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Breast Sonography > Instrumentation > Flashcards

Instrumentation Flashcards

1
Q

🎗What is B-Mode?

A

Brightness mode principle, offers a gray scale image

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2
Q

🎗What is the optimal transducer frequency for breast imaging?

A

10.0 to 18.0 MHz for superior axial and lateral resolution (detail) while maintaining penetration to chest wall

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3
Q

🎗A _____ transducer (wide frequency range) is optimal.

A

broadband

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4
Q

🎗What’s the trade-off between high and low frequency probes?

A

High frequency has superior detail but low penetration.

Low frequency has superior penetration but less detail.

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5
Q

🎗What probe design is optimal for breast imaging?

A

Linear array

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6
Q

1) rectangular image
2) direct contact perpendicular to chest wall
3) accurate measurements by avoiding beam divergence artifact
4) accurately guides interventional procedures

A

Why is the linear array optimal?

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7
Q

When might a curved array be used?

A

If a mass is too large to fit on a linear image (larger field of view, but lost resolution).

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8
Q

What’s the difference between the 1-D Linear and 1.5-D Matrix Array?

A

1-D has a single element across the short axis of the probe and a fixed elevation focus.

1.5-D has multiple elements across the short axis and can focus in both directions (better detail)

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9
Q

An imaging depth between __ and __ cm should be adequate.

A

3 and 6 cm

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10
Q

🎗This adjusts the brightness of each echo.

A

Gain (the amount of amplification applied)

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11
Q

🎗This controls the level of brightness of all echoes appearing on an image

A

Overall Gain

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12
Q

🎗This allows for the brightness to be controlled at varying depths throughout the image.

A

TGC (Time Gain Compensation)

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13
Q

This is the state-of-the-art feature that optimizes overall gain and TGC.

A

Auto Gain Optimization (‘the magic button’)

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14
Q

What’s the ALARA Principle?

A

Output power should be set ‘As Low As Reasonably Achievable’.

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15
Q

What happens when the power is decreased?

A

The image gets darker.

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16
Q

Can the brightness be increased without increasing the power?

A

Yes, by increasing the gain

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17
Q

Does increasing the gain have any effect on patient exposure to ultrasound energy?

A

No

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18
Q

🎗When should the sonographer decrease the Output Power?

A

If your image is too bright, decrease the output power. If your image is too dark, increase the receiver gain.

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19
Q

Multiple focal zones will yield the best ____ throughout the entire image at the expense of a ________.

A

best resolution; slower frame rate

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20
Q

Multiple focal zones are recommended, but if a single focus is used, set it at the ____.

A

depth of the area of interest

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21
Q

Define elevation plane focus

A

the focus in the short axis or elevation plane (short side) of an electronic transducer

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22
Q

🎗What’s the elevation plane focus in a 10 MHz probe? (conventional linear array)

A

1.5 cm

23
Q

What kind of gray scale and dynamic range is used for breast imaging?

A

BROAD gray scale and HIGH dynamic range - provides a lot of gray shades to show subtle detail.

24
Q

Acoustic enhancement

A

generally associated with a cyst or benign lesion

25
Q

Shadowing

A

generally associated with a solid/malignant lesion

26
Q

🎗Reverberation

A

artifactual linear echoes parallel to a strong interface. May have a distinct ‘stepladder ‘ or ‘Venetian blind’ appearance

27
Q

Side or Grating Lobe

A

secondary sound sources off the main sound beam that place artifactual eches within a cyst

28
Q

Slice (Section) Thickness

A

unwanted echoes from the thickness of the sound beam in the elevation plane that place artifacts within a cyst

29
Q

🎗Nipple Shadowing

A

shadowing in the subareolar region may be eliminated by angling the transducer posterior to the nipple or by using the ‘rolled nipple’ technique

30
Q

🎗Volume Averaging

A

decreases contrast resolution and spatial resolution (both axial and lateral). Places unwanted echoes in cysts.

31
Q

What are four reasons artifacts or unwanted echoes may show up in cysts?

A

reverb, side/grating lobe, slice/section thickness, and volume averaging

32
Q

Power doppler is [MORE or LESS] sensitive to low-velocity flow.

A

More

33
Q

Doppler is most helpful in distinguishing… (3 things)

A

1) cystic vs solid
2) inflamed vs non-inflamed
3) complicated cyst vs complex cyst or intraductal papilloma

34
Q

Doppler will NOT tell you the difference between… (1 thing)

A

benign vs malignant

35
Q

What kind of transducer pressure should be used with doppler breast scanning?

A

Minimal. Small vessels are easily compressed.

36
Q

🎗Doppler technique: In order to optimize, the sonographer should establish a technique for ___ velocity flow states.

A

Low

37
Q

Techniques for low-velocity flow states include: (4 things)

A

1) Low velocity scale (5-6 cm/s)
2) Low filter setting
3) Optimal color gain setting
4) Increased PRF for high-velocity flow velocities

38
Q

Spatial compounding is

A

used to combine multiple scan lines acquired from different directions (angles).

39
Q

Advantages of spatial compounding

A

sharper margins and reduced speckle

40
Q

Disadvantages of spatial compounding

A

reduces enhancement and shadowing, appears blurry

41
Q

Technique wherein the system ignores echoes from the transmitted frequency and captures echoes from the received frequency

A

Harmonic Imaging

42
Q

1) Improves detail resolution
2) Improves contrast resolution
3) Reduces artifact chose in breast cysts

A

Advantages of harmonic imaging (3)

43
Q

Disdavantage of harmonic imaging (1)

A

May lose detail in the far field

44
Q

Diagnostic method that evaluates the elastic properties of tissue

A

elastography

45
Q

Which is more stiff - malignant tumors or benign?

A

malignant

46
Q

What uses mechanical compression to deform the tissues and measure the reaction?

A

Strain elastography

47
Q

Is the strain elastography color map qualitative or quantitative?

A

qualitative

48
Q

Soft tissues will be [BLUE or RED] with strain elastography.

A

Blue

49
Q

Stiff tissues will be [BLUE or RED] with strain elastography.

A

Red

50
Q

What is the measurement used in strain elastography to represent not only the stiffness of the lesion, but the stiffness of the surrounding tissue involved in the cancer?

A

E/B Ratio

51
Q

What do the E and B stand for in E/B Ratio?

A

Elastogram, B-Mode

52
Q

What indicates a desmoplastic reaction (cancer invading the surrounding tissue)?

A

E/B Ratio of greater than 1 = BIRADS 5

53
Q

What is a common artifact of strain elastography that appears in breast cysts?

A

The ‘Tri-Laminar’ or ‘BGR’ artifact - all three colors are displayed within the cyst.

Breast Sonography (7 decks)

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