Physics Flashcards
Which of the following will increase the amount of color displayed in the abdominal AO?
increase frame rate
decrease color gain
decrease color threshold
increase wall filter
increase frame rate
**changing to a smaller sample size will increase frame rates
What type of transducer produced the image?
sector phased array
linear sequential array
curvilinear phased array
vector phased array
sector phased array
You are evaluating an obese patient with a known AAA. While using color Doppler to assess flow within the aneurysm, minimal flow is detected in the anechoic lumen. You decrease the color scale and increase the color gain but there is no improvement. Which of the following adjustments will most improve the color display on this exam?
decrease the color threshold
switch from a 4MHz curved array to a 4MHz linear array
increase color sample size
increase the color threshold
increase the color threshold
**increasing the color threshold will increase the amount of color displayed
What determines the transducer frequency used for the evaluation of a foreign body?
composition of the foreign body
depth of the foreign body
the radiologist reading the exam
age of the foreign body
depth of the foreign body
What acoustic artifact is demonstrated by the red arrow?
reverberation
refractive shadowing
mirror imaging
ringdown
refractive shadowing
The primary factor that determines transducer selection for a biopsy is:
physician preference
thickness of the sterile cover
depth of the mass
composition of the mass
depth of the mass
Which of the following would cause artifactual debris within a simple cyst?
increased rejection settings
short distance from the transducer
activation of spatial compounding
reduced gain settings
short distance from the transducer
Which of the following best describes the areas indicated by the yellow arrows?
reverberation artifact
refractive shadowing
PE element damage
posterior shadowing
PE element damage
A large angiomyolipoma in the right kidney is most commonly associated with what acoustic artifact?
mirror image
reverberation
comet tail artifact
propagation speed artifact
propagation speed artifact
What is the BEST way to evaluate the indicated vessel for the presence of blood flow?
color Doppler
PW Doppler
power Doppler
B-color
power Doppler
**preferred for smaller vessels and those coursing perpendicular to the US beam
Which of the following will reduce ansiotropy artifact?
dual screen imaging
turn of harmonic imaging
reduce color Doppler gain
rocking the transducer
rocking the transducer
**ansiotropy artifact refers to falsely hypoechoic areas of a tendon that occur when the transducer is not completely parallel to the tendon
Which of the following acoustic artifacts is identified on the image?
reverberation
lobe artifact
mirror image
misregistration
reverberation
Overgaining on an US exam can cause ___.
blood to appear anechoic
underestimation of arterial stenosis
overestimation of Doppler velocity
increased posterior shadowing
overestimation of Doppler velocity
You are scanning the GB and there appears to be sludge within the lumen. Which of the following will aid in differentiating the sludge from artifact?
ask the patient to perform the Valsalva maneuver
increase the transducer frequency
apply color Doppler
ask the patient to fast for 3-4 more hours and rescan
increase the transducer frequency
____ occurs posterior to highly attenuating structures.
enhancement
speckle
shadowing
refraction
shadowing
Acoustic Radiation Forced Impulse (AFRI) evaluation of the liver:
is performed with a subcostal midline window
is helpful in cases of suspected abscess formation
should be performed with the patient in the prone position
should be performed in the right lobe
should be performed in the right lobe
**used to assess the liver for signs of chronic disease
All of the following are characteristics of Power Doppler, EXCEPT:
demonstrates presence or absence of flow
demonstrates organ perfusion better than color Doppler
more sensitive to slow flow than color Doppler
demonstrates velocity of flow within the organ
demonstrates velocity of flow within the organ
When evaluating a liver transplant, you must use angle correction during Doppler evaluation of:
PVs only
HAs only
HAs and PVs
HAs and HVs
HAs and PVs
What system control should be turned off when trying to differentiate a small stone in the GB from a sludge ball?
compound imaging
harmonic imaging
focal zone
time gain compensation
compound imaging
** turning this feature off can improve visualization of posterior shadowing and enhancement
If there is no diastolic flow demonstrated on a Doppler tracing of the interlobar artery of the upper pole of the right kidney, what will the RI be?
unable to calculate RI, not enough information
0
1.0
0.5
1.0
(PSV - EDV)/PSV
Which type of transducer would be used to evaluate a patient with increased LFTs and height 5’3” and weight 275lbs?
