Module - Ultrasound Science, Haemodynamics and Instrumentation (SPS128)

STP

Aim of this module

This module will provide trainees with the underpinning scientific knowledge and practical skills to safely and competently use ultrasound instrumentation to assess the anatomy and haemodynamics of the peripheral vascular system.

Work-based learning outcomes

  1. Acquire an optimised B-mode image and evaluate the characteristic features of a normal and diseased artery and a vein on a B-mode ultrasound image.
  2. Acquire an optimised colour Doppler image and evaluate the characteristic features of a normal and diseased artery and a vein on a colour Doppler image.
  3. Acquire an optimised Doppler spectrum and evaluate the characteristic features of a normal and diseased artery and a vein on a Doppler spectrum with both imaging and non-imaging instrumentation.
  4. Recognise, identify the cause and minimise artefacts affecting the vascular B- mode image, colour Doppler image and Doppler spectrum.
  5. Obtain, record and calculate quantitative measurements from B-mode images and spectral Doppler traces. Label, record and store ultrasound images and data.
  6. Identify the safety features and displays available on ultrasound instrumentation. Critically evaluate their importance and relevance and be able to manipulate controls to minimise the bio-effects and hazards of ultrasound during the acquisition of ultrasound images and Doppler spectra.
  7. Carry out quality assurance (QA) measurements and safety assessments on an ultrasound machine and critically evaluate their relevance to Vascular Science.

Work-based Competencies

Learning outcome Title Knowledge
1 1

Manipulate an ultrasound probe to acquire B Mode images of arteries and veins in longitudinal and transverse cross-sections.
  • Fundamental scientific principles of B Mode imaging.
  • Application of ultrasound in the imaging of arteries and veins.
  • Anatomy of peripheral arteries and veins.
2 1

Acquire optimised B Mode images of arteries and veins by demonstrating the effect of different B Mode control settings and processing options.
  • Transducers and beam-forming.
  • B Mode instrumentation design, operation and controls.
  • B Mode processing techniques, e.g. harmonic imaging, compound imaging, speckle reduction techniques.
3 1

Identify the normal and diseased features of arteries and veins on a B Mode image.
  • Histology and pathology of arteries and veins.
4 2

Manipulate an ultrasound probe to acquire colour Doppler images of arteries and veins in longitudinal and transverse cross-sections.
  • Principles of Doppler ultrasound.
  • Fundamental scientific principles of colour Doppler imaging.
  • Application of colour Doppler ultrasound in the imaging of artery and vein haemodynamics.
5 2

Acquire optimised colour Doppler images of arteries and veins by demonstrating the effect of different colour Doppler control settings and processing options.
  • Colour Doppler instrumentation design, operation and controls.
6 2

Identify the normal and diseased features of arteries and veins on a colour Doppler image.
  • Haemodynamics of blood flow through normal and diseased peripheral arteries and veins.
7 3

Manipulate an ultrasound probe to acquire Doppler spectra from images of arteries and veins in longitudinal and transverse cross-sections.
  • Fundamental scientific principles of spectral Doppler imaging and spectral analysis.
  • Application of spectral Doppler ultrasound in the measurement of artery and vein haemodynamics.
8 3

Acquire optimised Doppler spectra from images of arteries and veins by demonstrating the effect of different Doppler control settings and processing options.
  • Spectral Doppler instrumentation design, operation and controls.
9 3

Identify the normal and diseased features of arteries and veins from their Doppler spectra.
  • Haemodynamics of blood flow through normal and diseased peripheral arteries and veins.
10 4

Recognise, identify the cause and minimise artefacts affecting the B Mode image, the colour Doppler image and the Doppler spectrum.
  • Artefacts inherent or produced in a vascular B Mode image, the colour Doppler image and the Doppler spectrum.
11 5

Make accurate measurements of distance and area on B Mode images.
  • Accuracy, precision and sources of errors in distance and area measurements.
  • B Mode instrumentation calipers.
  • Relevance of zoom.
12 5

Make accurate measurements of velocity on Doppler spectra.
  • Accuracy, precision and sources of errors in velocity measurements.
  • Doppler calipers.
  • Relevance of angle correction and scale.
13 5

Correctly label and record images.
  • Instrumentation controls for labelling and recording.
  • Display output and storage, PACS (picture archiving and communications system).
14 6

Identify the safety features available on ultrasound instrumentation and manipulate controls to minimise the bio-effects and hazards of ultrasound.
  • Safety of diagnostic ultrasound.
  • Mechanisms for the production of biological effects.
  • Current safety standards and relevance.
  • User responsibilities.
  • Machine controls and displays, e.g. MI (mechanical index), TI (thermal index) and power output.
15 7

Make measurements as part of the QA programme, including assessment of caliper positioning.
  • Test objects and tissue-mimicking phantoms for B Mode imaging.
  • Performance testing of B Mode systems.
  • Testing of spectral Doppler and colour flow systems.

