MODULE 5

Medical Imaging systems (Basic Principle only):

❑ X-ray imaging - Properties and production of Xrays, X-ray machine,

applications of X-rays in medicine.

❑ Computed Tomograpy (CT): Principle, image reconstruction, scanning

system and applications

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❑ Ultrasonic imaging systems: Basic pulse echo system, propagation of
ultrasonic through tissues and reflections, display types, A-Scan, B-Scan,
M-Scan, applications, real-time ultrasonic imaging systems and probes.

❑ Magnetic Resonance Imaging: Basic NMR components, Biological

effects and advantages of NMR imaging

❑ Patient Safety: Electric shock hazards, leakage current, safety codes for
electro medical equipments.
 X-ray imaging
➢ X-rays are electromagnetic radiation of exactly the same nature as light but
of very much shorter wavelength
➢ The x-rays in the medical diagnostic region have wavelength of the order
of 10-10m.
➢ They propagate with a speed of 3x 1010cm/s and are unaffected by electric
and magnetic fields.
➢ According to quantum theory , electromagnetic radiation consists of
photons , which are conceived as packets of energy and their interaction
with matter involves an energy exchange and the relation between the
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wavelength and the photon given by

E = hv = h

Where h is Planck's constant
c- velocity of propagation of photons
v- frequency of radiation
wavelength is lambda
 Properties of X-rays

➢ Properties can be classified as

➢ Physical
➢ Chemical
➢ Biological
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➢ Physiochemical
Physical properties:
➢ X rays belong to a family of electromagnetic radiations having
wavelength between 10A and .01 A
➢ They travel with the same speed of visible light.(1,86000 miles/sec)
➢ They are invisible to eye and cannot be seen, heard or smelt.
➢ They cannot be reflected , refracted or deflected by magnetic or
electric field as they do not possess any charge.

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➢ X-rays are pure energy , no mass and they transfer energy from
place to place in the form of quanta.
➢ X-rays can penetrate various objects and the degree of penetration
depends on the quality of the X-ray beam and also on the intensity
and the wavelength of the X-ray beam.
➢ X-rays able to penetrate through materials which readily absorb and
reflect visible light.
Chemical Properties:
➢ X-rays induce color changes. Methylene blue gets bleached.
Sodium platinocyanide which is apple green turns to dark green and
then to light brown and finally to darker brown.
➢ X-rays brings about chemical changes in solutions that are otherwise
stable
➢ X-rays cause destruction of fermenting power of enzymes.
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➢ X-rays produce ionization in gases and influence the electric
properties of liquids and solids. This property is made use in
construction of radiation measuring instruments.
➢ X-rays also produce fluorescence in certain materials to help them
emit light. Fluoroscopic screens and intensifying screens have been
constructed on the basis of this property.
➢ X-rays can affect photographic film in the same way as ordinary
visible light.
Biological Properties:
➢ When X-rays are incident on an atom, one of the reaction it
produces is excitation.
➢ These state of excitation in biological materials enable it to take part
in a chemical process into which in the normal state it would not
enter. This is an important cause of biological damage produced by
radiation.

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Physiochemical Properties:
➢ The photographic paper or film when exposed to x-rays and then
developed will be blackened.
➢ This blackening is known as film density and degree of blackening
depends on
➢ Amount of radiation
➢ Quality of radiation
➢
➢
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Characteristic of the film
Concentration and age of developing solution
➢ Length of developing time
➢ Use of intensifying screens.
 Production of X-rays
➢ X-rays are produced when electrons collide with matter at a very high speed.
➢ X rays are produced in a specially constructed glass tube which has source for
production of electrons ,a energy source to accelerate the electrons, a free
electron path , a means to focus the electron beam and a device to stop the
electrons.
➢ Two types of X ray tubes
➢ Stationary anode tube
➢ Rotating anode tube

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Figure Shows a Stationary anode tube

➢ The tube is a vacuum diode in which the cathode consist of a
tungsten filament and the anode has a tungsten film.

➢ Electrons are generated by thermionic emission from a filament of

the tube When the tungsten filament is heated, it emits electrons

➢ The electron beam is electrostatically focused on a target on the

anode by means of a suitably shaped cathode cup.
➢ The kinetic energy of the electron impinging on the target is
converted to x-rays.
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➢ The cathode block which has the filament is usually made from
nickel. The filament is closely wound helix of tungsten wire .
➢ Anode is constructed of the 2 materials copper and tungsten, known
as a compound anode.
➢ The target is normally comprised of a small tablet of tungsten and
in special cases , molybdenum are also used.
➢ Stationary anode tubes are used mostly in small capacity x-ray
machines.
X ray machine block diagram

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• It consist of two circuits: one for generating high voltage to the cathode and
other for heating the coil.
• The high tension circuit consist of an exposure switch. The exposure switch
controls the timer . Timer controls the time for which the high voltage is to be
given to the cathode.
• The voltage of the high tension voltage is measured by kV meter.
• It is then rectified before supplying to the anode.
• It also has a kV selector to select the range of voltage to be supplied.
• The heating circuit consist of a filament supply and a temperature control
which supplies the voltage to the coil and controls its temperature for proper
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emission of electrons.
• The voltage compensator provides compensation for variations in input supply
➢ Voltages in the range of 30-200kV are required for the production of x-rays for
diagnostic purposes. For this high voltage generation following circuits may
be used.
➢ Self rectified circuit
➢ Full wave rectification X-ray circuit
➢ Six rectifier circuit
➢ Twelve rectifiers circuit
 Application of x-rays in medicine
• X-rays are used in medicine for medical analysis. Dentists use them to find
complications, cavities and impacted teeth. Soft body tissues are transparent
to the waves. Bones and teeth block the rays and show up as white on the
black background.
• A standard radiograph is usually the first course of action when a patient is
suffering from a suspected bone injury. The excellent natural contrast
provided by bone produces clear images with good resolution for the
diagnosis of fractures, dislocations, spinal injuries and so on. Other
abnormalities, ranging from tumours and cysts in the spine to arthritis can
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also indicated .
• A standard chest X-ray is the commonest means of detecting lung cancer and
other abnormalities.
• Mammogram is a safe, low-dose x-ray of the breast. A high-quality
mammogram is the most effective tool for detecting breast cancer early.
Early detection of breast cancer may allow more treatment options. Using a
low-dose x-ray, the mammogram machine takes a snapshot of the inside of a
woman’s breast.
• An artificial contrast medium, typically an organic iodine
compound, is injected into the blood vessel to be examined. The
structure and effective flow diameter of both arteries and veins can
be examined, allowing the diagnosis of blood vessel blockages and
heart disease.
• Most dental practices now have small X-ray units, to investigate
problems with the overcrowding or uneven growth of teeth,

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particularly in juveniles, or with the growth of wisdom teeth.
• It is amazing what people, particularly children, will swallow! A
standard radiograph can help to identify the shape and position of
such objects to assist with their removal .
 COMPUTED TOMOGRAPHY (CT SCAN)

• There are two main limitations of using conventional X-rays to

examine internal structures of the body.
• First –Examination of three-dimensional information of body
in a single plane makes diagnosis confusing and often difficult.
• Second - the photographic film usually used for making
radiographs has a limited dynamic range.

