Understanding Transcranial Elastography and Stress Echo Applications

Ultrasound Systems, Understanding Ultrasounds - Tue Nov 20 2018


Our “Understanding Ultrasounds” blog series has been primarily focusing on understanding integral ultrasound applications, along with elaborating on the best transducers and ultrasound systems available for each application. 

This particular article will focus on understanding specialized applications: transcranial doppler, elastography, and stress echo. These applications are not quite as general as, say, the abdominal application, which has subcategories under “abdominal” – kidney and liver for example and refers to a region. Instead, these applications are very specific and refer to very a precise type of medical diagnosis procedure. 

Transcranial Doppler:


Transcranial doppler is a specialized type of ultrasound application. It is used to display the circulation and blood flow that occurs within the brain (hence the cranial in transcranial). Like all other doppler imaging, the imaging is not of a particular structure, but of blood flow through veins and vessels. 

Transcranial doppler ultrasound is also known as TCD, and is often employed during a stroke, or to determine whether a patient is at risk of suffering from a stroke. Any other brain related trauma or ailment that results from a lack of or excess blood flow can be diagnosed and prevented with the use of transcranial doppler ultrasound imaging. 


Considering the fact that one is diagnosing the vessels in one’s brain, the ultrasound transducer that is capable of producing images for this application must have a low frequency range (the lower the frequency range the deeper the potential penetration). The probes that are capable of providing images for TCD are the phased array/sector array transducers. They are the same transducers generally employed for cardiac and abdominal images for adult, pediatric and neonatal patients. 

Ultrasound Machines:

Absolute Medical Equipment recommendations consider a variety of factors before suggesting an ultrasound machine that best suits your demands. Among these factors are price, quality, user-friendly technology and design and versatility. 

The GE Logiq P7 ultrasound system is one that meets all of these prerequisites. That, along with the Mindray DC-8 and the Philips HD15 are stationary systems that A.M.E. Ultrasounds highly recommends. A.M.E. also recommends the Mindray M9, Philips CX50and the Sonosite M-Turbo portable ultrasound systems.  


Philips HD15 ultrasound machine is capable of producing TCD images



Elastography is, simply put, the imaging of tissue throughout the body in order to detect growths, tumors, tears or any other type of ailment. Elastography is not limited to one specific location, but can project images of the tissue anywhere in the body. 

There are a few types of elastography; shear wave and strain wave. Understanding the intricacies and differences of these two sub categories are beyond the scope of this specific article – but the goal of these two remains the same: To diagnose any irregularities in tissue throughout the body. 


Elastography is unlike other types of applications, where a certain level of penetration is required in order to capture an image for that body part. This is due to the fact that tissue in some parts of the body are deeper than tissue in other locations. 

Therefore, it is not a question of frequency range that determines whether a specific transducer is capable of elastography, but the technological capabilities of the probe. If one is examining the tissue by one’s liver, for example, one would require an abdominal probe capable of deeper penetration that is specifically capable of elastography (the GE C1-6-D probe for instance). 

Ultrasound Machines:

As we mentioned earlier, A.M.E. Ultrasounds has several crucial prerequisites that each ultrasound system that we recommend fulfills. For elastography applications, the GE Logiq S7 Expert, the Philips Epiq 5 ultrasound machines, and the Sonoscape S9 portable ultrasound system. 

Stress Echo Ultrasound:


Stress echo application is projecting images of the heart while the heart is being strained or pressured. This test is performed in order to examine whether the heart structure is sound and that it is functioning perfectly. A patient usually will be placed on a treadmill, where the speed of the treadmill slowly increases until the heart begins to work. The ultrasound system projects a moving image (which can be paused at any point – using the “Freeze” button), permitting the diagnostician to examine the heart and make sure all is in working order. 

Not every stress test uses an ultrasound machine. Stress machines usually are their own system that connects with the treadmill. If a problem had yet to be identified, or there’s reason to believe the heart structure is damaged, then an ultrasound exam is necessary. 

Siemens Acuson S2000 ultrasound machine


Seeing as stress test is just another type of cardiac application, it requires the same transducers as other cardiac ultrasound applications – namely phased array, sector array and vector array probes. These type of probes are some of the most advanced probes available and include special ultrasound technology such as single-crystal, PureWave, 3D/4D imaging, and matrix technology. 

A.M.E. Ultrasounds carries an extensive number of some of the most advanced cardiac probes, along with the most economical and versatile transducers – and everything in between. Whether you’re using a GE system, Philips ultrasound, or any other ultrasound machine from any manufacturer – feel free to contact us for your used ultrasound transducer demands. 

Ultrasound Machines:

There are a variety of quality used ultrasound machines, both portable and stationary, that are capable of producing stress echo images. A.M.E. Ultrasounds recommends the following systems: 

 The used Sonosite Edge II, the GE Logiq E, and the Philips CX50. Other stationary machines include the GE Logiq P9, the Philips HD15and the Siemens Acuson S1000

Ultrasound Safety:

There is always the concern, particularly when it comes to medical equipment, regarding the safety of the devices and the potential side effects that occur as a result of employing these machines.

It is important to know that ultrasound machines are known to be completely harmless. They function through the utilization of sound waves emitting from the probe or transducer. These sound waves are then translated into images by the ultrasound machine or system. There is no need to fear when using ultrasound machines – it is a quick, easy and efficient way to diagnose and help determine a patient’s ails.

At A.M.E. Ultrasounds we pride ourselves on providing top quality customer service. If you have a particular topic you’d be interested in learning more about or reading about, feel free to contact us!

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