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Master of Science in Medical Ultrasound

Reference: Notification No: CU-Reg ./Notif-712/11/1551 dated: December 01, 2011.

Scheme of Studies Master of Science in Medical Ultrasound.

Addition of Elective Courses: MS in Medical Ultrasound, MS (MU)

  1. HIS510: Ultrasound Physics and Instrumentation
  2. HIS511: Physics and Instrumentation I
  3. HIS512: Ultrasound Physics and Instruments Laboratory I
  4. HIS513: Physics and Instrumentation II
  5. HIS514: Physics and Instrumentation Laboratory I
  6. HIS515: Obstetric Ultrasound (CLINICAL)
  7. HIS516: Diagnostic and Interventional Neck Ultrasound
  8. HIS517: Clinical Sectional Anatomy
  9. HIS554: PACS and DICOM Implementation.
  10. HIS645: Evidence Based Medicine in HI.
  11. HIS641: Medical Imaging.

Course Code: HIS510

Course Title: Ultrasound Physics and Instrumentation

Credit Hours: 3(3, 0)

Course Objective: This subject provides a cohesive presentation of the physics and instrumentation of modern diagnostic medical ultrasound. It covers ultrasound wave properties, ultrasound propagation and attenuation in body tissue, ultrasonic transducers and their beam properties. The subject closely links these physical principles to the operation of modern diagnostic ultrasound instrumentation, such as two-dimensional, real-time scanning machines, M-mode scanners, and Spectral, Colour and Power Doppler instrumentation. Recent advances in transducer- and imaging- technology are also discussed. The subject looks at the physics of blood flow, i.e. Haemodynamics, and also covers quality assurance of ultrasound equipment, together with ultrasound bio effects and safety considerations.

Course’s Contents: be able to describe and solve relevant mathematical calculations pertaining to the physical properties of diagnostic ultrasound and its interaction with body tissue. To be able to explain the purpose, and describe the operation of current mainstream diagnostic ultrasound modalities (instrument systems), and employ some relevant quality assurance procedures. To be able to explain the physical basis underlying imaging/scanning artifacts and critically evaluate the artifacts with all modalities studied

To be able to describe and perform calculations relating to the physical principles governing blood-flow in the human body (Haemodynamics), and to the various modalities of Doppler ultrasound. To be able to explore and appraise a number of recent advances in ultrasound imaging technology, including tissue harmonic imaging, contrast harmonic imaging, 3-D imaging, elastography, and changes in transducer material. To be able to use research skills to maintain independent learning for continuing professional development on new and evolving ultrasound technologies

The subject will cover the following topics:

Basic wave theory, specific impedance, intensity and decibels, Ultrasound propagation and attenuation.

The ultrasound transducer and probe design, The ultrasound fields, multi-element array focusing and steering, A- and M-mode scanning, pulse-echo ranging, spatial- and temporal-average intensity descriptors, Modern real-time B-mode instrumentation; signal and image processing; grey scale artifacts; advanced ultrasound techniques and instrumentation, Doppler ultrasound and artifacts, Haemodynamics, signature waveforms, contrast harmonic imaging, harmonic DTI, Bio effects and safety of diagnostic ultrasound.

Recommended Text Books:

  1. Hoskins, P R, Martin k and Thrush A Diagnostic Ultrasound: Physics and Equipment. 2010.
  2. Cambridge University Press Zagzebski JA Essentials of Ultrasound Physics, 2006,
  3. Mosby Hedrick WR, Hykes DL and Starch man DE Ultrasound Physics and Instrumentation 4th Edition 2005 Elsevier Mosby

Further Reading:

  1. Kremkau F W Diagnostic Ultrasound: Principles and Instruments. 2005.
  2. Saunders Elsevier Hark G and Duck F A. The safe use of ultrasound in medical diagnosis. 2000
  3. British Institute of Radiology, London. Thrush AJ Hartshorne Vascular Ultrasound 2009 (3Ed) Elsevier, Fish, P. Physics and Instrumentation of Diagnostic Medical Ultrasound 1990.
  4. Wiley& Sons Evans D & McDicken N. Doppler ultrasound: - Physics and Instrumentation and signal process J. Wiley & Sons. 2nd Edition1999 Hill, C R, Bamber JC, tar Haar GR (Ed) Physical Principles of Medical Ultrasound (2nd Edition).

