a preferred embodiment of the present invention, the XY biplane probe including two one-dimensional 1D multi-element arrays; Figure 40 illustrates the operation of forming a biplanar image of an xy probe; Figure 41 illustrates the operation of forming a biplanar image of an xy probe; Figure 42 illustrates a high voltage driver circuit that forms a biplane image of an xy probe; Figures 43A-43B illustrate simultaneous biplane assessment of left ventricular status; and 44A and 44B illustrate a shot rate probe measurement technology according to a preferred embodiment of the present invention; Figure 45 shows the calculated sound pressure levels at the fundamental frequency, second harmonic frequency and superharmonic frequency in the tissue at the focal length as a function of lateral distance (in mm); Figure 46 shows the beam profiles of the fundamental, second harmonic, and third harmonic; Figure 47 shows an A-mode curve of 15 MHz fundamental wave image, 15 MHz transmission waveform, and 15 MHz received A-mode waveform; Figure 48 shows the full width at half maximum (FWHM) curve of the phantom A-mode image of the 15 MHz received fundamental wave image and the 15 MHz transmitted waveform; Figure 49 illustrates the use of the GAMMAX 4040GS phantom, second harmonic half maximum (FWHM) pin dimensions in the axial dimension, 7.5 MHz transmitted waveform, and 15 MHz received second harmonic image; Figure 50 illustrates the use of GAMMAX 4040GS Phantom, third harmonic half maximum (FWHM) pin dimensions in the axial dimension, 5 MHz transmitted waveform and 15 MHz received waveform; Figure 51A and Figure 51B illustrate that a spectrum of a square waveform has a third harmonic component at about -4 dB lower than the fundamental frequency. The third harmonic component is a third high harmonic component; therefore, the conventional square wave is not suitable for use. To realize the transmission waveform of high-order harmonic imaging; Figure 52 illustrates a two-thirds waveform illustrating a harmonic signal; Figure 53 shows a two-thirds square waveform and a spectrum of a sine wave; this modified waveform has a third harmonic component that is much larger than the third harmonic component of a regular square wave, and is close to a pure sine wave ; Figure 54A and Figure 54B provide a comparison of a fundamental image and superharmonic imaging, where the superharmonic image is generated using pulse cancellation technology by transmitting two-thirds of the modified waveform using 4.5 MHz and is generated from a third-order high-frequency waveform. It consists of harmonics, fourth harmonic and fifth harmonic; Figure 54C illustrates a single line placed through the area of interest. Figures 54D and 54E show the shape of a return echo after a first frequency pulse and a return echo after a negative single pulse transmission waveform at a second frequency; Figure 54F illustrates several lines passing through the area of interest through which the process is automatically repeated; Figure 55A shows a hydrogel pad marked with scanning direction and probe placement. Each rectangle is 50 mm × 200 mm. Place the transducer at the top of the first rectangle and move it to the bottom with your bare hands. And move the probe to the starting point of the second rectangle, and start scanning again until four rectangular areas are covered. Figure 55B illustrates a transducer array having an imaging array and a position tracking array. Figure 55C illustrates an imaging sequence using position tracking of a transducer probe. Figure 56A illustrates a computational neural network model with fully connected artificial neural nodes in accordance with various embodiments of the present application. Figure 56B illustrates a portion of a radial basis function classifier model having an input layer and a hidden layer in accordance with various embodiments of the present application. Figure 57 illustrates a flow diagram of a process for imaging using multiple modalities in accordance with various embodiments of the present application. Figure 58A illustrates a system for performing multi-modal imaging in accordance with various embodiments set forth herein. Figure 58B illustrates yet another embodiment that includes a graphics processor that performs the machine learning and image processing and diagnostic methods described herein. Figure 58C illustrates an exemplary ultrasound application data flow according to one of the various embodiments set forth herein. Figure 58D illustrates an exemplary artificial intelligence application data flow according to one of the various embodiments set forth herein. Figure 58E illustrates an image of a circuit board layout of a tablet computer configuration according to various embodiments. Figure 59 illustrates the use of a shared memory to provide communication with an external application in accordance with various embodiments described herein. Figure 60A illustrates a distributed processor system 4954 integrated into an exemplary tablet or laptop ultrasound system. Figure 60B shows a screenshot of a software engine performing echocardiography on a patient. Figure 61 illustrates a triple scan image used to perform range gate analysis. Figure 62 illustrates an image window display soft key or touch icon. Figure 63 illustrates a keyboard control panel of a mobile ultrasound system. Figure 64 illustrates a plurality of soft keys displayed on the imaging window. Figure 65 illustrates imaging of uterine fibroids with arrows and text added. Figure 66 illustrates a time gain control (TGC) curve as a function of depth. Figure 67 illustrates a modified ROI window launched using a touch screen or control panel. Figure 68 illustrates the measurement of an ellipse on an image. Figure 69 shows the trace measurement of the shape on an image. Figure 70 shows a time series measurement display window. Figure 71 illustrates an anatomy study preset selection window. Figure 72 illustrates a needle visualization once the transmission frequency is adjusted. Figure 73 illustrates a cross-sectional view of a flat-panel ultrasound device according to various embodiments. Figure 74 illustrates a bottom schematic view of a flat-panel ultrasound device with the bottom portion of the housing and the ultrasound engine removed, in accordance with various embodiments set forth herein. Figure 75 illustrates a schematic diagram of a display of a flat-panel ultrasound device in accordance with various embodiments set forth herein.

