E3463. Shady Business: Causes, Uses, Fixes of Common Grayscale Sonographic Artifacts
  1. Michelle Bondero; University of California - Los Angeles
  2. Gail Hansen; Olive View - UCLA Medical Center
  3. Karoly Viragh; Olive View - UCLA Medical Center
Ultrasound artifacts occur on every single sonographic examination. Though they may degrade imaging quality, artifacts can frequently improve diagnosis by characterizing the underlying tissue properties. Therefore, understanding the basic mechanisms of how these artifacts occur as well as how they can be made better or worse is key in clinical imaging. The goal of the exhibit is to teach and illustrate the most common sonographic artifacts in a simplified, interactive manner.

Educational Goals / Teaching Points
The exhibit aims to (1) define the basic principles of grayscale ultrasound imaging, (2) explain the most common artifacts, (3) demonstrate their mechanisms through animated diagrams, and (4) richly illustrate clinical uses and fixes through imaging examples.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The exhibit will begin with a practical, diagram-rich review of the basic sonographic principles, specifically, how sound waves form (piezoelectricity) and interact with tissues (absorption, reflection, scatter, refraction), as well as how images are created by the computer based on basic assumptions about the ultrasound beam and the underlying tissues. Building on this foundation, the most common artifacts will be defined and illustrated through animations and clinical examples, including beam shape artifacts (width, secondary lobes), propagation artifacts (reverberation, comet-tail versus ring-down, mirror-image, anisotropy, refraction, range ambiguity, speed displacement), as well as attenuation artifacts (shadowing, enhancement). For each artifact, their clinical applications and fixes/solutions will be discussed. The explanations will be intermixed with carefully selected interactive board-style educational cases, which are aimed at both trainees preparing for board examinations and radiologists reviewing for their maintenance-of-certification examinations.

Understanding the ultrasound artifacts will help imagers improve diagnostic acumen and patient care.