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• These limitations have been overcome by means of CT scan.
• Tomography is a term derived from the Greek word ‘tomos’
meaning to write a slice or section‘.
• In computed tomography (CT), the X-ray picture of patient is
taken from various angles and mathematically reconstructed to
get the detailed structure of the body.
Principle of operation
• In computed tomography, X-rays from a finely collimated source are made to pass
through a slice of the object or patient from a variety of directions.
• While passing through the tissue, some of the x-rays gets attenuated in the tissue
and the remaining is transmitted through it.
• The length and density of tissues, presence of bones will change the attenuation of
X-rays.
• In principle, computed tomography involves the determination of the amount of
attenuation of X-rays and the transmitted radiation intensity from various angles.
• These calculated tissue attenuation and transmission characteristics are composed to
get the CT image.
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Working
• X-ray source and detectors are mounted opposite to each other with patient lying in between.
• X-ray tube and collimator generates the X-ray beam.
• This beam is transmitted through the body of the patient.
• At the detector located opposite to the x-ray tube, the intensity of the transmitted X-ray is
calculated.
• The detectors absorb the Xray photons and emit the energy as visible light. This is converted
to electrons by a photo multiplier tube and then amplified.
• The intensity of the X-ray being received varies depending upon the length of cross-section of
body, presence of organs and bones.
• The intensity of the receiving X-rays gives the information of the inner parts of the body.
•
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This intensity is then mathematically developed by means of computer, to build the image of
the layer of the body through which the X-ray is passed.
 Subsystem of Tomography (Components of CT)
➢ Scanning system:-takes suitable readings for a picture to be
reconstructed and includes X-ray source and detectors
➢ Processing Unit:- converts these readings into picture
information
➢ Viewing part :- presents this information in visual form and

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includes other manipulative aids to assist diagnosis.
➢ Storage Unit:-enables the information to be stored for
subsequent analysis.
Image Reconstruction
• The formation of a CT image is a distinct three phase process
• The scanning phase produces data
• The reconstruction phase processes the acquired data and forms a
image.
• Digital-to analog conversion phase: convert the analog image to
digital image
• The scanning phase
– During the scanning phase a fan-shaped x-ray beam is scanned around the
body.
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– The amount of x-radiation that penetrates through the human body is
measured by the detectors that intercept the x-ray beam after it passes
through the body.
– The projection of the fan-shaped x-ray beam from one specific x-ray tube
focal spot position produces one view.
– Each view produces one "profile“
– Many views projected from around the patient's body are required in
order to acquire the necessary data to reconstruct an image.
• The reconstruction phase
– Image reconstruction is the phase in which the scan data set is
processed to produce an image.
– The image is digital and consist of a matrix of pixels.
– Filtered back projection is the reconstruction method used in CT.
– "Filtered" refers to the use of the digital image processing algorithms
that are used to improve image quality or change certain image quality
characteristics, such as detail and noise.
– "Back projection" is the actual process used to produce or "reconstruct"
the image
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• In general, the reconstruction methods can be classified into the following
three major techniques: .
• Back projection, which is analogous to a graphic reconstruction;
• Iterative methods, which implement some form of algebraic solution;
• Analytical methods, where an exact formula is used
• Two of these are filtered-back projection, which incorporates the
convolution of the data and Fourier filtering of the image, and the two-
dimensional Fourier reconstruction technique.
 CT image reconstruction

➢ For an NxN image , we have N2 unknowns to estimate the

digital image reconstruction.
Back propagation
Iterative reconstruction

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Analytical methods
[Link] back propogation
[Link] filtering
 Back projection

➢ The oldest method

➢ No used in commercial scanners
➢ Method is analogous to a graphic representation
➢ Processing part is simple and direct
➢ In this method each of the measured profiles is projected back over the
image area at the same angle from which it was taken.

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➢ At the same time, each projection contributes not only to the points that
originally formed the profile, but also to all the other points in its path.
➢ This technique in fact produces 'starred' images With sufficient projection
angles , structures can somewhat be restored.
➢ Problem with Back propagation include mainly sever blurring in computed
images.
Iterative reconstruction
➢ This method is not in use in commercial method.
➢ This method implements some form of algebraic solution
➢ The earlier brain scanners used the iterative method which took a succession of back
projections correcting at each stage until an accurate reconstruction was achieved.

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➢ The above figure illustrates how the iterative or successive approximation method
is used to get the image of attenuation coefficients from the measured intensity
data.
➢ Suppose attenuation coefficients not known in the first row is 4 and 6 and second
row is 1 and 8 representing characteristics of tissue within the patient.
➢ Object is scanned with xrays, the sum in all directions is done .
➢ For scan 1 vertical sum is 5 and 14, scan 2 diagonal sum is 1, 12 and 6, scan 3
horizontal sum is 10 and [Link] datas will be used to calculate the image matrix.
➢ Data in scan 1 is back projected and distributed equally 2.5 and 2.5(5/2) and 14
again projected as 7 and 7 (14/2).

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➢ The matrix of resulting image is of the first iteration is summed diagonally as 2.5,
9.5 and 7 and compared with values of scan 2. The differences -1.5,2.5 and -1 are
projected with equal weighting diagonally to get scan third iteration result.
➢ Disadvantage is more computing time.
Analytical methods-Filtered back projection(FBP)
➢ Filtered back projection incorporates the convolution of data
➢ This method uses a spatial filter to remove the blurring artifacts
➢ This is got by convolving a shadow function with a filter so that each point
in the projection has a negative value instead of 0, at every point other than
its proper place in projection.

