ARTIFACTS

Lecture notes by:

Dr. Shumail Mukhtar
Definition:
 Ultrasound imaging artifacts are echoes on the display
that do not properly represent the structures being imaged.
 There are many types of artifacts, some can be caused by
improper control settings, or by equipment malfunction.
 Understanding the physical properties responsible for
various acoustic artifacts permits sonographers to
recognize them with greater certainty and avoid them
when necessary.
Following is the list of some common artifacts with a brief
explanation.
Spatial resolution:
 Spatialresolution refers to the ability of an imaging
modality to differentiate two adjacent structures as
being distinct from one another.
 Poor spatial resolution is an artifact since a failure to
resolve adjacent interfaces means a loss of detail, and
two closely spaced interfaces are displayed as one echo
rather than two.
Axial resolution:
 Axial resolution artifacts occur when the imaging
system is not capable of resolving two-point reflectors
in an axial direction.
 Mathematically, it is equal to half the spatial pulse
length.
 Axial resolution is high when the spatial pulse length is
short.
Beam width artifact:
 This occurs when a reflective object located beyond the
widened ultrasound beam, after the focal zone, creates
false detectable echoes that are displayed as overlapping
the structure of interest.
 Itcan be reduced by adjusting the focal zone,
diminishing the gain settings, and viewing the structure
through multiple acoustic windows at different angles.
Slice thickness artifact:
 This is similar to the beam width artifact but occurs due
to the thickness of the beam.
 Slice thickness determines the trade-off in image quality
between spatial resolution (how clearly you can
differentiate small changes in the image) and image
noise (the standard deviation of the image).
 Increased slice thickness will result in decreased spatial
resolution and image noise.
Reverberation:
 Itis caused by echoes bouncing back and forth between
two strong interfaces before returning to the transducer
for detection.
 Its appearance is multiple equidistantly spaced linear
reflections like a ladder.
 Itcan be reduced by adjusting the transducer angle of
incidence or by decreasing the distance between the
reflective structure and the transducer.
Ring down artifact:
 Ultrasound energy causes resonant vibrations of the air
bubbles. It is generated when a small column of fluid
between the gas bubbles is caused to resonate when
struck with a pulse of ultrasound. Also known as
resonance artifact.
 Itoccurs posterior to the collections of gas (e.g. portal
venous gas, gas in abscess, bowel)
 Itappears as a line or series of parallel bands extending
posteriorly to a gas collection.
Comet tail artifact:
 Itis a form of reverberation, two reflective interfaces,
and thus sequential echoes are so closely spaced that
individual signals are not perceivable in the image.
 Itoccurs due to surgical clips, and copper intrauterine
devices.
 The appearance is a series of multiple, closely spaced
small bands of echoes.
 Itcan be prevented by changing the beam angle or with
an alternate window.
Ghosting artifact:
 Sound is refracted and the degree of this change in
direction is dependent on both the angle of the incident
ultrasound beam and the difference in velocity between
the two media.
 The speed of sound varies in different tissues.
 Thisappears as a duplication of a structure appearing
wider on the ultrasound image.
 It can be prevented by changing the angle.
Mirror image artifact:
 The return of the sound beams is delayed, and therefore the
structures from which these delayed beams are reflected are
displayed at a greater depth than their true anatomic depth.
 Appears as a duplicated structure equidistant from a
strongly reflective interface.
 It occurs around the diaphragm with liver lesions or the
liver itself being duplicated.
 Its prevention includes scanning from different angles, by
adjusting the focal zone or scanning from multiple
windows.