Course Code: HIS511

Course Title: Physics and Instrumentation I

Credit Hours: 3(3, 0)

Course Objective:

  • This core course is designed to prepare the student toward eligibility for the Sonography Physics and Instrumentation portion of Diagnostic Medical Sonologist The course encompasses the theoretical concepts and practical applications related to ultrasound physics and instrumentation introduction to physics of acoustics and Sonographic instrumentation. Production and types of sound waves discussed.
  • Demonstration of propagation of ultrasound through tissues, transducers, pulse-echo instruments and display methods

Course Content:

Concepts include: sound, sound waves, pulse waves, intensities, interaction of sound and media, transducers, sound beams and display modes. These concepts are tied in with terms used in Introduction to Sonography course and how they apply to practical, daily scanning skills

  1. Patient care, safety and communication
  • Patient identification / documentation
  • Patient interaction
  1. Physics principles
  • Properties of ultrasound waves
  • Interactions of sound with tissue

III. Ultrasound transducers

  • Transducer construction and characteristics
  • Transducer types (sector, linear, phased arrays, etc.)
  • Spatial resolution
  1. Pulse-echo instrumentation
  • Display modes and their formation (A-mode, B-mode, M-mode, 3-D, etc.)
  • Transmission of ultrasound
  1. Doppler instrumentation and Haemodynamics
  • Ability to acquire color flow image
  • Ability to acquire a Doppler spectral image
  1. Quality assurance / quality control of equipment
  • Preventive maintenance
  • Malfunctions

Ultrasound program Sonographers ultrasound physics preparing to focus and spend more time on the areas with higher percentages such as:

  • Pulse-echo instrumentation
  • Doppler instrumentation and Haemodynamics

After you have prepared these Ultrasound Physics chapters, then spend some time on:

  • Patient care, safety and communication Quality assurance / quality control of equipment

Recommended Books:

  1. Evolve Learning Resources to Accompany Ultrasound Physics and Instrumentation, 4th Edition By Wayne R. Hedrick, PhD, David L. Hykes, PhD and Dale E. Starch man, PhD Ultrasound Physics and Instrumentation - Elsevier 4th Edition
  2. Wayne R. Hedrick, PhD, Professor, Medical Radiation Biophysics, David L. Hykes, Medical Physics Services, Inc., Canton, OH, USA and Dale E. Starch man, Medical Radiation Biophysics, Textbook of Diagnostic Sonography 7th Edition Sandra L. Hagen-Ansert ISBN-13: 978-0323073004 ISBN-10: 032307300X

Course Code: HIS512

Course Title: Ultrasound Physics and Instruments Laboratory I

Credit Hours: 3(3, 0)

(240 Clinical Hours)

Course Objective: Presents practice with basic instrumentation, mathematical calculations, and basic properties of acoustical physics. Laboratory 3 hours per week.

General Course Purpose This course provides hands-on experience to reinforce knowledge

The student must satisfactorily complete all previous Sonography courses with a grade of "C" or better.

Course Contents: At the completion of this course the student will be able to:

Demonstrate the principles of acoustical physics, Demonstrate proper use of the basic types of equipment used in Sonography, Demonstrate the interactions of sound with tissue, Differentiate among various transducer types to include sector, linear and phased arrays, Calculate using the units of measurement used in Sonography, Demonstrate basic quality assurance practices related to Sonography equipment

Major Topics to be Included

  1. Principles of acoustical physics
  2. Components of ultrasound equipment
  3. Units of measurement
  4. Quality assurance pro

Recommended Text Books:

  1. Sonography Principles and Instruments 8th Edition Understanding Ultrasound Physics, 3rd Author(s): Frederick W. Kremkau Sidney K. Edelman, Ph.D. ISBN: 9781437709803 0962644447 Publishers: Elsevier

Course Code HIS513

Course Title: Physics and Instrumentation II

Credits Hours: 3(3, 0)

Note: For Echo-Cardiologist Only

Course Objectives: Focuses on the areas of ultrasonic, instrumentation, image artifacts, biologic effects, quality control as well as Doppler principles and applications and basic types of equipment through lecture and laboratory exercises. Lecture 2 hours per week.

