The idea to listen to the body to decipher its secrets is relatively modern – just over 200 years. In a moment of modesty, Rene Laennec, in 1812, rolled up a piece of paper and turned his head, to listen to the chest of a female patient. The success of this trial was revolutionary, as it led to the birth of the stethoscope. Laennec and others realised that through this simple invention the bodies sounds could be magnified and interpreted, leading to the diagnosis of a myriad of different diseases.
The original wooden Stethescope used by Laennec.
The stethoscope did not immediately take off however, and interestingly there was initial resistance by the established physicians of the time. People dismissed it, decried it as a fad, and lamented the loss of other clinical skills. Sound familiar?? Many of the same arguments have been made against Ultrasound! Luckily science and progress won, and the stethoscope has become the symbol of a doctor and contributed to a major revolution in clinical medicine.
The origins of Ultrasound (US) begin with Laennec, but the technology has taken longer to evolve. The first attempts occurred in the 1800s, but meaningful progress didn’t really occur until 1890 when the Currie brothers introduced the Piezoelectric element. In WW1 the utility of underwater sonar was developed. In 1956 Donald introduced the first in human application of US by using an A mode US technique to measure the foetal skull length. This was then supplemented in 1958 by Donald and Brown who used US to measure a female genital tumour.
B Mode through the Mitral Valve
More modern Ultrasound began in 1963 when the first B “Brightness” mode became commercially available. Grey scale US developed in the 1970’s, and finally the full potential of the doppler effect was appreciated and made commercially available in the late 1970’s.
Through the 1970’s-1990’s widespread adoption of 2D Ultrasound especially in obstetrics and cardiology occurred. In the 2000s, the next evolution of ultrasound occurred with strain and 3d ultrasound.
In the last few years, minature ultrasound scanners have been developed, and will undoubtedly change the landscape once again, as students are now being taught to use them at medical school. These scanners incorporate hundreds of years of clinical medicine, with over 100 years of US and computer development into a tiny hand held package. The march from Laennec to 3d will continue!