
In 1942, Karl Dussik, a neuropsychiatrist, and his brother, Friederich Dussik, a physicist, described ultrasound as a medical diagnostic tool to visualize neoplastic tissues in the brain and the cerebral ventricles. However, limitations of ultrasound instrumentation at the time prevented further development of clinical applications until the mid-1960s. As a result, throughout the early 1950s ultrasound was used to treat patients with Ménière disease, Parkinson disease, and rheumatic arthritis. Diagnostic applications of ultrasound began through the collaboration of physicians and sonar (sound navigation ranging) engineers. In the late 1920s, Paul Langevin discovered that high-power ultrasound could generate heat in bone and disrupt animal tissues. In the medical field, however, ultrasound was initially used for therapeutic rather than diagnostic purposes. During World War I, ultrasound was introduced in the navy as a means to detect enemy submarines. Paul Langevin, a student of Pierre Curie, developed piezoelectric materials, which can generate and receive mechanical vibrations with high frequency (therefore ultrasound). In 1880, French physicists Pierre Curie and his elder brother, Paul-Jacques Curie, discovered the piezoelectric effect in certain crystals. Understanding the basic ultrasound physics presented in this section will be helpful for anesthesiologists to appropriately select the transducer, set the ultrasound system, and then obtain satisfactory imaging. An ultrasound-guided nerve block is a critical growth area for new applications of ultrasound technology and has become an essential part of regional anesthesia. Because ultrasound imaging has improved tremendously over the last decade, it can provide anesthesiologists opportunity to directly visualize target nerve and relevant anatomical structures. Although the physics behind ultrasound generation, propagation, detection, and transformation into practical information is rather complex, its clinical application is much simpler. Ultrasound scanning is an interactive procedure involving the operator, patient, and ultrasound instruments. Real-time ultrasound images are integrated images resulting from reflection of organ surfaces and scattering within heterogeneous tissues.

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