 Course Contents: At the completion of this course the student will be able to:

Identify the information presented in a spectral Doppler display, Differentiate factors that impact the characteristics of spectral Doppler waveforms, Compare and contrast the spectral waveforms of laminar and turbulent flow, Describe factors that influence laminar and turbulent flow, Describe the effects of stenosis on flow characteristics, Describe the Doppler waveform changes associated with proximal and/or distal stenosis.

 Describe the production, image characteristics, clinical examples, and techniques to eliminate or minimize artifacts.

  • Identify ultrasound artifacts.
  • Describe the purposes and the requirements of quality control (QC).
  • Compare and contrast multipurpose phantoms versus test objects.

.

Major Topics to be Included

Doppler instrumentation and Haemodynamics

  • Doppler effect
  • Factors influencing the magnitude of the Doppler shift frequency
  • Continuous wave and pulsed wave Doppler
  • Doppler PRF, NY Quist limit and aliasing
  • Color flow imaging

Quality assurance / quality control of equipment

  • Preventive maintenance
  • Malfunctions
  • Performance testing with phantoms

Pulse-echo instrumentation

  • Display modes and their formation (A-mode, B-mode, M-mode, 3-D, etc.)
  • Transmission of ultrasound
  • Reception of ultrasound (preprocessing) d. Beam former

Recommended Text Books

  1. Comprehensive Textbook of Echocardiography (Vols 1 & 2), Volume 1 By Navin C Nanda JP Medical.
  2. Diagnostic Ultrasound: Principles and Instruments 2005 by Frederick W. Kremkau PhD Dr.(Author) Publisher: Saunders; 7 editionISBN-10: 0721631924- ISBN-13: 978-0721631929

Course Code: HIS514

Course Title: Physics and Instrumentation Laboratory II

Credits Hours: 3(3, 0)

(240 Clinical Hours)

Note: For Echo-Cardiologist Only

Course Objective: Presents advanced practice with instrumentation, Haemodynamics, Doppler instrumentation and pulse echo technology. Laboratory 3 hours per week.

General Course Purpose: This course provides hands-on experience to reinforce knowledge gained in DMS 208. Course Prerequisites/Co-requisites Co-requisite is DMS 209. The student must satisfactorily complete all previous Sonography courses with a grade of "C" or better.

 Course Contents: At the completion of this course the student will be able to:

Demonstrate understanding of advanced acoustical physics principles, Demonstrate acoustical attenuation

Demonstrate use of Doppler instrumentation, Demonstrate Haemodynamics, Identify the components in pulse-echo instrumentation, Demonstrate the use of storage devices for images, Design an advanced quality assurance program to include phantom testing

Major Topics to be Included

  1. Advanced acoustical physics
  2. Doppler technology
  3. Haemodynamics
  4. Pulse-echo instrumentation
  5. Advanced quality assurance

Recommended Text Books:

  1. Horowitz and Hill, The Art of Electronics, 2nd Ed. (Cambridge) Recommended for Reference: Hayes and Horowitz, Student Manual for the Art of Electronics, (Cambridge) Sedra & Smith, Microelectronic Circuits, 5th Ed. (Oxford University Press
  1. Electrical Engineering: An Introduction (Saunders) Mill man& Grabel, Microelectronics, 2nd Ed. (McGraw Hill)

Course Code: HIS515

Course Title: Obstetric Ultrasound (CLINICAL)

Credit Hours: 3(3, 0)

(240 Clinical Hours)

Course Objective:

  • The clinical aspects contained in specific sections of this parameter (Introduction, Classification of Fetal Sonographic Examinations, Specifications of the Examination, Equipment Specifications, and Fetal Safety
  • Fetal ultrasound should be performed only when there is a valid medical reason, and the lowest possible ultrasonic exposure settings should be used to gain the necessary diagnostic information.
  • A limited examination may be performed in clinical emergencies or for a limited purpose such as evaluation of fetal or embryonic cardiac activity, fetal position, or amniotic fluid volume.

