link
Bookmarks
Artifacts: Ultrasound
Regina J. Hooley, MD; Wendie A. Berg, MD, PhD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
16
4
0

KEY FACTS

  • Terminology

    • Imaging

      TERMINOLOGY

      • Definitions

        • Artifact: Physical, electronic, or technical phenomenon → abnormal echogenicity or shadowing on US
        • Dynamic range: Range of highest and lowest amplitudes that can be displayed, in decibels (dB)
          • Typically 55-60 dB optimal for breast imaging
        • Time gain compensation (TGC): Adjust image brightness at all depths from skin
          • Compensates for sound absorption in deeper tissue
            • Manual or automatic adjustment
            • Gain should ↑ with ↑ depth to compensate for sound absorption in deeper tissue
        • Spatial compounding: Use of multiple off-angle beams (or splitting beam to insonate only one part of image at a time) to create image
          • Averages signal from multiple beams: Noise cancels out
          • ↓ specular reflection, reverberation artifacts
          • ↑ detail in masses and lateral/posterior margins
          • ↓ posterior enhancement and shadowing
        • Harmonic imaging: Insonate tissue with one frequency (e.g., ~ 10-12 MHz) and receive at multiple of that frequency (e.g., 20-24 MHz)
          • ↓ reverberation artifacts and internal echoes in cysts
          • ↑ soft tissue contrast and lateral resolution: ↑ conspicuity of isoechoic masses surrounded by fat lobules
            • Improved lateral resolution
          • Posterior features retained
          • Less effective beyond ~ 2-cm depth

      IMAGING

      • Mammographic Findings

        • Ultrasonographic Findings

          • Imaging Recommendations

            DIFFERENTIAL DIAGNOSIS

              DIAGNOSTIC CHECKLIST

              • Consider

                • Image Interpretation Pearls

                  Selected References

                  1. Bönhof JA: Ultrasound artifacts - Part 1. Ultraschall Med. 37(2):140-53; quiz 154-5, 2016
                  2. Hooley RJ et al: Breast ultrasonography: state of the art. Radiology. 268(3):642-59, 2013
                  3. Feldman MK et al: US artifacts. Radiographics. 29(4):1179-89, 2009
                  4. Cha JH et al: Differentiation of benign from malignant solid breast masses: conventional US versus spatial compound imaging. Radiology. 237(3):841-6, 2005
                  5. Szopinski KT et al: Tissue harmonic imaging: utility in breast sonography. J Ultrasound Med. 22(5):479-87; quiz 488- 9, 2003
                  6. Rosen EL et al: Tissue harmonic imaging sonography of breast lesions: improved margin analysis, conspicuity, and image quality compared to conventional ultrasound. Clin Imaging. 25(6):379-84, 2001
                  7. Lopez H et al: Ultrasound interactions with free silicone in a tissue-mimicking phantom. J Ultrasound Med. 17(3):163-70, 1998
                  8. Kremkau FW et al: Artifacts in ultrasound imaging. J Ultrasound Med. 5(4):227-37, 1986
                  Related Anatomy
                  Loading...
                  Related Differential Diagnoses
                  Loading...
                  References
                  Tables

                  Tables

                  KEY FACTS

                  • Terminology

                    • Imaging

                      TERMINOLOGY

                      • Definitions

                        • Artifact: Physical, electronic, or technical phenomenon → abnormal echogenicity or shadowing on US
                        • Dynamic range: Range of highest and lowest amplitudes that can be displayed, in decibels (dB)
                          • Typically 55-60 dB optimal for breast imaging
                        • Time gain compensation (TGC): Adjust image brightness at all depths from skin
                          • Compensates for sound absorption in deeper tissue
                            • Manual or automatic adjustment
                            • Gain should ↑ with ↑ depth to compensate for sound absorption in deeper tissue
                        • Spatial compounding: Use of multiple off-angle beams (or splitting beam to insonate only one part of image at a time) to create image
                          • Averages signal from multiple beams: Noise cancels out
                          • ↓ specular reflection, reverberation artifacts
                          • ↑ detail in masses and lateral/posterior margins
                          • ↓ posterior enhancement and shadowing
                        • Harmonic imaging: Insonate tissue with one frequency (e.g., ~ 10-12 MHz) and receive at multiple of that frequency (e.g., 20-24 MHz)
                          • ↓ reverberation artifacts and internal echoes in cysts
                          • ↑ soft tissue contrast and lateral resolution: ↑ conspicuity of isoechoic masses surrounded by fat lobules
                            • Improved lateral resolution
                          • Posterior features retained
                          • Less effective beyond ~ 2-cm depth

                      IMAGING

                      • Mammographic Findings

                        • Ultrasonographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Bönhof JA: Ultrasound artifacts - Part 1. Ultraschall Med. 37(2):140-53; quiz 154-5, 2016
                                  2. Hooley RJ et al: Breast ultrasonography: state of the art. Radiology. 268(3):642-59, 2013
                                  3. Feldman MK et al: US artifacts. Radiographics. 29(4):1179-89, 2009
                                  4. Cha JH et al: Differentiation of benign from malignant solid breast masses: conventional US versus spatial compound imaging. Radiology. 237(3):841-6, 2005
                                  5. Szopinski KT et al: Tissue harmonic imaging: utility in breast sonography. J Ultrasound Med. 22(5):479-87; quiz 488- 9, 2003
                                  6. Rosen EL et al: Tissue harmonic imaging sonography of breast lesions: improved margin analysis, conspicuity, and image quality compared to conventional ultrasound. Clin Imaging. 25(6):379-84, 2001
                                  7. Lopez H et al: Ultrasound interactions with free silicone in a tissue-mimicking phantom. J Ultrasound Med. 17(3):163-70, 1998
                                  8. Kremkau FW et al: Artifacts in ultrasound imaging. J Ultrasound Med. 5(4):227-37, 1986