10MHz vector array
5MHz linear phased array
5MHz sector phased array
3MHz curvilinear phased array
3MHz curvilinear phased array
Harmonic imaging leads to:
increased image noise
reduced signal to noise ratio
reduced appearance of lobe artifact
improved axial but degraded lateral resolution
reduced appearance of lobe artifact
On a scrotal ultrasound exam, how do you differentiate acute epididymitis from post-vasectomy enlargement of the epididymis?
use dual screen imaging
use color Doppler
use power Doppler
use a stand off pad
use color Doppler
** hypervascularity is demonstrated with infection, but not with post-surgical changes
The artifact that is produced when the incident beam hits a curved surface and produces an acoustic shadow is referred to as:
lobe artifact
posterior shadowing
refractive shadowing
comet tail artifact
refractive shadowing
If the entire image is too dark, what console adjustment should you make first?
adjust the near field TGC
increase the output power
adjust the far field TGC
increase overall gain
increase overall gain
When performing a Doppler evaluation of the renal arteries the cursor angle should be set at ___ degrees or less for the main renal arteries and ___ degrees or less for the intraparenchymal arteries.
45, 60
20, 0
60, 20
60, 45
60, 20
If the entire image is too bright, what console adjustment should you make first?
decrease the overall gain
adjust the far field TGC
adjust the near field TGC
decrease the output power
decrease the output power
How are the gain settings adjusted to the proper level for evaluation of abdominal structures?
A normal GB or IVC should look anechoic throughout the exam
the spleen echogenicity should be set to a medium grey level at the start of the exam
the liver echogenicity should be set to medium grey at the start of the exam
the anterior abdominal fat should appear as a medium grey level throughout the exam
A normal GB or IVC should look anechoic throughout the exam
Which of the following is a resonance artifact only seen with a gas/tissue interface?
mirror imaging
misregistration
ringdown
posterior shadowing
ringdown
A patient presents for a liver ultrasound with contrast to evaluate a tumor. Which of the following lists the correct machine settings needed for the exam?
MI over 1.5, harmonics off, and focal zone at the abdominal wall
low MI, harmonics off, and focal zone at the abdominal wall
highest output power setting available, harmonics on, and at least three focal zones surrounding the area of interest
low MI, harmonics on, and focal zone placed at the area of interest
low MI, harmonics on, and focal zone placed at the area of interest
While performing a Doppler evaluation of the main RAs, multiple patient positions may be required in order to maintain a Doppler angle of ___ degrees or less.
0
30
60
90
60
Color Doppler demonstrates the ___.
direction of flow only
peak velocity of blood flow only
average velocity and direction of flow
peak velocity and direction of flow
average velocity and direction of flow
Which of the following techniques will lead to degraded lateral resolution?
trapezoidal field of view on linear array
increase in number of focal zones
increased probe frequency
none of the above
trapezoidal field of view on linear array
**increasing size of FOV will lead to increased beam divergence which leads to reduced lateral resolution
What is the cause of the vertical acoustic shadow seen on the images?
electrical interference
element damage
patient motion
air in the trachea
element damage
Increasing the imaging depth will:
improve temporal resolution
reduce beam intensity
increase the PRF
reduce the frame rate
reduce the frame rate
**pulses are longer/slower which reduces frame rate
Increasing the ___ will most improve the ability to properly trace the contour of this Doppler waveform.
sweep speed
velocity scale
wall filter
baseline
sweep speed
**decreases the amount of Doppler information displayed over a shorter time
While performing color Doppler on a routine renal ultrasound, extreme turbulence is noted at the RRA origin. How should your exam change to evaluate the finding?
use PW Doppler to record a flow pattern in the area of turbulence
advise the patient that they may have to return for an additional exam because of the suspected renal stenosis
have the patient perform the Valsalva maneuver and reassess the vessel for changes
all of the above
use PW Doppler to record a flow pattern in the area of turbulence
Which Doppler artifact is demonstrated on the image?
side lobes
reverberation
cross talk
aliasing
cross talk
What change in system controls can reduce the appearance of color displayed over vessel walls?
decreasing color priority
decreasing color PRF
increasing color threshold
increasing persistence
decreasing color priority
**lower threshold settings reduce the display of color
Which of the following exams does not require angle corrected Doppler evaluation?