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➢ The resulting profiles are then back projected and added.
➢ Thus the negative portion of each shadow function cancels out image
artifacts that would otherwise be caused by other functions.
➢ The figure below shows the block diagram of the image reconstruction
computer.
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CT or CAT – Advantages
➢ significantly more data is collected
➢ superior to single X-ray scans
➢ far easier to separate soft tissues other than bone from one
another (e.g. liver, kidney)
➢ data exist in digital form -> can be analyzed quantitatively
➢ adds enormously to the diagnostic information
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➢ used in many large hospitals and medical centers throughout
the world
CT or CAT – Disadvantages
➢ significantly more data is collected
➢ soft tissue X-ray absorption still relatively similar
➢ still a health risk
CT or CAT - APPLICATIONS
➢ CT enables direct imaging and differentiation of soft tissue structures, such as
liver, lung tissue, and fat.
➢ CT is especially useful in searching for large space occupying lesions, tumors and
metastasis and cannot only reveal their presence, but also the size, spatial location
and extent of a tumor.
➢ CT imaging of the head and brain can detect tumors, show blood clots and blood
vessel defects, show enlarged ventricles and image other abnormalities such as
those of the nerves or muscles of the eye.
➢ Due to the short scan times of 500 milliseconds to a few seconds, CT can be used
for all anatomic regions, including those susceptible to patient motion and
breathing.
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➢ CT images are also used as basis for planning radiotherapy cancer treatment. CT is
also often used to follow the course of cancer treatment to determine how the
tumor is responding to treatment.
➢ CT imaging provides both good soft tissue resolution (contrast) as well as high
spatial resolution. This enables the use of CT in orthopedic medicine and imaging
of bony structures including prolapses (protrusion) of vertebral discs, imaging of
complex joints like the shoulder or hip as a functional unit and fractures,
especially those affecting the spine.
➢ The image post processing capabilities of CT - like multi planar reconstructions
and 3-dimensional display (3D) - further enhance the value of CT imaging for
surgeons. For instance, 3D CT is an invaluable tool for surgical reconstruction
following facial trauma.
 Properties of Ultrasound and X-rays

• Ultrasound rays are Non-invasive, While X-rays are invasive.

• Ultrasound rays are Externally applied and non-traumatic, also
apparently safe at the acoustical intensities. While X-rays only respond
to atomic weight differences and often require the injection of a more
dense contrast medium for visualization of non-bony tissues.
• Diagnostic ultrasound is applied for obtaining images of almost the
entire range of internal organs in the abdomen . These include the
kidney, liver, spleen, pancreas, bladder, major blood vessels and of
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course, the fetus during pregnancy.
• It has also been usefully employed to present pictures of the thyroid
gland, the eyes, the breasts and a variety of other superficial structures.
• In a number of medically meaningful cases, ultrasonic diagnostics has
made possible the detection of cysts, tumors or cancer in these organs.
• The main limitation of ultrasound is that it is almost completely
reflected at boundaries with gas and is a serious restriction in
investigation of and through gas-containing structures.
 ULTRASONIC IMAGING SYSTEMS
• The term ultrasound refers to acoustical waves above the range of
human hearing (frequencies higher than 20000 Hz).
• Medical ultrasound systems operate at frequencies of up to 10 MHz
or more.
• An ultrasonic wave is acoustical; i.e., it is a mechanical wave in a
gaseous, liquid, or solid medium. Such mechanical waves consists
of alternating areas of higher and lower pressures, called
compression and rarefaction zones, respectively.
Characteristics

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• Ultrasonic waves can be easily focused, i.e., they are directional and
beams can be obtained with very little spreading.
• They are inaudible and are suitable for applications where it is not
advantageous to employ audible frequencies.
• By using high frequency ultrasonic waves which are associated
with shorter wavelengths, it is possible to investigate the properties
of very small structures.
• Information obtained by ultrasound, particularly in dynamic studies,
cannot be acquired by any other more convenient technique.
 Use of Ultrasound in Medical Field
• The use of ultrasound in the medical field can be divided into two major
areas: the therapeutic and the diagnostic.

• The major difference between the two applications is the ultrasonic power
level at which the equipment operates.

• In therapeutic applications, the systems operate at ultrasonic power levels

of up to several watts per square centimeter while the diagnostic equipment
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operates at power levels of well below 100 in W/ cm.

• The therapeutic equipment is designed to agitate the tissue to the level

where thermal heating occurs in the tissue, and experimentally has been
found to be quite successful in its effects for the treatment of muscular
ailments such as lumbago.
• For diagnostic purposes, on the other hand, as long as a sufficient amount
of signal has returned for electronic processing, no additional energy is
necessary. Therefore, considerably lower ultrasonic power levels are
employed for diagnostic applications.
 BASIC PULSE ECHO SYSTEM
• The pulse-echo technique, basically, consists in transmitting a train of
short duration ultrasonic pulses into the body and detecting the energy
reflected by a surface or boundary separating two media of different
specific acoustic impedances.
• With this technique, the presence of a discontinuity can be conveniently
established and its position located if the velocity of travel of ultrasound in
the medium is known. Also, it is possible to determine the magnitude of
discontinuity and to assess its physical size.

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Basic Principle
• The transmitter generates a train of short duration pulses at a
repetition frequency determined by the PRF generator.
• These are converted in to corresponding pulses of ultrasonic waves
by a piezoelectric crystal acting as the transmitting transducer.
• The echoes from the target or discontinuity are picked up by the
same transducer and amplified suitably for display on a cathode ray
tube.
• The X plates of the CRT are driven by the time base which starts at

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the instant when the transmitter radiates a pulse.
• In this way, the position of the echo along the trace is proportional to
the time taken for a pulse to travel from the transmitter to the
discontinuity and back again.
• Knowing the velocity of ultrasonic waves and the speed of the
horizontal movement of trace on the CRT, the distance of the target
from the transmitting end can be estimated.
Transducer :
• The transducer consists of a piezo-electric crystal which generates and detects
ultrasonic pulses.
Pulse Repetition Frequency Generator
• This unit produces a train of pulses which control the sequence of events in the rest of
the equipment. The PRF is usually kept between 500 Hz to 3 kHz.
• Oscillator or some form of the astable multivibrator can be used as the PRF Generator.
• The width of the output pulse from the PRF generator should be very small, preferably
of the order of a micro-second, to generate short duration ultrasonic pulse.
Transmitter
• The transmitter is driven by a pulse from the PRF generator
Receiver:
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• The function of the receiver is to obtain the signal from the transducer and to extract
from it the best possible representation of an echo pattern.
• To avoid significant worsening of the axial resolution, the receiver bandwidth is about
twice the effective transducer bandwidth
Wide Band Amplifier:
• The echo-signals received at the receiving transducer may be as small as a few
microvolts, which needs to be amplified.
• This is achieved in a wide-band amplifier, which is wide enough to faithfully reproduce
the received echoes
• It amplifies the detected ultrasonic pulses and removing the noise
• Due to the wide dynamic range of echo-amplitudes that are contained in an ultrasonic
image, a log amplifier is usually utilized.
Swept Gain Control:
• The receiving amplifier can only accept a limited range of input signals without
overloading and distortion.
• Adjust the amplification of the detected ultrasonic pulses depending upon the depth
of reflection
Detector:
• After the logarithmic amplification, the echo signals are rectified in the detector
circuit.
• This is followed by a demodulation circuit in which the fundamental frequency
signal upon which the echo amplitude information has been riding, is eliminated.