 

 Course Content:

 

Classification of Fetal Sonographic Examinations

 

First-Trimester Examination A standard obstetric sonogram in the first trimester includes evaluation of the presence, size, location, and number of gestational sac(s). The gestational sac is examined for the presence of a yolk sac and embryo/fetus. When an embryo/fetus is detected, it should be measured and cardiac activity recorded by a 2-dimensional video clip or M-mode imaging. Use of spectral Doppler imaging is discouraged

. The uterus, cervix, adnexa, and cul-de-sac region should be examined

  1. Obstetric Ultrasound the use of the terms ultrasound and Sonography at the discretion of each
  2. Standard Second- or Third-Trimester Examination
  • Specialized Examinations.

Second- and Third-Trimester Ultrasound Examination

 

  1. Indications for second- and third-trimester Sonography
  2. Fetal cardiac activity, fetal number, and presentation
  • . A qualitative or semi quantitative estimate of amniotic fluid volume should be documented.
  1. A velamentous placental cord insertion that crosses the internal os of the cervix is vasa previa, a condition that has a high risk of fetal mortality if not diagnosed before labor.
  2. Gestational (menstrual) age assessment

Recommended Text Books:

  1. Cullen’s Ultrasonography in Obstetrics and Gynecology, 6th Edition Author M Norton Elsevier 2016, ISBN: 9780323328340
  2. Ultrasound in Obstetrics and gynecology: A Practical Approach by Alfred Abuhamad, 2015
  3. Clinical Ultrasound: A Comprehensive Text—Ultrasound in Obstetrics and Gynaecology. 2nd Ed by Hylton Meire, David O. Cosgrove Keith Dewsbury, Philadelphia, Harcourt Health Sciences, 2001. ISBN: 0-443-06154-8

Course Code: HIS516

Course Title: Diagnostic and Interventional Neck Ultrasound

Credits Hours: 3(3, 0)

This course is designed for Endocrine Surgeons, Physicians, Registrars and surgical trainees who are interested incorporating Thyroid ultrasound and procedures into their practice. The intensive course will provide registrants with basic ultrasound physics, artifacts and instrumentation give them an understanding of Sonographic scan planes, probe manipulation skills, and terminology and ultrasound guided needling techniques.

Course objectives; upon completion of the course learners should be able to:-

  • Understand and demonstrate the basic physical principles of ultrasound
  • Understand the relevant ultrasound technology quality control and safety
  •  Effectively perform a cervical/neck ultrasound
  • Demonstrate competency in correlating ultrasound images with clinical findings
  • Understand Sonographic imaging criteria of neck ,thyroid ,parathyroid and node pathology
  • Identify the major salivary glands
  • Demonstrate competency in performing ultrasound directed interventional procedures
  • Understand limitations of ultrasound and the importance of seeking assistance and advice
  • Have an understanding and skills to perform an ultrasound guided interventional procedure.

Course Content:

Basic Physics of ultrasound , artifacts, instrumentation and Colour Doppler, Anatomy of the thyroid ,parathyroid’s and salivary glands , normal dimensions and relationship with the surrounding anatomy of the Cervical Region, Sonographic Imaging criteria of Thyroid , parathyroid and nodes pathology, Identify and understand anatomic relations of the major salivary glands, Performance of Ultrasound examinations of the Neck, scan techniques and image acquisition, Image documentation and measurement protocols, Ultrasound Directed Interventional procedures

Recommended Text Books:

  1. Diagnostic Ultrasound Head and Neck 1st Edition by Anil T. Abuja, 2014ISBN: 978-1-937242-16-9AMIRSYS- 2015

 

Course Code: HIS517

Course Title: Clinical Sectional Anatomy

Credit Hours: 3(3, 0)

Course Objective: This subject is divided into two major strands, separated primarily on the basis of the anatomical structures best demonstrated by the modalities and the differences in imaging technique, image representation and the imaging planes used.