RA duplex
TIPS evaluation
IVC duplex
AO duplex
IVC duplex
Which imaging plane can demonstrate the IVC and the AO on the same image in a normal patient?
coronal and TRV
coronal only
mid SAG only
TV only
coronal and TRV
When performing contrast enhanced ultrasound evaluation of the liver, when are the images obtained?
after the saline flush, record an image the area of interest every 60 seconds
when the contrast is first visualized in the areas of interest and again when it dissipates completely
at the start of the contrast injection, record an image the area of interest every 30 seconds
at the start of the saline flush, record the area of interest for 1 minute and image every 30-60 seconds until the 6 minute mark
at the start of the saline flush, record the area of interest for 1 minute and image every 30-60 seconds until the 6 minute mark
Put the following in order in decreasing echogenicity:
renal sinus, renal parenchyma, liver, spleen, pancreas
renal parenchyma, spleen, liver, pancreas renal sinus
pancreas, spleen, liver, renal sinus, renal parenchyma
renal sinus, pancreas, spleen , liver, real parenchyma
renal sinus, pancreas, spleen , liver, real parenchyma
Which type of transducer would be used to evaluate a palpable lump in the neck?
3MH curvilinear sequential array
12MHz linear phased array
12MHz curvilinear phased array
12MHz sector phased array
12MHz linear phased array
What acoustic artifact is commonly seen with a liver abscess, adenomyomatosis of the GB, and emphysematous cholecystitis?
mirrior image artifact
posterior enhancement
propagation speed artifact
posterior reverberation artifact
posterior reverberation artifact
You are currently using a curved probe with a 3.5MHz frequency to evaluate a patient’s liver. What can be done to better visualize the area indicated by the arrow?
switch to a 12MHz linear probe
switch from a curved array to a vector array of the same frequency
switch to a 2.5MHz curved probe
switch to a 5MHz linear probe
switch to a 5MHz linear probe
** would provide the largest near field
All of the following techniques will aid in the visualization of a small renal calculi with questionable shadowing, EXCEPT:
using multiple scanning planes to evaluate the kidney
reducing the dynamic range
decreasing transducer frequency
rescanning the patient in the decubitus position
decreasing transducer frequency
What acoustic artifact is demonstrated by the mass within the liver?
comet tail artifact
reverberation
posterior enhancement
dirty shadowing
posterior enhancement
What can be used to alter the displayed brightness of the image after it has been stored in the memory?
compression
post-processing
pre-processing
rejection
post-processing
What acoustic artifact is demonstrated on the image by the red X?
posterior enhancement
speed error
edge shadowing
mirror imaging
mirror imaging
All of the following can cause artifactual debris within a simple cyst, EXCEPT:
improper gain settings
increased rejection settings
superficial location of the cyst
small size of the cyst
increased rejection settings
Which of the following adjustments would reduce the aliasing displayed on the image while maintaining the diagnostic quality?
reducing the color Doppler gain is the preferred method to remove the appearance of color aliasing on the image
repositioning the patient and scanning through the anterior abdominal wall will reduce or eliminate the color aliasing
increasing the color scale velocity setting is the preferred method to reduce the aliasing in the RA
increasing the color priority setting is the preferred method to reduce the aliasing in the RA
increasing the color scale velocity setting is the preferred method to reduce the aliasing in the RA
Which of the following operator controls adjusts the beam intensity?
output
overall gain
dynamic range
TGC
output
When you change the angle on the Doppler cursor, the ___ also changes.
amplitude of the reflected signal
the volume of flow interrogated
the wall filter settings also change
flow velocity displayed
flow velocity displayed
B-color can be helpful in the evaluation of:
subtle differences in tissues
low velocity blood flow
high velocity blood flow
anechoic fluid/cysts
subtle differences in tissues
What is the name of the universally accepted image file type that is used by a PACS system to store and view images?
MPEG
DICOM
AVI
JPEG
DICOM (digital imaging and communications in medicine)
Increasing the size of the field of view will ___ the frame rate.
cause a 50% decrease
decrease
have no effect on
increase
decrease
Which of the following machine adjustments will produce black and white 2D images?
reducing the compression
reducing overall gain
increasing dynamic range
reducing monitor contrast
reducing compression
** compression adjusts the dynamic range or number of shades of gray on the image
Which supplemental technique, used to better visualize the size of a large hydrocele, is demonstrated on the image?