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• The output of the demodulator circuit is in the form of an envelope of the echo
signal.
Video Amplifier:
• The signal requires further amplification after its demodulation in detector circuit
before it can be given to the Y- plates of the Cathode ray tube (CRT).
• The output of the detector circuit is typically around I V. but for display on the CRT,
the signal must be amplified to about 100 to 1000 V.
Time Delay Unit:
• The start of the trace can be delayed by the time delay unit so that the trace can be
expanded to obtain better display and examination of a distant echo.
Time Base:
• The Time base speed is adjusted so that echoes from deepest
structures of interest will appear on the screen before the beam has
completely traversed It.

Time Marker:
• The time marker produces pulses that are a known time apart and,
therefore, respond to a known distance apart in human tissues. These

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marker pulses are given to the video amplifier and then to the Y
plates for display along with the echoes.

Display:
• After amplification in the video amplifier, the signal is given to the
Y plates of the CRT. CRT is not only a fast-acting device but also
gives a clear presentation of the received echo signals.
 Propagation Of Ultrasonic Through Tissues And Reflections
• Ultrasound waves are vibrations or disturbances consisting of alternating zones of
compression and rarefaction in a physical medium such as gas, liquid, or solid matter.
• All waves, including both acoustical and electromagnetic possess three related
attributes: frequency (F). wavelength (X), and velocity (V).
Frequency:
• It is defined as the number of complete cycles per unit of time.
• In terms of sound and ultrasound waves, the cycle consist of one complete zone of
compression and followed by one complete zone of rarefaction.
• The basic unit of cycles is the hertz (Hz), which equals one cycle per second (1 Hz = 1
cps);
Wavelength:
• It is the distance traveled by one cycle propagating away from the source and is
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expressed in meters (m), or subunits centimeters (cm) or millimeters (mm).
• The wavelength is also the distance between successive identical features on
successive cycles.
• Distance between two positive peaks or between two negative peaks
Velocity:
• It is the speed of propagation of the wave. In radio signals, the velocity is the speed of
light (c), or 300,000,000 m/s. In human tissue, ultrasound propagates at a much slower
rate. i.e.. around 1500 m/s.
v = λf where λ = wavelength, f = frequency.

• The period of a wave is the time required to complete one cycle and can be measured
in terms of either time or angle
• The type of wave refers to the method of propagation
• The two forms of propagation are
1. Longitudinal Propagation
• In the longitudinal form, the waves propagate in the same direction
as the zones of compression and rarefaction.
2. Transverse Propagation
• In transverse propagation, the waves propagate in a direction
orthogonal (at right angles) to the direction of the zones of
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compression and rarefaction. Transverse propagation occurs when
the wave propagate along the surface of the medium, as on the
surface of a container of water or the surface of a bone.

• In medical ultrasound both forms are seen. While the main mode is
longitudinal propagation, a mode conversion to transverse
propagation can occur. Mode conversion is associated with a
significant loss of signal level.
Reflection of Ultrasound
• Ultrasound travels freely through fluid and soft tissues. However,
ultrasound bounces back (is reflected back) as echoes when it hits a more
solid (dense) surface.
• For example, the ultrasound will travel freely though blood in a heart
chamber. But, when it hits a solid valve, a lot of the ultrasound echoes
back.
• Another example is that when ultrasound travels though bile in a
gallbladder it will echo back strongly if it hits a solid gallstone. So, as
ultrasound hits different structures of different density in the body, it sends
back echoes of varying strength.
• Ultrasonography (sonography) uses a probe containing multiple acoustic
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transducers to send pulses of sound into a material. Whenever a sound
wave encounters a material with a different density (acoustical impedance),
part of the sound wave is reflected back to the probe and is detected as an
echo.
• The time it takes for the echo to travel back to the probe is measured and
used to calculate the depth of the tissue interface causing the echo.
• The greater the difference between acoustic impedances, the larger the echo
is. If the pulse hits gases or solids, the density difference is so great that
most of the acoustic energy is reflected and it becomes impossible to see
deeper.
• Figure given below illustrates the
situation for reflection and refraction.
• At the boundary between two zones
of different density, some of the wave
energy is reflected back into the
original medium, and some
propagates into the second medium
but is refracted (i.e.. changes its
direction of travel).

• If the incident wave impinges on the

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surface or boundary at an angle of 90
degrees (i.e.. it is coincident with the
normal line), it will be reflected back
on itself. But if the angle is other than
90 degrees, then the reflected wave
will travel away from the surface at
the same angle.
• Refraction phenomena affect the
portion of the incident wave that
enters the second medium.
Specular reflection, diffuse reflection, and scattering
• A single incident ray resulting in a single reflected ray is
termed specular reflection.
• In medical ultrasound systems this rarely occurs because it

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requires a flat surface that is large compared with the
wavelength of the signal.
• In most situations, however, the surface is rough and thus so
produces diffuse reflections.
• Scattering is a change in the direction of motion of a particle
because of a collision with another particle.
 DISPLAY TYPES OR IMAGING MODES
• The reflected echoes are now displayed on the screen as a
useful image.
• Various imaging modes or display types found in today's
ultrasound systems are:
• A mode
• B mode
•
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M mode or T-M mode
 A-mode (Amplitude Mode):
• In the A-mode presentation of ultrasound images, echoes returning
from the body are displayed as signals on an oscilloscope.
• A mode means amplitude modulation.
• In this mode, the reflected echoes are displayed as vertical spikes.
• A-scans can be used in order to measure distances.
• A transducer emits an ultrasonic pulse and the time taken for the
pulse to bounce off an object and come back is graphed in order to
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determine how far away the object is.
• A-scans only give one-dimensional information and therefore are
not useful for imaging.
• This mode is considered One Dimensional and used to measure the
distance between two objects by dividing the speed of sound by half
of the measured time between the peaks in the A-mode plot.
• A-Mode display is very difficult to interpret when many echoes are
present simultaneously and often potentially useful information is
wasted.
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• This mode displays the amplitude of a sampled voltage signal

for a single sound wave as a function of time.
Applications:
1. Echoencephalograph:
• In the normal brain, the mid-line surfaces are parallel to the flat
areas of the bone near the ear. When there is a head injury, the brain
gets tilted to one side or the other due to bleeding, but it still retains
its normal shape. In such cases, the echoes can be easily obtained
but they are placed at different distances from the probe, when the
probe is placed first on one side and then on the other side of the
skull.

