Ultrasound Image Optimization Settings

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10 Questions

What effect does increasing the output power have on ultrasound imaging?

Increases pulses and echo signals

Which artefact in ultrasound imaging is characterized by a single long hyperechoic echo that 'trails off' distally?

Comet tail

What is the primary cause of the shadowing artefact in ultrasound imaging?

Total reflection from a strong reflector

How does reducing gain in ultrasound imaging affect the image?

Darkens image with no change in energy transmitted

Which statement is true regarding increasing the frequency in ultrasound imaging?

Increases resolution but decreases penetration

What is the primary function of focus in ultrasound imaging?

Creates a focal zone for improved image clarity

Which type of artefact in ultrasound imaging is typically observed due to resonance of fluid trapped among gas bubbles?

Ring down

What is the purpose of adjusting depth in ultrasound scanning?

Varies the depth of field of view

What happens when output power is reduced in ultrasound imaging?

Darkens image with reduced intensity of pulses

What is a characteristic feature of shadowing artefacts in ultrasound imaging?

Everything posterior to reflector appears black due to total reflection

Study Notes

Image Optimization

  • Image optimization involves adjusting settings to improve image quality
  • Settings include output power, frequency, depth, zoom, gain, and focus

Output Power

  • Adjusting output power varies sensitivity and detects weaker echoes
  • Increasing output power:
    • Increases pulses and echo signals
    • Increases acoustical exposure (ALARA principle)
  • Reducing output power:
    • Reduces intensity of pulses and energy transmitted to the patient
    • Reduces brightness of echoes visualized within the displayed image


  • Increasing frequency:
    • Increases resolution
    • Decreases penetration
  • Multifrequency transducers are used for different applications:
    • Transabdominal: 3-5 MHz
    • Transvaginal: 5-20 MHz


  • Depth of field of view varies with transducer type
  • Increasing depth:
    • Increases far field and reduces near field
  • Decreasing depth:
    • Focuses on superficial structures
    • Increases near field and reduces far field


  • Read zoom magnifies still image
  • Write zoom magnifies live image
  • Provides greater anatomical detail


  • Echo signal amplification compensates for attenuation loss
  • Increasing gain:
    • Brightens image
    • No change to amount of energy transmitted
    • High gain setting: noise and misdiagnosis
  • Decreasing gain:
    • Darkens image
    • No change in energy transmitted
    • Low gain setting: misdiagnosis


  • Focal zone can be single or multiple
  • Decreases frame rate
  • Artefacts can occur due to equipment malfunction, operator error, violation of assumptions, or physical principle


  • Occur due to equipment malfunction, operator error, violation of assumptions, or physical principle
  • Types of artefacts include:
    • Reverberation
    • Comet tail
    • Ring down
    • Mirror image
    • Shadowing
    • Enhancement

Reverberation Artefacts

  • Produced due to repeated reflections
  • Causes false echoes
  • Characteristics:
    • Equally spaced echoes
    • Strong echoes due to high acoustic mismatch
    • Can be result of defective equipment or improper technique
    • Examples: biopsy needle, comet tail artefact

Comet Tail Artefact

  • Type of reverberation artefact seen in US imaging of metallic objects
  • Characteristics:
    • Single long hyperechoic echo
    • Parallel to sound of beams main axis
    • ‘Trails off’ distally
    • Examples: IUDs, surgical clips, needle tips

Ring Down Artefact

  • Similar to comet tail artefact
  • Typically occurs due to resonance of fluid trapped among gas bubbles after being insonated with ultrasound
  • Characteristics:
    • Vibrations produce a continuous sound wave that is transmitted to the transducer

Mirror Image Artefact

  • Created as sound reflects off strong reflector and is redirected towards object
  • Characteristics:
    • Appears as second copy of object – deeper on image
    • Straight line: true reflector and artefact are equal distances from mirror

Shadowing Artefact

  • Occurs when ultrasound beam meets reflector that causes almost total reflections
  • Characteristics:
    • Everything posterior to reflector appears black – no energy

Enhancement Artefact

  • Lower density mass – little attenuation
  • Characteristics:
    • Increased through transmission amplitude of distal echo signal
    • Area of increased brightness relative to echoes from adjacent tissues
    • Examples: cystic/fluid masses

Test your knowledge on optimizing ultrasound image quality by adjusting settings such as output power, frequency, depth, gain, focus, and artifacts. Understand how changes in settings affect the image clarity and exposure levels.

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