extended field of view
vector array imaging
harmonic imaging
curved array imaging
curved array imaging
Harmonic imaging:
improves the spatial resolution but causes degradation of temporal resolution
is not recommended for use on fetal exams due to increased beam intensity
uses information from reflections creates by the non-linear behavior of sound waves to form the image
improves spatial resolution but causes degradation of contrast resolution
uses information from reflections creates by the non-linear behavior of sound waves to form the image
Posterior shadowing can be helpful in the diagnosis of all of the following, EXCEPT:
GB calculi
choledocholithiasis
nephrocalcinosis
steatosis
steatosis
___ may be a cause for liver echoes distal to the GB to appear brighter than the surrounding parenchyma.
posterior enhancement
decreased gain settings
portal venous reflections
posterior shadowing
posterior enhancement
Why did the sonographer steer the US image during the thyroid biopsy?
to make the US beam more perpendicular to the nodule
to reduce the side lobe artifact
to make the US beam more perpendicular to the long axis of the needle
to better visualize the borders of the nodule
to make the US beam more perpendicular to the long axis of the needle
Which statement is true about the image?
the red arrows are pointing to the anterior wall of the Baker cyst and the associated enhancement
the red arrows are pointing to the posterior wall of the Baker cyst and the associated shadowing
the red arrows are pointing to the anterior wall of the Baker cyst and the associated shadowing
the red arrows are pointing to the posterior wall of the Baker cyst and the associated enhancement
the red arrows are pointing to the anterior wall of the Baker cyst and the associated enhancement
In order to assess low velocity flow, which of the following operator adjustments should be made?
decrease wall filter setting and compression
increase scale setting
decrease compression
decrease the rejection and wall filter setting
decrease the rejection and wall filter setting
When the sonographer decreases the imaging depth the ___.
PRF will decrease
frame rate will decrease
PRF will increase
elevational resolution will improve
PRF will increase
Time gain compensation is necessary due to:
the inability of high frequency transducers to penetrate the body effectively
sound impedance difference between transducer and skin
the non-linear behavior of sound waves
reflection, refraction, and scatter
reflection, refraction, and scatter
Which imaging plane is most commonly used to obtain the length of the spleen during an abdominal ultrasound?
TRV
SAG
axial
coronal
coronal
A patient presents with a palpable lump adjacent to the umbilicus. Which of the following transducers would be best to use for this exam?
10MHz linear array
3.5 MHZ linear array
3.5MHz curvilinear array
8MHz sector array
10MHz linear array
Which of the following would be associated with posterior enhancement artifact in the liver tissues?
fatty infiltration
lymphoma
dilated intrahepatic ducts
large lipoma
dilated intrahepatic ducts
Power Doppler:
is preferred for evaluation of blood flow in a TIPS shunt
is preferred for evaluation of blood flow in a patient with suspected PHTN
is less sensitive than color Doppler when evaluating renal transplant perfusion
display is not dependent on incident beam angle
display is not dependent on incident beam angle
An average sized patient presents with a fever, acute RLQ pain and vomiting. The ER physician wants to rule out appendicitis in this patient. Which transducer would best be suited for the exam?
5MHz curvilinear
3MHz curvilinear
12MHz linear
5MHz linear
5MHz linear
The use of multiple focal zones will improve ___ but degrade ___.
axial resolution, lateral resolution
temporal resolution, lateral resolution
lateral resolution, axial resolution
lateral resolution, temporal resolution
lateral resolution, temporal resolution
___ resolution is defined as the ability of an ultrasound system to differentiate structures on an image based on variations in the brightness of the echo/pixel.
contrast
axial
elevational
lateral
contrast
Which acoustic artifact is demonstrated on the image?
posterior shadowing
comet tail
mirror imaging
range resolution
mirror imaging
All of the following controls affect the amount of color fill in a vessel evaluated with color Doppler, EXCEPT:
sample size
color Doppler baseline
sample angle
color Doppler scale settings
color Doppler baseline
** affects what color is displayed but not how much color is displayed
Which imaging plane can produce a longitudinal image of the IVC and the AO on the same image?
coronal and TRV
mid SAG only
coronal only
TRV only
coronal only
A contrast agent consists of a cellulose suspension is administered to a patient to better visualize:
an aortic aneurysm
the pancreatic tail
functioning thyroid nodules
non-functioning adrenal adenomas
the pancreatic tail
What is the twinkle artifact?