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2. Echo-ophthalmoscope
• A-mode ultrasonic technique was found to be useful in
ophthalmology for the diagnosis of retinal detachments, intra-ocular
tumours, vitreous opacities, orbital tumours, and lens dislocation. It
helps in the measurement of axial length in patients with progressive
myopia, localization of intra-ocular foreign bodies and extraction of
nonmagnetic foreign bodies.
 B-mode (Brightness)
• B scan means brightness modulation.
• It is the same as A-mode, except that brightness is used to represent the amplitude of the
sampled signal.
• The reflected echoes are showed as dots on the screen
• B-scans can be used to take an image of a cross-section through the body.
• The transducer is swept across the area and the time taken for pulses to return is used to
determine distances, which are plotted as a series of dots on the image.
• B-Scans will give two-dimensional information about the cross- section.
• The B-scan mode may use the same time base as the A-scan but plots the strength of the
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returning signal as changes in brightness, i.e., a strong reflection is brighter than the
weaker reflection..
 M-mode (Motion) display

• In M-mode (M for motion) ultrasound, pulses are emitted in quick

succession - each time, either an A-mode or B- mode image is taken.
• M-mode (Motion) display refers to scanning a single line in the object and
then displaying the resulting amplitudes successively. This shows the
movement of a structure such as heart.
• Because of its high pulse frequency (up to 1000 pulses per second), this is
useful in assessing rates and motion and is used extensively in cardiac and

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foetal cardiac imaging.
• M-mode (M for motion) is a technique that uses B-mode information to
display the echoes from a moving organ, such as the myocardium and valve
leaflets.
• The echo data from a single ultrasound beam passing through moving
anatomy are acquired and displayed as a function of time,
• Over time, this is analogous to recording a video in ultrasound. As the
organ boundaries that produce reflections move relative to the probe, this
can be used to determine the velocity of specific organ structures.
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REAL-TIME ULTRASONIC IMAGING SYSTEMS
• One of the serious limiting factors in B-scanning is the length of time taken to
complete a scan. This results in blurring and distortion of the image due to organ
movement, as well as being tedious for the operator.
• Elimination of motion artifact is important in conventional B-scanning but is critical
if rapidly moving areas such as the chambers of the heart are to be made visible.
• Rapid scanning techniques have been developed to meet these needs. The approaches
used include fast physical movement of a single transducer . Alternatively, electronic
methods using arrays of transducers which can be triggered in sequence or in groups,
may be utilized.
• In these systems, electronic manipulation allows the beam to be swept rapidly
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through the area of interest.
• Finally, instruments in which an array of transducers is combined with mechanized
motion, have also been introduced.
• These instruments are called real-time scanners as there is negligible time delay
between the input of data and the output of processed data in such systems.
• A very important property of ultrasonography is the short image reconstruction time
of about 20 to 100 ms, permitting the real-time scanning and observation of processes
in the organs of the body.
• Consequently, sonography is well-suited to the fast, interactive screening of even
larger organ regions and the display of dynamic processes, such as cardiology.
The real-time systems, therefore, have the following characteristics:
• Possibility of studying structure in motion—this is important for cardiac and foetal
structures.
• During observation, the scan plane can be easily selected since the echo image
appears instantaneously on the display.
Requirements of Real Time Ultrasonic Imaging Systems
• The primary requirements of an ultrasonic imaging system are:
1. High resolution
• High resolution or the ability of the system to resolve fine spatial dimensions is a
key performance requirement.

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• A resolution of 1-3 mm in all three spatial dimensions is desirable for a number of
diagnostic studies like the early detection of tumours or other pathological
conditions.
2. Adequate field of view
• The field of view should be large enough to display the entire region under
examination and to provide a useful perspective view of an organ of interest. When
viewing small superficial structures such as the thyroid, a field of approximately 5
cm * 5 cm can encompass the desired region. For cardiac imaging, sector scans are
preferable to rectilinear scans since a large structure is to be viewed through a small
window. An angle of 60° is adequate to simultaneously view most of the heart.
3. Long range
• The required depth range varies considerably for different anatomical studies. For
example, a range of 25-30 cm is desirable for abdominal and obstetrical studies. For
cardiac studies, the distance from the chest wall to the posterior heart wall is 15 cm
or more. In superficial organs like the breast, thyroid, carotid and femoral arteries
and in infant studies, the range of depth is 3-10 cm.
4. Sufficiently high frame rate
• In real-time imaging systems, the frame rate (the rate at which the image is
retreated) should be rapid enough to resolve the important motions and to obtain the
image without undesirable smearing. Most of these requirements are met with a
frame rate of about 30 frames/s.
• This also satisfies the requirements for flicker-free display and is compatible with
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standard television formats. For some special studies, greater frame rates are often
required for the data acquisition mode. These frames would then be stored and
played back at about 30 frames/s to provide a slow motion presentation.
5. High Detectivity
• It is the ability of an imaging system to effectively capture, process and display the
very wide dynamic range of signals which may, in turn, help to detect ah image,
lesion or other abnormal structure or process. Poor system detectivity manifests
itself in lack of fidelity or picture quality which is often apparent in the visual
displays of ultrasonic images.
 Magnetic Resonance Imaging(MRI or NMR)
• NMR is powerful imaging technique.
• It has high resolution and potential for chemical specific imaging.
• It Uses magnetic fields and RF signals to get anatomical information about the
human body as cross sectional images in any direction and can easily
discriminate between diseased and healthy tissues.
• CT provides information about the bones and tissue structure of an organ
whereas NMR highlights the liquid like areas in those organs and can be used

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to detect flowing liquids.
NMR images are essentially a map of distribution density of hydrogen nuclei
inside the body.
• Since it does not use any kind of ionizing radiation, it has become a safe and
attractive imaging technique.
• MRI also shows flowing liquids like blood inside the body
• MRI can be used to detect the tumors in tissue because the protons in different
tissue return to their equilibrium state at different rates. By manipulating the
return rate, the affected tissues can be identified.
Working principle

• MRI scanner is tube surrounded by a giant circular magnet. The magnet is the largest
and most expensive component of the scanner
• Our body consist of large number of hydrogen nuclei. They have spin moment aligned
in different directions.
• The magnet create a strong magnetic field and which aligns the protons of hydrogen
atoms in the direction of strong magnetic field in water in the body.

• When RF Electric felid is turn on, hydrogen atoms absorb energy and jump to excited
state.

• Again the RF electric field is turn off, now the hydrogen protons return to the original
magnetization alignment.

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These alignment changes create a signal which can be detected by the scanner & with
computer the images can be produce.

• The frequency at which the alignment changes depend on the strength of the magnetic
field.
• The orientation of the image is controlled by varying the main magnetic field using
gradient coils

• High magnetic field produce high signal to noise ratio.

• MRI requires a magnetic field that is both strong and uniform. The field strength of the
magnet is measured in tesla - and while the majority of systems operate at 1.5T
,commercial systems are available between 0.2T - 7T.
 BASIC NMR COMPONENTS
• The basic components of an NMR imaging system are shown in Fig.

