In the first part of the review, recent developments in medical imaging technology are described. Developments in transducer materials and matching, leading to improvements in band-width and sensitivity are discussed. Improvements in dynamic range due to increased transducer sensitivity, lower electronic noise levels and more efficient filtering are then considered. The benefits of the application of digital signal processing (DSP) techniques to radiofrequency (RF) echo signals are described, including more precise filtering and beam forming, synthetic aperture and parallel receive beam forming. Finally, the current situation in regard to 1.5 D arrays, 3 D scanning, ultrasound computed tomography (UCT), harmonic imaging with contrast agents and elastography are discussed. In the second part, some predictions for future developments are made. These will be possible largely due to the power of DSP. Parallel transmissions will make more efficient use of time, allowing greater spatial and temporal resolution, and greater accuracy in Doppler imaging. Adaptive transmission tailoring will be used, where the pulse characteristics to each part of the image field are independently optimized, as will adaptive receive processing in which echo sequences from each part of the image are independently and optimally processed. An important potential development will be automatic feature recognition, making possible accurate compound scanning with high spatial resolution, and quantitative information about the spatial distribution of acoustic speed. Compound scanning will provide more complete visualization of all structures and, particularly when incorporated into intravascular probes, should greatly aid the investigation of arterial plaque morphology. Feature recognition will also make it possible to have UCT systems (array based in future) which require less than 360 degrees access. Harmonic imaging without contrast agents, based simply on the inherent non-linearity of sound propagation in tissue, will become common. 2 D phased array transducer will permit symmetric beam focusing and scanning throughout a solid cone, greatly facilitating the development of 3 D scanning applications. Large 2 D arrays would have the potential to produce a five-fold increase in spatial resolution of a limited volume of tissue, or to measure the variation of backscatter with angle, as an aid to tissue characterization. Finally, ultrasound will be increasingly used to measure the elastic and dynamic properties of local regions of tissue.
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