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my siu m

Medical Ultrasound
Nguyn hu t

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Phn I. Gii thiu chung v Thit b y t


Thit b y t bnh vin
Thit b y t gia nh

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I.1. Thit b y t bnh vin


thit b trong cn lm sng (thm khm)
Thit b trong lm sng (iu tr)
thit b ph tr

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I.1. Thit b y t dng trong thm khm


I.1.1. thit b chn on hnh nh:
thit b xquang: xquang thng, cao tn, tng sng, s
thit b siu m: en trng (sch tay, xe y), mu, 3D, 4D
ni soi: tmh, d dy, i trng, t trng...
Ct lp in ton (CT scanner): chia theo lp ct
Cng hng t: chia theo cng sut
Pet-CT, Spect-ct

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I.1. Thit b y t dng trong thm khm


I.1.2. thit b xt nghim:
phn tch huyt hc (bn t ng, t ng)
xt nghim sinh ha (quang k, bn t ng, t ng)
Xt nghim nc tiu
xt nghim min dch (elisa, ha pht quang, in ha pht
quang)
Xt nghim ng mu
xt nghim in gii
xt nghim kh mu
xt nghim pcr (Polymerase Chain Reaction )

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I.1. Thit b y t dng trong thm khm


I.1.3. thit b thm khm khc:
my in tim
my in no
monitor theo di bnh nhn
monitor sn khoa
siu m doppler nghe tim thai
cc thit b thm khm chuyn khoa khc

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I.2. Thit b y t dng trong iu tr


my th (my tr th)
my gy m
dao m in
my ph rung tim
bn m
My truyn dch t ng, Bm tim in
my ht
my kh dung
my to xi
nng p
thit tr liu in, tr liu t, siu m tr liu

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I.3. Thit b y t ph tr
ni hp
t sy
my git
t lnh y t
h thng nc y t
h thng kh y t
h thng x l rc y t

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II. Thit b y t gia nh


cc loi my massage
my o huyt p
my tr thnh
my o ng huyt
my o nhit

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Phn II. Cc thit b siu m y t


siu m chn on hnh nh
siu m tr liu
siu m doppler tim thai- monitor sn khoa
kh dung siu m

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A. siu m chn on hnh nh


I. Phn loi
theo hnh dng vt l: xch tay, xe y
Theo chc nng: en trng, mu, 3 chiu (3D), 4 chiu
(4D), siu m tim, siu m mt

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II. Mt s hng siu m ti vit nam


2.1. Aloka:
SSD 500, ssd 900
ssd 620, ssd 630, ssd 650
ssd 1000, ssd1100, ssd 1200
ssd 1700, ssd 2200
ssd Prosoud anpha, ssd 3500, ssd 4000

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I. siu m chn on hnh nh


2. Mt s hng siu m ti vit nam
2.2. GE
logiq: 100, 200, E9, P3, P5... 400, logiq 500, 7, P6..
Vivid: i, e, q, S5, s6...
Voluson: 530, 730, e, i, e6, e8..

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I. siu m chn on hnh nh


2. Mt s hng siu m ti vit nam
2.3. siemens
Sonoline: ls1, ls2, adra, G40, g50, g60S
acusion: P10, X150, x350, x500, S2000...

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I. siu m chn on hnh nh


2. Mt s hng siu m ti vit nam
2.4. mt s hng khc
hitachi
toshiba
hp
shimadzu
mt s hng ca trung quc, hn quc, m, h lan

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II. C s siu m chn on hnh nh

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1. C s v t l
C s sng m
bn cht sng siu m
cc i lng c trng ca sng siu m
cc quy lut ca sng siu m

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1. C s v t l
1.1. cc i lng c trng
tn s siu m

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1. C s v t l
1.1. cc i lng c trng
tn s siu m

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1. C s v t l
1.1. cc i lng c trng
vn tc lan truyn sng
tr khng m

1
c
0 K

Z 0c
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vn tc lan truyn sng


tr khng m

TT

Mi trng vt cht

1 M

1470
m/s

0.79 g/cm3

1,42.105 g/cm3.S

2 Sn

1700
m/s

9.97 g/cm3

1,65. 105 g/cm3.S

3 T bo tht

1568
m/s

1.04 g/cm3

1,63. 105 g/cm3.S

4 T bo no

1530
m/s

1.02 g/cm3

1,56. 105 g/cm3.S

5 Xng

3600
m/s

1.70 g/cm3

6,12. 105 g/cm3.S

6 Nc

1492
m/s

0.9982 g/cm3 1,489. 105 g/cm3.S

331 m/s

0.0013 g/cm

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7 Khng kh

0,0043. 105
g/cm3.S

1.2. cc quy lut truyn m


quy lut phn x v khc x
s tn x
s hp th
hiu ng doppler

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1.2. cc quy lut truyn m


quy lut phn x v khc x

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H s phn x
Z2
Z1
_
pr cos t cos i
R