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1. Magnet: Provides a strong uniform, steady, magnet field B0.
2. RF transmitter, which delivers radio-frequency magnetic field to the sample.
3. Gradient system, which produces time-varying magnetic fields of controlled
spatial non-uniformity;
4. Detection System, which yields the output signal; and
5. Imager system, including the computer, which reconstructs and displays the
images.
Imager System
• The imaging sequencing in the system is provided by a computer.

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Functions such as gates and envelopes for the NMR pulses, blanking for
the pre-amplifier and RF power amplifier and voltage waveforms for the
gradient magnetic fields are all under software control.
• The computer also performs the various data processing tasks including the
Fourier transformation, image reconstruction, data filtering, image display
and storage. Therefore, the computer must have sufficient memory and
speed to handle large image arrays and data processing, in addition to
interfacing facilities
The Magnet:
• In magnetic resonance tomography, the base field must be extremely uniform in space
and constant in time as its purpose is to align the nuclear magnets parallel to each
other in the volume to be examined.
• Four factors characterize the performance of the magnets used in MR systems; viz.,
field strength, temporal stability, homogeneity and bore size.
• Such a magnetic field can be produced by means of four different ways, viz.,
permanent magnets, electromagnets, resistive magnets and super-conducting magnets.
• Permanent Magnet:
In case of the permanent magnet, the patient is placed in the gap between a pair
of permanently magnetized pole faces. Permanent magnet materials normally used in
MRI scanners include high carbon iron alloys such as alnico or neodymium iron.
• Electromagnets:

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– Make use of soft magnetic materials such as pole faces which become
magnetized only when electric current is passed through the coils wound around
them. Electromagnets obviously require external electrical power supply.
• Resistive magnets:
– make use of large current-carrying coils of aluminium strips or copper tubes
– Need very high electricity to produce high rage of magnetic field
• Superconductive magnets
– Most of the modem NMR machines utilize superconductive magnets. These
magnets utilize the property of certain materials, which lose their electrical
resistance fully below a specific temperature
– High field intensity
RF Transmitter System
• The system consists of an RF transmitter, RF power amplifier
and RF transmitting coils.
RF Transmitter
• In order to activate the nuclei so that they emit a useful signal,
energy must be transmitted into the sample. This is what the
transmitter does.

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• It generate RF pulses .
RF Power Amplifier
• These pulses are amplified to levels varying from 100W to
several kW and are fed to the transmitter coil.
RF Transmitting Coils
• The coil generates RF field perpendicular to the direction of
main magnetic field.
• Coils are tuned to the NMR frequency
Detection System :-
• The function of detection system is to detect the nuclear
magnetization and generate an output signal for processing by the
computer.
• The detector circuit accepts the inputs, the NMR signal V(t) and a
reference signal, and multiplies them, so that the output is the
product of the two inputs
Matching Network :
Following the receiver coil is a matching network which couples it
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to the pre-amplifier in order to maximize energy transfer into the
amplifier. This network introduces a phase shifty to the phase of the
signal.
Pre-amplifier:
The pre-amplifier is a low-noise amplifier which amplifies the
signal and feeds it to a quadrature phase detector.
 BIOLOGICAL EFFECTS OF NMR IMAGING
• The three aspects of NMR imaging which could cause potential health
hazard are:
(i) Heating due to the RF power.
A temperature increase produced in the head of NMR imaging would be
about 0.3°C. This does not seem likely to pose a problem.
(ii) Static magnetic field:
No significant effects of the static field with the level used in NMR are

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known, but the possible side effects of electromagnetic fields are decrease
in cognitive skills, mitotic delay in slime moulds, delayed wound healing
and elevated serum triglycerides.
(iii) Electric current induction due to rapid change in magnetic field:
It is believed that oscillating magnetic field gradients may induce electric
currents strong enough to cause ventricular fibrillation. However, no
damage due to NMR from exposures has been reported. It is suggested that
fields should not vary at a rate faster than 3 Tesla/s.
 ADVANTAGES OF NMR IMAGING SYSTEM

[Link] NMR provides substantial contrast between soft tissues

that are nearly identical.
2. NMR uses no ionizing radiation and has minimal hazards for
operators of the machines and for patients.
3. Unlike CT, NMR imaging requires no moving parts, gantries
or sophisticated crystal detectors.

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4. The system scans by superimposing electrically controlled
magnetic fields consequently, scans in any pre-determined
orientation are possible.
5. With the new techniques being developed, NMR permits
imaging of entire three-dimensional volumes simultaneously
instead of slice by slice, employed in other imaging systems.
6. In NMR both biochemical (spectroscopy) and spatial
information (imaging) can be obtained without destroying the
sample.
 Advantages of MRI over CAT
• The most important advantage of MRI scan is that it is proved to be
harmless to the patients
• It uses strong magnetic field and non ionizing radiation in the RF range
• MRI provides good contrast resolution than CAT Scanning. The contrast
resolution is the ability to distinguish the differences between two arbitrary
similar but not identical tissues
• In MRI, by variation of scanning parameters, tissue contrast can be altered
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and it can be changed in various ways to detect different features
• MRI machines have the ability to change the imaging plane without
moving the patient
• As the MRI scanning does not use ionizing radiations, it is best suited for
cases when a patient is to undergo the test several times successively.
• The brain, spinal cord and nerves are seen much more clearly with MRI
scan
 Patient Safety
• Electric shock burns and fire hazards result from the careless use of electricity.
When electricity is relied upon to support life with devices like external
pacemakers, respirators, etc. power failure is a continuous threat.
• Shock resulting from electric power is a common experience. Disruption of
physiologic function by leakage current applied internally remains sometimes
hidden and mysterious. While faulty electric cords and appliances contribute to the
former, lack of concept and faulty design are responsible for the latter.
Electric current can flow through the human body either accidentally or intentionally.
Electrical currents are administered intentionally in the following cases:

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(i) for the measurement of respiration rate by impedance method, a small current at
high frequency is made to flow between the electrodes applied on the surface of the
body,
(ii) high frequency currents are also passed through the body for therapeutic and
surgical purposes,
(iii) when recording signals like EGG and EEG, the amplifiers used in the preamplifier
stage may deliver small currents themselves to the patient. These are due to bias
currents.
Accidental transmission of electrical current can take place because of a defect in the
equipment; excessive leakage currents due to defect in design; operational error
(human error) and simultaneous use of other equipment on the patient which may
produce potentials on the patient circuit
 ELECTRIC SHOCK HAZARDS
• Hazards due to electric shock are also associated with equipment other than that used in hospitals.
Some such special situations are as follows:
(i) A patient may not be usually able to react in the normal way. He is either ill,
unconscious, anaesthetized or strapped on the operating table. He may not be able to
withdraw himself from the electrified object, when feeling a tingling in his skin, before
any danger of electrocution occurs.
(ii)The patient or the operator may not realize that a potential hazard exists. This is because
potential differences are small and high frequency and ionizing radiations are not
directly indicated.
(iii)A considerable natural protection and barrier to electric current is provided by human
skin. In certain applications of electromedical equipment, the natural resistance of the

