Echo machine

The echo machine is a device with a unique purpose. Doctors use it to assess the heart’s structure, chamber sizes, valve functions, and measure the heart's pumping efficiency. An echo machine plays an important role in imaging by generating clear pictures of the heart. 

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In this article, we will explore how echo machines work, their use, and advancements.

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What is an Echo machine?

A highly specialised machine that uses high-frequency sound waves to determine the structural and functional aspects of the heart. It uses a transducer or probe that moves across the chest, sending ultrasound waves that bounce off the structures inside the heart. The probe picks up the echoes. The machine uses these to create images on an integrated screen.

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Types of echo machines

There are two types of echocardiogram machines

• Transthoracic echocardiogram, TTE
• Trans esophageal echocardiogram, TEE

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TTE is the most common type, and it involves moving the transducer or the probe on the chest to capture images of the heart

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TEE is inserting a special probe into the patient’s esophagus to get a closer view of the heart

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Modes available on the Echo machine

A -mode or amplitude mode: It is the simplest mode of ultrasound imaging and echocardiography. It is valuable for measuring distances and sizes of the aortic valve.

B-mode, also known as brightness mode, is the foundation for 2D imaging in echocardiography. It creates cross-sectional images of the heart in real time.

M-mode is used for capturing motion: It captures the motion of specific heart structures, such as the left ventricle. It is used for measuring ventricular dimensions in different phases of the cardiac cycle, such as the size of the left ventricle at the end of diastole.

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Components of the machine

Transducer probe

The ultrasound probe sends sound waves through the piezoelectric effect, a phenomenon that causes quartz crystals present in the transducer to vibrate rapidly, thereby generating sound waves. These waves then bounce off objects and are reflected to the probe, which sends them to the processor, where they are amplified.

Central Processing Unit (CPU)

All signals from the machine are processed, interpreted, and converted into electrical signals to generate images that are displayed on the monitor. The CPU, like our brain, is the central processing unit of the ultrasound machine.

Transducer pulse controls

The amplitude, frequency, and duration of pulses emitted from the transducer are adjusted by transducer pulse controls.

Display

The display of the machine resembles a computer screen, which displays the data analyzed and interpreted by the CPU as an image of the scanned area. It also helps the sonographer visualize the area being scanned.

Keyboard with control knobs

The keyboard facilitates the entry of information, including name, height, weight, and the reason for being there.

The control knobs help adjust the image on the screen, making it sharper and clearer.

Printer

It is used to make a hard copy of the ultrasound image

Uses of echo machines

In the medical field, the echo machines are used for a variety of purposes

• Diagnosing heart conditions, echo machines are mostly used to evaluate the heart’s function and diagnose its condition
• During surgery, echo machines are used to monitor the patient’s heart function
• Tracking blood flow: It tracks the pumping efficiency of the heart
• Assessing heart damage: They help to determine the extent of damage to the heart after a cardiac event
• Evaluating the effectiveness of treatment, echo machines are used to evaluate the effectiveness of treatment, medication, or surgery

The working principle

SONAR (Sound Navigation and Ranging) forms the basis of the working principle of echo sounders. Echo machines use high-frequency sound waves. Transducers attached to the machine emit sound waves towards the body, which penetrate the skin and bounce off the internal organs and tissues. How these waves penetrate and reflect off depends on the wavelength or frequency of the sound waves used.

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The frequency of ultrasound waves used in medical applications ranges from 2 megahertz to 15 megahertz. Higher frequency has a shorter wavelength. Thus, reducing frequency and absorption allows us to study the structures in the body. Superficial body structures are studied by increasing the frequency of the echo machine.

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Maintaining the echo machines

Echo machines are sophisticated mechanical devices that require a rigorous maintenance schedule for accurate diagnosis. Unmaintained machines can cause diminished image quality to complete system failure.

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As we use the components, wear and tear occur. Dirt, gel, residue, and body fluids can damage the transducer's surface, resulting in poor image quality, incorrect diagnosis, and unnecessary strain on the machine.

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Training to use an echo machine

The machine controls the process of acquiring and interpreting images. Classroom instructions, hands-on practice, and real-world clinical experience enable sonographers to operate the machine effectively. 

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Calibrate and update

Follow all guidelines to calibrate the machine and adhere to specific procedures to maximize the equipment's life and reliability.

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The updates improve image processing algorithms and protect against emerging vulnerabilities.

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Daily cleaning and disinfection

Transducers are the most delicate component of the machine, and they should be wiped with mild disinfectants. No abrasive material or scrubber should scratch the surface of the transducer; even minor damage can impact the ultrasound's image quality.

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Clean the machine's body with disinfectant wipes daily to remove all residual ultrasound gel fingerprints and impurities. The cables of the machine are often overlooked and can get damaged, posing a risk. After every use, store the cables properly to prevent kinks or bends. Bends can cause internal wire damage, reducing their lifespan.

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Weekly deep cleaning 

Remove all detachable parts and clean them of dust and debris once a week. Deep cleaning removes the buildup of dirt and dust in the connectors, which interferes with the transmission of ultrasound signals.

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Limitations of the echocardiogram machine

Echocardiography is a widely used diagnostic tool, but it has limitations. These limitations arise not only from the machine itself but also from patient-specific factors and operator techniques. 

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Tissue penetration

Ultrasound waves cannot penetrate deep into tissues in

• Obese individuals.

Patients with lung disease, chest wall abnormalities, or a history of previous heart surgery. These obstruct the passage of ultrasound waves.

• Operator dependency

The quality of the image captured is dependent on the skill and experience of the sonographer or cardiologist.

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Patient cooperation

If the patient does not lie still, it affects the quality of the image.

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AI-related challenges

Limited data and poorly trained models reduce the diagnostic accuracy of AI-powered machines, as they depend on them.

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Rapid technological advancement

AI-powered machines require continuous training for cardiac sonographers and regular updates to software and hardware, which is costly and requires institutional support.

Advances in echo machines

Cardiologists now have access to enhanced images, more accurate measurements, and reduced human error, enabling them to make diagnoses quickly and precisely through the use of AI. 

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Using portable echo machines, echocardiograms can be performed in remote areas, emergency settings, and at the patient's bedside.

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3D and 4D Echocardiography have made it convenient for cardiologists to view cardiac images with greater clarity, assess heart valve function and congenital heart defects, and guide interventional procedures.

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Speckle tracking echocardiography allows for the assessment of myocardial deformation and function by tracking the movement of speckles or tiny particles in the muscle, which could otherwise have gone undetected.

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Contrast echocardiography has enhanced the quality of ultrasound images in areas where blood flow is limited, visualization of vessels is challenging, and chambers have defects or holes between them. 

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Conclusion

An echo machine is important for assessing the structure and function of the heart to diagnose and monitor various heart conditions. With emerging technology, it is possible to conduct bedside or remote monitoring, thereby improving reach and efficiency. The automation of machines has also reduced the workload, enhanced reporting accuracy, and enabled the early detection of heart diseases, which contributes to better patient outcomes.