Z2
Z1
pi

cos t cos i

khi, i = t = 0 and
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Z 2 Z1
R
Z2 Z 1

H s phn x ti b mt mt s mi trng

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1.2. cc quy lut truyn m


quy lut phn x v tn x

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1.2. cc quy lut truyn m


quy lut hp th v suy gim
Mt
[kg/m3.10
3
]

Vn tc
[m/s]

H/P dist.at
2 Mhz [cm]

Atennuat.at
1MHz [dB/cm]

Khng kh

0,00129

331

0,08

1,7

Nc

1,0

1492

380

0,002

Mu

1,0

1560

15

0,1

Nc bin

1,02

1535

15

0,0025

0,97

1470

15

0,4

1,04

1568

1 0.6

0,7

Gan

1,06

1560

0,6

Thn

1,04

1565

0,5

Mi trng

No
Da

1,03

1520

1,1

Xng
1,7 9,97
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0,5

1950
1700
3600

1,0
0,7 0,2
5,1 1

1.2. cc quy lut truyn m


quy lut hp th v suy gim

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1.2. cc quy lut truyn m


quy lut hp th v suy gim

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Hiu ng doppler

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Hiu ng doppler

v
Fd =

2*V*F0 *Cos
C

Sng thu tn s

F0 Fd

A
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Sng pht tn s

F0

vn tc chuyn ng

fDc
V
2 f cos
f D Doppler shift
f Excitation frequency
c Speed of sound in tissue

Angle of excitation

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Dng nh mu t hiu ng doppler

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HNH NH DOPPLER

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HNH NH DOPPLER

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Nguyn l siu m

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vng t cc c quan trong c th

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2. Nguyn l my siu m
2.2. phng php to nh theo mode a

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2.3. Phng php dng nh mode B (bright)

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A-mode

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B-mode Example

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Siu m tim

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Lt ct siu m tim

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Hnh nh ca Tim trong Mode B

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Hi chng hp van hai l

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3.4. Phng php dng nh mode m (motion)

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M-mode

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3. u d my siu m
3.1. Hiu ng p in

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Nguyn l p in

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Phn t p in

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3. u d my siu m
3.2. nh dng chm tia siu m

Chm siu m c th nh dng bng cc


thu knh
u d pht siu m theo ba vng
Vng gn (Fresnel region)
Vng hi t (Focused field)
Vng xa (Fraunhofer region)

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nh hng chm tia siu m

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Hi t chm tia

Mt thu knh s
hi t chm tia
theo phng
trnh:

l f
d 2.44
D
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nh hng chm tia

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Hng chm tia (thu v)

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3.3. Cu to u d
3.3.1. cu to chung

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Cu to u d

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Transducer

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Types of Probes

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3.3.2. u d r qut c kh (sector)

Hnh 18. Hai phng php qut ca u d sector c kh

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u d r qut c kh
ng dng: siu m tim, ni, sn ph khoa
u im:
Vng tip xc nh
trng quan st ln

Nhc im:
dng c kh nn bn khng cao
chuyn mode chm

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3.3.3. u d phng

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u d mng phng (Phased Linear Array)

Hnh 14. Cu to v nguyn l lm vic ca u d phng

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u d mng phng (Phased Linear Array)

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u d mng phng (Phased Linear Array)

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u d mng phng (Phased Linear Array)

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u d mng phng (Phased Linear Array)


ng dng: vng bng, tuyt gip, vng nng
u im:
Vng thm khm rng
gi thnh phi chng
khng c phn c kh

Nhc im:
kch thc ln
phn di theo chiu dc v ngang khc nhau
i hi vng tip xc gia u d v c th ln.

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3.3.4. u d r qut in t (convex)

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u d convex
ng dng: vng bng, sn ph khoa, tim mch
u im:
Vng thm khm rng
gi thnh phi chng
khng c phn c kh
b mt thm khm nh

Nhc im:
cht lng siu m vng bng khng cao

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3.3.5. cc loi u d chuyn dng


u d tim
u d sn ph khoa
u do mt
u d 3d, 4d
..

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Ti to hnh nh 3d t u d khi

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3.3.6. phn di ca u d

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3.3.6. phn di ca u d

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3.3.6. phn di ca u d

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4. My siu m
4.1. nguyn l

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4. My siu m
4.2. s khi
u d

Khi thu
pht siu
m

dsc

tn hiu
hnh
nh

Mn hnh
My in
a

Ngun AC

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Khi
ngun

Khi iu
khin, b
nh

Bn phm, chut,
cng tc chn

4. My siu m chn on hnh nh


4.3. ng dng
bng (abdoment).
sn khoa/ph khoa (0b/gyn)
tim mch (cardiology)
thn, tit niu (urology)
phn nh (small part)

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