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skin may be by-passed. Such situations arise when the tests are carried out on the
subject with a catheter in his heart or on large blood vessels.
(iv) Electro-medical equipment, e.g. pacemakers may be used either temporarily or
permanently to support or replace functions of some organs of the human body. An
interruption in the power supply or failure of the equipment may give rise to hazards,
which may cause permanent injuries or may even prove fatal for the patient.
(v) Several times there are combinations of high power equipment and extremely sensitive
low signal equipment. Each of these devices may be safe in itself, but can become
dangerous when used in conjunction with others.
(vii) The environmental conditions in hospitals, particularly in the operating theatres, cause
an explosion or fire hazards due to the presence of anaesthetic agents, humidity and
cleaning agents, etc.
• There are two situations which account for hazards from
electric shock.
• They are (i) Gross shock and (ii) Micro-current shock.
• In the case of gross shock, the current flows through the
body of the subject, e.g. as from arm to arm.
• The other case is that of micro-current shock in which the
current passes directly through the heart wall. This is the case
when cardiac catheters may be present in the heart chambers.
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Here, even very small amounts of currents can produce fatal
results.
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• Gross shock is experienced by the subject by an accidental contact with the
electric wiring at any point on the surface of the body. The majority of
electric accidents involve a current pathway- through the victim from one
upper limb to the feet or to the opposite upper limb and they generally
occur through intact skin surfaces. In all these cases, the body acts as a
volume conductor at the mains frequency.

• For a physiological effect to take place, body must become part of an

electric circuit. Current must enter the body at one point and leave at some
other point. In this process, three phenomena can occur. These are:

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(i) Electrical stimulation of the excitable tissues, nerves and muscles
(ii) Resistive heating of tissue
(iii) Electro-chemical burns and tissue damage for direct current and very
high voltages.
• The value of electric current, flowing in the body, which causes a given
degree of stimulation, varies from individual to individual. Typical
threshold values of current produce certain responses where the current
flows into the body from external contacts (e.g. hand to hand) and these
have been investigated.
• For a given voltage present on the surface of the body, the value of current passing
through it would depend upon the contact impedance. Besides this, it depends on
many other factors such usage, condition of skin (dry or wet, smooth or rough, etc.),
frequency of current. duration of current and the applied voltage.
• Effects of Electric Current on the Human Body
Threshold of Perception: Bruner (1967) states that the threshold of perception of
electric shock is about 1 mA. At this level a tingling sensation is felt by the subject
when there is a contact with an electrified object through the intact skin. The
threshold varies considerably among individuals and with the measurement
conditions. The lowest threshold could be 0.5 mA when the skin is moistened at 50
Hz. Threshold for dc current are 2 to 10mA.
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Let-go Current: As the magnitude of alternating current is increased, the sensation of
tingling gives way to the contraction of muscles. The muscular contractions
increase as the current is increased and finally a value of current is reached at which
the subject cannot release his grip on the current carrying conductor. The maximum
current at which the subject is still capable of releasing a conductor by using
muscles directly stimulated by that current is called "let-go current".
Physical Injury and Pain: At current levels higher than the ‘let-go current’, the
Subject loses the ability to control his own muscle actions and he is unable to
release his grip on the electrical conductor. Such currents are very painful and hard
to bear. This type of accident is called the 'hold-on-type accident, and is caused by
currents in the range of 20-100mA.
• Ventricular Fibrillation: If current comes in contact with intact skin and passes
through the trunk at about 100 mA and above, there is a likelihood of pulling the
heart into ventricular fibrillation. In this condition, the rhythmic action of the heart
ceases, pumping action stops and the pulse disappears. Ventricular fibrillation
occurs due to the derangement of function of the heart muscles rather than any
actual physical damage to it. Ventricular fibrillation is serious cardiac emergency
because once it starts; it practically never stops spontaneously, even when the
current that triggered it is removed.
• Sustained Myocardial Contraction: At currents in the range of 1 to 6 A. the entire
heart muscle contracts. Although the heart stops beating while the current is

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applied, it may revert to a normal rhythm if the current is discontinued in time, just
as in fibrillation. The damage is reversible if the shock duration is only of a few
seconds.
• Burns and Physical Injury: At very high currents of the order of 6 amperes and
above there is a danger of temporary respiratory paralysis and also of serious burns.
Resistive heating causes burns, usually on the skin at the entry points, because skin
resistance is high. The brain and other nervous tissue loose all functional
excitability when high currents pass through them.
• Gross shock hazards are usually caused by electrical wiring
failures, which allow personal contact with a live wire or surface at
the power line voltage. This type of hazard is dangerous not only to
the patient but also to the medical and attending staff. The most
vulnerable part in the system of electrical safety is the cord and
plug. Their use can result in fatal accidents. Broken plugs, faulty
sockets and defective power cords must be immediately replaced.
• The commonly found fluids in medical practice such as blood, urine,
intravenous solutions, etc. can conduct enough electricity to cause
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temporary short circuits if they are accidentally spilled into normally
safe equipment. This hazard is particularly more in hospital areas
that arc normally subject to wet conditions, such as haemodialysis
and physical therapy areas. The cabinets of many electrically
operated equipment have holes and vents for cooling that provide
access for spilled conductive fluids, which can cause potential
electric shock hazard.
Micro-current Shock
• The threshold of sensation of electric currents differs widely
between currents applied arm to arm and currents applied internally
to the body
• In the latter case, a far greater percentage of the current may flow
via the arterial system directly through the heart, thereby requiring
much less current to produce ventricular fibrillation. Such situations
arc commonly encountered in hospitals;
• For example, The patients in the catheter laboratory or in the
operating room, with a catheter in the heart, would have very little
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resistance 10 electric currents. A cardiac catheter connected to an
electrical circuit for the measurement of pressure provides a
conductive fluid connection directly to the heart. This makes the
patient highly vulnerable to electric shock because the protection he
would have had from layers of intact skin and tissue between his
heart and the outside electrical environment has now been by-passed
by the wire of fluid column within his heart or blood vessels.
Electrophysiology of Ventricular fibrillation
• Current passing through the human body can prove hazardous as it
can induce circulatory arrest. The primary cause of circulatory arrest
induced by low voltage electric shock is ventricular fibrillation.
• The shock hazards described above lead to the classification of
patients in hospitals into three categories:
(i) A general patient who is normally not connected to any
instrumentation. Such patients would not ordinarily be present in