mosaic color pattern displayed in a linear pattern posterior to a dense object, such as a renal stone
thin line of reverberation artifact that is caused by calcium deposits in the renal parenchyma
varied brightness of vascular calcifications causes a twinkling effect on 2D
describes the color display seen as urine is entering the bladder during real time imaging
mosaic color pattern displayed in a linear pattern posterior to a dense object, such as a renal stone
Which of the following renal abnormalities is commonly associated with propagation speed artifact?
staghorn calculus
mycetoma
hypernephroma
4cm renal angiomyolipoma
4cm renal angiomyolipoma
Increasing the wall filter setting could reduce the display of all of the following, EXCEPT:
aliasing artifact
clutter artifact
beam width artifact
cross talk artifact
aliasing artifact
Which of the following probe frequencies should be used when trying to evaluate the pancreas in an obese patient?
3MHz curvilinear
3MHz linear
5MHz vector
5MHz curvilinear
3MHz curvilinear
Harmonic imaging will:
improve temporal resolution
allow for deeper penetration with improved spatial resolution
degrade lateral resolution and improve axial resolution
reduce the appearance of microbubble contrast on a contrast echo
allow for deeper penetration with improved spatial resolution
Which acoustic artifact is a common sonographic sign of emphysematous pylonephritis?
side lobe
misregistration
resonance artifact
propagation speed error
resonance artifact
Acoustic Radiation Forced Impulse (AFRI) is typically used to assess the ___ for signs of ___.
kidneys, obstructive calculi
AO, stenosis
abdominal wall, hernia formation
liver, chronic disease
liver, chronic disease
No flow is detected while performing a color Doppler evaluation of a normal splenic vein. What will improve the color display?
increase the color packet size
increase the sample size
increase the color velocity scale
increasing angle of insonation
increase the color packet size
Which acoustic artifact will commonly be identified with hydrocele formation?
edge shadowing
posterior shadowing
posterior enhancement
comet tail artifact
posterior enhancement
Propagation speed artifact, reverberation artifact and the bayonet artifact are acoustic artifacts seen with:
needles
pneumothorax
abdominal aortic aneurysms
abscess formation
needles
Which of the following correctly describes why the arcuate arteries are not easily or accurately evaluated by PW Doppler?
because the flow is very low resistance
the renal capsule attenuates the Doppler signal so only limited information is reflected to the probe
because the blood flows perpendicular to the Doppler sound beam
because the blood flows parallel to the Doppler sound beam
because the blood flows perpendicular to the Doppler sound beam
Which acoustic property causes the echogenic appearance of the diaphragm related to surrounding structures?
refraction
attenuation
specular reflection
non-specular reflection
specular reflection
**occurs with large smooth structure
When performing contrast enhanced ultrasound evaluation of the liver, when is the timer started for the procedure?
when the contrast is first visualized in the areas of interest
at the start of the contrast injection
at the start of the saline flush
after the saline flush
at the start of the saline flush
Which probe can best evaluate the surface nodularity of the liver in a patient with cirrhosis?
vector 10MHz
curved 8MHz
curved 5MHz
linear 7.5MHz
linear 7.5MHz
A mass that demonstrates propagation speed artifact may lead to a positive diagnosis of:
lipoma
staghorn calculus
renal cyst
RCC
lipoma
Which of the following will improve the color Doppler visualization of flow in the arcuate arteries?
increased transducer frequency
increased wall filter settings
reduced color gain
smaller packet size
increased transducer frequency
** for small vessels
increase frequency, packet size, and color gain settings
Which of the acoustic artifacts is demonstrated on the image?
range resolution
volume averaging
mirror image
side lobes
mirror image
What system settings should be adjusted to better visualize the abnormality displayed?
increase the dynamic range
turn off compound imaging
reduce the rejection settings
turn up the overall gain
turn off compound imaging
Which of the following best describes the probe position used to evaluate the long axis of the pancreas?
TRV oblique probe position at the midline with notch side of the probe rotated slightly superior to the side of the probe without the notch
SAG probe position just to the left of midline with notch rotated slightly to the left side of the patient
TRV oblique probe position at the midline with notch side of the probe rotated slightly inferior to the side of the probe without the notch
SAG probe position just to the left of midline with notch rotated slightly to the right side of the patient
TRV oblique probe position at the midline with notch side of the probe rotated slightly inferior to the side of the probe without the notch
Potential bioeffects of ultrasound can be minimized by which of the following?
increase PRF
decrease overall gain
reduce exam time
using a lower frequency transducer
reduce exam time
