RECENT ADVANCES IN ULTRASONORAPHY

Ultrasound since its introduction in medical practice has seen many advances . From A mode to B mode , from static to real time ultrasound. From Black and white to Colour doppler. From 2D to 3D, 4D  and 5D. There are two newer applications of ultrasound which are getting introduced in medical practice like

1. CONTRAST ENHANCED ULTRASOUND [ CEUS ]
2. ULTRASOUND ELASTOGRAPHY

Contrast-enhanced ultrasound (CEUS) is a new technique that makes use of microbubble-based contrast agents to improve the echogenicity of blood and thus improve the visualization and assessment of cardiac cavities, large vessels and tissue vascularity. The combination of ultrasound contrast agents with the latest evolving equipment has the potential to transform the whole clinical role of ultrasound to provide a flexible low-cost diagnostic imaging capability equivalent or superior to many existing modalities such as CT, MRI and Nuclear Medicine.
Ultrasound contrast agents offer high sensitivity (the ability to ‘see' a single bubble) with a safety profile that is at least as good as conventional contrast agents. CEUS offers several advantages over the alternative imaging modalities. It can be performed immediately after baseline ultrasound, the first-line imaging modality in many clinical settings, and it can be carried out in a variety of scenarios (echo labs, bedside, operating room, CT suite, etc.). It does not involve exposure to ionizing radiations, and it allows prolonged real time examinations where also rapid changes can be captured, or the study repeated if needed.
Targeted bubbles, computer aided diagnosis, focused ultrasound therapy are just a few of the potential equipment-contrast combinations that will provide cost-effective future healthcare solutions. 

stography is a medical imaging modality that maps the elastic properties of soft tissue. [1] The main idea is that whether the tissue is hard or soft will give diagnostic information about the presence or status of disease. For example, cancerous tumours will often be harder than the surrounding tissue, and diseased livers are stiffer than healthy ones.
Elastography is a relatively new technology, and entered the clinic primarily in the last decade. The most prominent techniques use ultrasound or magnetic resonance imaging (MRI) to make both the stiffness map and an anatomical image for comparison. Tactile imaging composed from acquired stress-strain data reveals elasticity and anatomical features.
Elastography is used for the investigation of many disease conditions in many organs. It can be used for additional diagnostic information compared to a mere anatomical image, and it can be used to guide biopsies or, increasingly, replace them entirely. Biopsies are invasive and painful, presenting a risk of infection, whereas elastography is completely noninvasive.
Elastography is used to investigate disease in the liver. Liver stiffness is usually indicative of fibrosis or steatosis, which are in turn indicative of numerous disease conditions, including cirrhosis and hepatitis. Elastography is particularly advantageous in this case because when fibrosis is diffuse, a biopsy can easily miss sampling the diseased tissue, which results in a misdiagnosis.
Naturally, elastography sees use for organs and diseases where manual palpation was already widespread. Elastography is used for detection and diagnosis of breast, thyroid and prostate cancers. Certain types of elastography are also suitable for musculoskeletal imaging, and they can determine the mechanical properties and state of muscles and tendons.
Because elastography does not have the same limitations as manual palpation, it is being investigated in some areas for which there is no history of diagnosis with manual palpation. For example, magnetic resonance elastography is capable of assessing the stiffness of the brain, and there is a growing body of scientific literature on elastography in healthy and diseased brains.