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intensive care wards. They may. however, come in casual contact
with electrical instrumentation.
(ii) The susceptible patients will be all those patients who are ordinarily
connected to instruments like cardioscopes and other monitoring
instruments. They are decidedly more susceptible to ventricular
fibrillation than the general category.
(iii) A critical patient will have a direct electrically conductive path to
any part of the heart. Based on this classification, the type of leakage
current associated with each category can be worked out.
LEAKAGE CURRENTS
• Currents of extremely small magnitude can be fatal to a patient when a direct,
localized electrical path exists to the heart.
• Patients in coronary care units recovering from heart diseases are especially
vulnerable since their hearts are already in an irritable state.
• In such cases, the amount of electrical stimulation necessary to induce a life
threatening arrhythmia is greatly reduced. Accidents of this nature can occur in
unpredictable circumstances.
The major source of potentially lethal currents is the Leakage Current
• Leakage current by definition is an inherent flow of non-functional current
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from the live electrical parts of an instrument to the accessible metal parts.
Leakage currents usually flow through the third wire connection to the ground.
They occur by the presence of a finite amount of insulation impedance, which
consists of two parts: capacitance and resistance.
 Types of Leakage Current
• Leakage currents are divided according to the current path into the
following types:
1. Enclosure Leakage Current:
The enclosure leakage current is the current which flows, in normal
condition, from the enclosure or part of the enclosure through a
person (or an external conductive part other than the earth
connection) in contact with an accessible part of the enclosure to
earth or another part of the enclosure. This current becomes
significant when the person touching the equipment is connected to

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earth either directly or via a large capacitance
2. Earth Leakage Current
The earth leakage current is the current which flows, in normal
condition, to earth from the mains parts of an apparatus via the earth
conductor.
3. Patient Leakage Current
The patient leakage current is the current which flows through the
patient from or to the applied part of the patient circuits. This
current does not include any functional patient current.
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Path of leakage current in a normal case, i.e. the ground wire intact
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➢ A leakage current of 100 microA can be assumed to be
flowing through the ground wire. If the chassis of this
equipment is connected to the patient who is grounded,
then very little of this current will flow through him.

➢ In the above case the patient offers a resistance of 1000

ohm to the ground and the ground connection from the
instrument has 1 ohm of series resistance. The current
division shall be such that only 0.1 microA of current
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shall pass through the patient, the rest will flow to the
ground.
➢ If by chance the ground connection breaks, the full
leakage current will flow through the patient. This is a
very hazardous situation particularly if the current goes
through internal electrodes in the vicinity of the patient's
heart.
 SAFETY CODES FOR ELECTROMEDICAL
EQUIPMENT
➢ The International Electro technical Commission (IEC) has brought out a
fairly voluminous document, the IEC 601 (General Requirements for the
Safety of Medical Electrical Equipment), to provide a universal standard
for manufacturers of electro-medical equipment as well as a reference
manual on good safety practice.

Based on the International Electro technical Commission (IEC )Document, the

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Bureau of Indian Standards (BIS) has issued the IS:8607 standard to cover
general and safety requirements of electromedical equipment. The standard
issued in eight parts, covers the following aspects:
• Protection against electric shock
• Protection against mechanical hazards
• Protection against unwanted or excessive radiation
• Protection against explosion hazards
• Protection against excessive temperature, fire and other hazards
• Construction
• Behavior and reliability
➢ This standard applies to all medical electrical equipment
except or otherwise stated in the individual specification for
the particular medical equipment for which additional or
modified equipments have been specified.
➢ Individual standards on different electromedical equipment
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have also been issued by the BIS. Some of the important
standards issued are: Radiofrequency diathermy apparatus
(IS.7583), ectrocardiograph (IS:8048), Cardiac Defibrillators
(IS:9286), Diagnostic medical X-ray equipment 5:7620), and
Electromyograph (IS:8885).
 Precautions to Minimize Electric Shock Hazard
➢ The following precautions should be observed to prevent hazardous situations:
➢ In the vicinity of the patient, use only apparatus or appliances with three-wire power cords.
➢ Provide isolated input circuits on monitoring equipment.
➢ Have periodic checks of ground wire continuity of all equipment.
➢ No other apparatus should be put where the patient monitoring equipment is connected.
➢ Staff should be trained to recognize potentially hazardous conditions.
➢ Connectors for probes and leads should be standardized so that currents intended for
powering transducers are not given to the leads applied to pick up physiologic electric
impulses.
➢ The functional controls should be clearly marked and the operating instructions be perma-

➢
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nently and prominently displayed so that they can be easily familiarized.
Many of the portable medical equipment such as dialysis units, hypothermia units,
physiotherapy apparatus, respirators and humidifiers are used with adapter plugs that do
not ensure a proper grounding circuit.
➢ The operating instructions should give directions on the proper use of the equipment, for
electro-medical equipment, the operating instructions should be regarded as an integral pail
of the unit.
➢ The mechanical construction of the equipment must be such that the patient or operator
cannot be injured by the mechanical system of the equipment, if properly operated.
➢ The patient equipment grounding point should be connected individually to all receptacle
grounds, metal rods and any other conductive services.
 Previous university questions
2017
• How X-rays are produced? What are its properties? Mention any three applications
of X-rays in medicine. (8)
• What is the basic principle of Computed Tomography (CT)?How image
reconstruction is done in CT. (8)
• Mention four major applications of CT. (4)
• What is the principle of Ultrasonic imaging and describe the imaging modalities of
Ultrasonic imaging system? (8)
• Compare A-mode, B-mode and M-mode displays in Ultrasonic imaging system. (6)
•
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Describe the image acquisition and reconstruction techniques in Magnetic
Resonance Imaging (MRI).(6)
• What are the sources of electrical hazards? Explain about the precautions to be
observed to prevent electric shock hazards.
2019
• How ultrasonic wave propagates through tissues. ( 8)
• Explain X-Ray imaging. ( 8)
• Explain basic approaches to protection against shock. (4)
• Explain about micro shock hazards. (8)
• What is real time ultrasonic imaging? (4)
• Explain the biological effects of NMR imaging. (7)
• What is basic pulse echo system? (5)
• What are macro shock hazards? (8)
2018
•

•
ray machine. (10) TRACE KTU
List any four properties of X-ray. With a neat block diagram explain the working of a X-

What is the principle behind NMR imaging? What are the advantages of NMR imaging?
(10)
• Explain about image reconstruction in CT scan. (7)
• Compare CT scan and X-ray imaging technique. (4)
• With a neat block diagram explain single channel ECG telemetry transmitter. (9)
• With a neat block diagram explain basic pulse echo system. (10)
• What are the requirements of a real time ultrasonic imaging system? (3)
• What are the precautions taken to minimize electric shock hazards?