2000‧‧‧Medical ultrasound imaging equipment/tablet computer system

2010‧‧‧Touch screen monitor

2020‧‧‧Ultrasonic Control

2030‧‧‧Case

2040‧‧‧Ultrasound data

2060‧‧‧Front panel

2070‧‧‧Rear panel

2080‧‧‧Port

2082‧‧‧Card

2084‧‧‧SIM card/SIM circuit

Claims (24)

A movable medical ultrasound imaging device, which includes: a transducer probe that accommodates a transducer array; a tablet housing that communicates with the transducer probe , the tablet computer case is powered by a battery and has a computer located in the tablet computer case, the computer has at least one processor including a central processing unit and at least one memory; a touch screen display that displays an ultrasound image, the touch screen display positioned on the tablet case; a graphics processor located in the tablet case communicating with the central processing unit and a shared memory; and an ultrasound beam An ultrasound beamformer processing circuit receives image data from the transducer array. The ultrasonic beamformer processing circuit is communicatively connected to the computer and generates beamformed image data, wherein A machine learning operation is performed on the beamformed image data by the graphics processor to generate a processed ultrasound image displayed on the touch screen display. The device of claim 1, wherein the central processing unit and the graphics processor connected to a core memory are mounted on a circuit board. The device of claim 1, wherein the transducer array includes a bi-planar transducer array. The device of claim 1, wherein the probe further includes a probe installed together Laparoscopic imaging device or a camera. The device of claim 1, wherein the central processing unit and the graphics processor configured to operate a neural network are mounted on a circuit board. The device of claim 1, wherein the tablet case is powered by a battery within the tablet case, and the beamformer processing circuit is located in the tablet case with an encryption circuit. The device of claim 1, wherein the computer can receive an input from the touch screen display, the input being received at a first position within a region of a virtual window on the display. The device of claim 1, wherein an input on the touch screen display corresponds to a pressing gesture on the touch screen display. The apparatus of claim 8, further comprising receiving a second input from the touch screen display at the computer, the second input being received substantially simultaneously with the input. The device of claim 1, wherein the transducer array includes a plurality of transducer arrays, each of the plurality of transducer arrays being operated by a probe beamformer processing circuit. The device of claim 1, further comprising executing, by the computer, the ultrasound image based at least in part on a first cursor at a first position in a display area or virtual window, as appropriate. At least one quantitative measurement. The device of claim 1, further comprising receiving an input from a keyboard control panel or a virtual control panel at the computer. The device of claim 8, wherein the further input corresponds to a press and drag gesture on the touch screen display. The device of claim 1, further comprising a bus connecting the graphics processor to the ultrasonic processor and the shared memory. The device of claim 1, wherein the tablet casing has a volume of less than 1/2500 cubic centimeters. The device of claim 1, wherein the processor is configured to operate a graphical user interface to display one or more menus in response to a touch gesture, so that a user can select one or more computer programs to execute. At least one of the machine learning operation, a computer-aided imaging operation and/or an augmented reality operation. The device of claim 1, wherein the tablet computer casing is installed on a truck, and the device optionally further includes a multiplexer located on the truck, and the multiplexer can be electrically connected to the tablet computer casing To connect to multiple transducer arrays, the multiplexer can be switched using a touch gesture. A movable medical ultrasound imaging device, which includes: a transducer probe having a plurality of transducer elements; a tablet computer display device that communicates with the transducer during an ultrasound imaging procedure The probe communicates to process and display ultrasound data and images. The tablet display device has a battery, at least one processor including a central processing unit in communication with a graphics processing unit, and a touch screen display, wherein the touch screen Gestures actuate multiple operating modes for displaying ultrasound images; an ultrasound beamformer device located in the transducer probe that processes ultrasound signals from the transducer elements to Generating ultrasound data; and wherein the graphics processing unit in the tablet display device is configured to perform a machine learning operation and generate processed data for display on the touch screen display during the ultrasound imaging process Ultrasound images. The device of claim 18, wherein the machine learning operation includes processing data with a neural network. The apparatus of claim 18, wherein the machine learning operation includes overlaying an image generated in an ultrasound imaging mode with an image generated in a first imaging mode. The device of claim 18, wherein the graphics processing unit is connected to a shared memory. The device of claim 19, wherein the neural network includes a pulse coupled neural network. The device of claim 18, wherein the ultrasonic beamformer device is operated by a controller located within the transducer probe. The device of claim 18, further comprising a graphical user interface configured to operate on the touch screen display and having a touch function for selecting one of a plurality of ultrasound imaging modes. a touch actuated menu window, and at least one touch-activated icon for selecting a machine learning mode.