QC8 Case Study PDF

Key Factors Influencing Ultrasound Quality Control in Ultrasound Quality Probe positioning and pressure Quality control (QC) in ultrasound is essential for maintaining image quality and ensur...

Key Factors Influencing Ultrasound Quality Control in Ultrasound Quality Probe positioning and pressure Quality control (QC) in ultrasound is essential for maintaining image quality and ensuring diagnostic accuracy. QC involves the regular assessment and Machine settings adjustment maintenance of ultrasound equipment and procedures. This presentation will explore common clinical scenarios, image quality errors, and Experience and training of the operator case studies to illustrate the importance of effective QC. Communication with patients. Impact of Probe Pressure on Image Quality Angle and positioning of the probe directly affect the image Correct probe pressure ensures proper sound wave penetration Impact of Probe Angle Incorrect angles can result in Too much pressure can distort tissues, too and suboptimal visualization of anatomy little can reduce image clarity Positioning Regular training is needed to maintain Training needed to ensure proper technique. correct pressure.  Machine Settings Adjustment Operator Experience and Skill Level Operator’s understanding of settings like More experienced operators produce higher- quality images. gain, depth, and frequency Incorrect settings can compromise image Skill affects how the operator adapts to complex Glessthen quality high scans and new technologies standers Regular updates and continued education Ongoing competency assessments. on machine technology. Patient Interaction and Communication Structured training programs for new Clear communication ensures patient cooperation operators Training Programs Regular workshops Proper positioning of the patient is essential for good imaging and and courses to update skills Continuing Reducing patient movement reduces variability. Education Training in new modalities like elastography and AI- enhanced systems.  Case Study 1 A 35-year-old patient presented with a suspected liver mass. The initial ultrasound diffuse heterogeneity of the liver parenchyma with an area of Competency assessments focal fat just superficial to discontinuity at the liver's diaphragmatic interface (blue arrows)- making diagnosis challenging. for ensuring skills. Assessing Regular review of scan Operator quality produced by Competency operators Feedback and corrective actions when necessary. Speed displacement artifact Solution: Adjusting the transducer angle and frequency. Case Study 3 Case Study 2 A 50-year-old patient underwent an echocardiogram, but the A routine abdominal scan was obscured by noise, making it difficult to visualize the contrast between the heart pancreas. chambers and walls was poor. Solution: Using contrast-enhancing agents improved the image quality, allowing for better visualization of heart Solution: By adjusting the gain and using noise reduction software, the noise was structures. minimized, providing a clearer view of the target area.  Case Study 3 A 60-year-old patient presents for an abdominal ultrasound to evaluate gallstones. The bowel gas obscures the gallbladder, making visualization difficult. Error: Failure to address bowel gas interference. Misinterpretation Due to Gas Solution: Reposition the patient or apply gradual pressure with the transducer to move gas. Using a higher frequency transducer or adjusting the scanning angle can also help avoid gas interference Case study 4: Missed Kidney Pathology A patient presents for a renal ultrasound, but the sonographer misses a small renal cyst. Error: Failure to sweep the area adequately. Poor Scanning Technique Solution: Perform systematic sweeps across the kidney in multiple planes (longitudinal, transverse, and oblique) to ensure full coverage. Regular practice with anatomical landmarks helps ensure complete scanning.  Case Study 5: : Incomplete Rotator Cuff Visualization Anisotropy artifact A 55-year-old patient is referred for an ultrasound to evaluate a suspected rotator cuff tear. The sonographer fails to visualize the entire rotator cuff tendon due to poor patient Anisotropy occurs when the sound positioning, leading to incomplete imaging. echo misses the transducer when it returns because of the curve of the structure. Error: Improper patient positioning and The ultrasound beam should be probe angulation. perpendicular to the orientation of the collagen fibres. The artefact can be corrected by rocking the probe to be Solution: Ensure the patient is positioned perpendicular to the structure. properly (e.g., shoulder extended and rotated). Adjust the transducer angle to fully visualize the tendon and surrounding structures. 19 Anisotropy artifact Anisotropy artifact A 90-degree angle of the probe results in the best amount of reflection. At non-perpendicular incidence, the echoes miss the probe, resulting in the display of decreased brightness of the visualized structure. 20 21  Anisotropy Anisotropy In this long-axis scan of the Achilles insertion on the When the transducer is angled 90 degrees to the distal calcaneus, the proximal portion of the imaged tendon tendon insertion, the tendon then becomes fibrillar demonstrates a normal fibrillar appearance (arrow), whereas and is normal in appearance (arrowhead). C, the distal tendon insertion is hypoechoic (arrowhead). Calcaneus. 22 23 Missed DVT Diagnosis A patient with leg swelling undergoes a venous duplex scan for suspected deep vein thrombosis (DVT). Error: The sonographer fails to adequately compress the vein in all regions, leading to a false negative result. Normal Compression Inadequate compression technique during venous ultrasound. Solution: Apply firm, steady pressure with the transducer during scanning to ensure complete vein compression in all segments. Repeat scanning in different positions to ensure complete venous visualization.  Case study 6 Normal Compression A 28-year-old man was referred for thyroid US. SFV SFV SFA SFA SFV A. Before compression, hypoechoic lesion (arrows) is visible in anterior portion of right thyroid lobe. B. Following compression, lesion disappeared as it was pseudo-lesion caused by shadow (field with dots) from sternocleidomastoid muscle interface.  Pitfalls Associated with Anatomy Recommendation: turning the transducer and confirming the lesion on both transverse and longitudinal scans is imperative. https://doi.org/10.3348/kjr.2014.15.2.267 Pseudo-lesion caused by posterior thyroid septum. Thyroid lobulation caused by septum (arrows) may be misdiagnosed as parathyroid lesion or thyroid nodule. In this instance, turning the probe results in abrupt discontinuation of the septum and provides additional diagnostic assistance. 31 A 35-year-old male was referred for renal Doppler ultrasound to rule out renal stenosis. Tiff www.steuosisspetpdppler movement It’s expected to see 2 sample volumes in an image in case of stenosis, because when we measure velocity of a vessel with stenosis, we will increase the scale to the highest level casing the machine to show 2 sample volumes , BUT u have to ensure that the second sample volume is not placed on another vessel ‫ وتكون القراءة غلط‬spectrum‫عشان مايصير دمج للسرعتني على ال‬  Conclusion we id Effective quality control in ultrasound is essential for ensuring accurate diagnoses. Regular equipment maintenance and proper technique adjustments can minimize image quality errors. PELÉ Through case studies, we see how addressing these issues can improve patient outcomes. can I