Work-based assessment

Complete 4 Case-Based Discussion(s)
Complete 4 of the following DOPS and/or OCEs
Type Title
DOPS Acquire optimised B Mode images of the carotid bifurcation in transverse and longitudinal views
DOPS Acquire optimised B Mode images of the common femoral vein and sapheno femoral junction, demonstrating valves and the effects of compression.
DOPS Acquire optimised B Mode images of an Abdominal Aortic Aneurysm in transverse and longitudinal views.
DOPS Acquire optimised B Mode images a segment of varicose vein
DOPS Acquire optimised B Mode and Colour Doppler images of a segment of lower limb bypass graft and either proximal or distal anastamosis.
DOPS Acquire optimised B Mode and Colour Doppler images of a segment of femoral vein demonstrating phasicity and effect of augmentation.
DOPS Acquire optimised B Mode and colour Doppler images of a diseased SFA or popliteal
DOPS Acquire optimised B Mode and colour Doppler images of postphlebitic femoral vein
DOPS Acquire optimised B Mode, colour Doppler and Doppler spectra from the common carotid and vertebral arteries.
DOPS Acquire optimised B Mode, colour Doppler and Doppler spectra along a diseased SFA or popliteal.
DOPS Acquire optimised B Mode, colour Doppler and Doppler spectra from a common femoral vein demonstrating phasicity, valsava manouvre and distal augmentation.
DOPS Acquire optimised B Mode, colour Doppler and Doppler spectra from an incompetent vein to demonstrate reflux.
DOPS Acquire optimised B Mode images demonstrating reverberation and slice thickness artefact in an artery or vein.
DOPS Acquire optimised B Mode and colour Doppler images of the vertebral artery and vein to demonstrate acoustic shadowing
DOPS Acquire optimised B Mode and colour Doppler images in the iliac arteries to demonstrate acoustic shadowing, aliasing and movement artefacts.
DOPS Acquire optimised B Mode and colour Doppler images of the subclavian artery to demonstrate mirror image arterfact, acoustic shadowing and aliasing.
DOPS Acquire B Mode, colour Doppler and Doppler spectra to demonstrate aliasing in a diseased carotid artery.
DOPS Acquire B Mode, colour Doppler and Doppler spectra to demonstrate aliasing in a diseased SFA popliteal artery
DOPS Acquire, label and store optimised B Mode images of aorta, common femoral and popliteal artery and measure the diameter in transverse and longitudinal orientations.
DOPS Acquire, label and store optimised B Mode images of the long saphenous vein and take diameter measurements along its entire length.
DOPS Acquire, label and store optimised B Mode images of a carotid plaque e.g. on pre endarterectomy patient and measure calculate the diameter and area reduction.
DOPS Acquire, label and store optimised B Mode, colour Doppler and Doppler spectra from internal and common carotid arteries, measure the peak systolic and end diastolic velocities and calculate the ratios.
DOPS Acquire, label and store optimised B Mode, colour Doppler and Doppler spectra from an incompetent vein to demonstrate and measure reflux time.
DOPS Acquire, label and store optimised B Mode, colour Doppler and Doppler spectra from a fistula and calculate the volume flow rate.
DOPS Acquire, label and store Doppler spectra from an artery with a range of insonation angles, measure peak systolic velocity and analyse the effects on calculated velocity
DOPS Acquire, label and store Doppler spectra from an artery with a range of insonation angles, and then measure effect of angle correction errors on the peak systolic velocity for each insonation angle.
DOPS Acquire, label and store Doppler spectra from an artery using a range of sample volume sizes and positions and analyse the effect on the spectral waveform shape and measurements.
DOPS Adjust and analyse B Mode, colour Doppler and Doppler spectra settings on a range of transducers to demonstrate lowest and highest possible mechanical and thermal indices.
DOPS Perform and interpret B Mode QA measurements
DOPS Perform and interpret Doppler QA measurements
OCE Explain the arterial scan procedure and purpose to the patient
OCE Explain the venous scan procedure and purpose to the patient
OCE Explain the graft scan procedure and purpose to the patient
OCE Obtain patient consent for the arterial scan
OCE Obtain patient consent for the venous scan
OCE Obtain patient consent for the graft scan
OCE Obtain the relavant clinic history and symptoms pertinent to the arterial scan.
OCE Obtain the relavant clinic history and symptoms pertinent to the venous scan.
OCE Obtain the relavant clinic history and symptoms pertinent to the graft scan.
OCE Prepare and position a mobile patient for the arterial scan
OCE Prepare and position a mobile patient for the venous scan
OCE Prepare and position a mobile patient for the graft scan
OCE Prepare and position a patient with mobility difficulties for the arterial scan
OCE Prepare and position a patient with mobility difficulties for the venous scan
OCE Prepare and position a patient with mobility difficulties for the graft scan
OCE Communicate with the patient during the scan to explain the practical aspects of the arterial scan e.g. leg position
OCE Communicate with the patient during the scan to explain the practical aspects of the venous scan e.g.augmentation
OCE Communicate with the patient during the scan to explain the practical aspects of the graft scan e.g. leg position
OCE Explain the arterial scan findings to the patient
OCE Explain the venous scan findings to the patient
OCE Explain the graft scan findings to the patient
OCE Explain to a patient what happens with the arterial scan results
OCE Explain to a patient what happens with the venous scan results
OCE Explain to a patient what happens with the graft scan results