  • The normal gross anatomical relationships and organization, including normal variants, of major soft tissue structures of the neck, abdomen, pelvis and the upper and lower limbs.
  •  The normal appearances of these structures and their relationships, as demonstrated by Sonographic imaging are considered in detail.
  • The development of the embryo and fetus through to birth, including the developmental anatomy of the major organ systems and the embryological basis of congenital anomalies and common pathological conditions.

 

Course Contents:

The subject will cover the following topics:

 

Module 1: Gross Anatomy (As listed for each strand)

 

  • CT/MRI Strand: Detailed consideration of the structure and three dimensional, anatomical relationships of the upper and lower limb structures including: major branches of the arterial and venous systems.
  • Medical Ultrasound Strand: Detailed consideration of the structure and three dimensional, anatomical relationships of the upper and lower limb structures including: major branches of the arterial and venous systems; joints, ligaments and tendons.
  • Embryology (Medical Ultrasound Strand only) including: gametogenesis and female reproductive cycles; 1st to 3rd weeks of development; 4th to 8th weeks of development; placenta and fetal membranes; embryonic folding (cavities, mesenteries, lungs); pharyngeal apparatus; cardiovascular system; gastrointestinal tract; urogenital tract; limbs; head, neck, eyes and ears; brain and cranial nerves; integumentary system
  • Medical imaging appearances (As applicable to the student's strand) Consideration of the appearances and relationships of the above listed structures as may be imaged on the following diagnostic imaging modalities including: computer tomographic imaging; magnetic resonance imaging; medical ultrasound imaging; nuclear medicine imaging
  • Specialized Resources: Web based PACS

 

Recommended Text Books:

  1. Introduction to Sectional Anatomy By Michael E. Madden Lippincott Williams & Wilkins
  2. Clinically Oriented Anatomy By Keith L. Moore, Arthur F. Dalley Lippincott Williams & Wilkins By Keith L. Moore, Arthur F. Dalley

Course Code: HIS554

Course Title: PACS and DICOM Implementation

Credit Hours: 3(3, 0)

Course objective:

 This course provides the fundamental information necessary for the implementation of Picture Archive and Communication System.

A combination of lecture and hands-on workshops will be provided on configuration and operation of the PACS system software

Course Requirements: Attendance in this course should occur no more than a few weeks prior to the installation and implementation of PACS System. The suggested attendee of this course will be the institution’s personnel functioning as the PACS System Administrator, Assistant PACS System Administrator, or IT Department support. The attendee should possess a basic general knowledge of a PACS system, networks, Radiology Information Systems, and the clinical workflow of the institution.

Course contents:

 The goal of the course is to prepare attendees for the installation and implementation of PACS System.

Students will be able to achieve this goal by being able to:

Describe the components of a PACS system, Compare data & workflows in an analog and digital environment, Identify system software components, Describe the concept of streaming and compression of images, Identify and construct system users, groups, profiles, Describe features and functions of the Work Flow Manager Administration tool, Perform updates and reconciliation of studies in the PACS database, Illustrate the flow of images to be stored on the PACS system, Perform the DICOM parsing function to map DICOM fields to other DICOM fields, Describe the function of Info Router software, construct rules and perform monitoring of jobs, Describe the IS Link software and its relationship with Radiology Orders and Reports, Describe, utilize and configure the Non-DICOM Import key features and functions, List the eight (8) key functions of the PACS System Administrator.

Describe, interpret and utilize DICOM

Header information PACS, Course System Administration, Describe, configure and utilize Display Protocols, List and perform how to start and stop system processes, Perform system check, Monitor license status, Describe and perform daily, weekly and situational preventative maintenance procedures

Demonstrate a working knowledge of Digital Dashboard, Monitor log files

Recommended Books:

 

  1. Textbook of Veterinary Internal Medicine By Stephen J. Ettinger, Edward C. Feldman Echo Made Easy, 2nd Edition Author: By Sam Kaddoura, ISBN: 9780443103636, 02-02-2009 publisher Elsevier
  1. PACS and Imaging Informatics: Basic Principles and Applications, 2nd Edition K. Huang March 2016, Wiley-Blackwell
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