A new safety parameter for diagnostic ultrasound thermal bioeffects: safe use time.

It is widely accepted that diagnostic ultrasound has the potential to elevate the temperature of tissue being scanned. Because both the maximum value of the temperature rise and the temporal profile of that rise are necessary to estimate the risk correctly, the temperature rise [DeltaT(t)] at an observation point for an exposure condition is presumed to have two components, that is, DeltaT(t)=DeltaT(max)X(t). The amplitude component DeltaT(max) is the maximum value of DeltaT(t), and the exposure time component X(t) represents the time dependency of that DeltaT(t). Ninety-six cases were investigated to obtain the proposed DeltaT(t) model at six frequencies, four source diameters, and four f-numbers. Then, using the relative change in the rate of induction of a thermal effect due to ultrasound exposure that produces DeltaT(t) different from a threshold exposure, the safe use time (SUT) model was constructed. SUT informs the user of the maximum duration of exposure in a region at a particular output level that would be no more hazardous than scanning at the threshold exposure. Using the SUT model, high power ultrasound can be applied for a short time so that the user can improve imaging performance while staying within safe limits.

Evaluation of free radical formation associated with diagnostic ultrasound.

Our objective was to evaluate kidney antioxidant status in rats subjected to an ultrasound examination. Thirty rats were divided into five groups for injection of saline (S) or anesthetic (A), and application of ultrasound using different modes, B mode, pulsed wave Doppler, and continuous wave Doppler, under anesthesia. Ultrasound was performed on days 1, 3, and 5 relative to the initiation of the experiment. Rats were then scarified on day 6. The kidney tissue thiobarbituric acid reactive substance (TBARS) level and superoxide dismutase (SOD) activity were measured. Both TBARS level and SOD activity increased, 21% and 38%, respectively, due to anesthesia (P < 0.04 for both). SOD activity increased further by a factor of 1.2 in response to ultrasound examination (P < 0.05), whereas TBARS level was not affected by Doppler and continuous wave Doppler compared to anesthesia. Increases in the level of TBARS (P < 0.03) and SOD activity (P < 0.01) were greatest when B-mode ultrasound was employed. These substances did not increase further when continuous wave Doppler was employed. The peak-negative acoustic pressure (9.16 vs. 9.74 MPa) and frequency (3.57 vs. 6.95 MHz) for B mode and pulsed wave Doppler were greater than those for continuous wave Doppler (0.22 MPa and 1.96 MHz). The estimated mechanical indexes were 4.87, 3.70, and 0.15 for B mode, pulsed wave Doppler, and continuous wave Doppler, respectively. In conclusion, anesthesia may cause tissue damage as reflected by elevated lipid peroxidation and free radical formation and ultrasound examination may amplify tissue damage through mechanical effects caused by ultrasound absorption.