Echo Artifacts: The Cause and Solution
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1 Echo Artifacts: The Cause and Solution David Adams, RCS, RDCS, FASE Duke University Medical Center
2 Disclosures None
3 My Happy / Sad ratio 20% Sad 1 st talk on Sunday (post party) Talk about Artifacts
4 Artifacts - definition From 2 Latin words: arte = by skill factum = to make OLD!!!!
5 Happy / Sad ratio 20% Sad 1 st talk on Sunday (post party) Talk about Artifacts 80% Happy Being here Finished the talk Saturday No snow or tornadoes
6 Artifact Talks I ve Heard Knowledge Why I Drink Time
7 The Kisslo Rules 1. If you don t point at it you can t see it. 2. If you don t see it you can t diagnosis it. 3. It s not the heart stupid!
8 It s Not the Heart Stupid! DUKE: Adams
9 Kissloisms Artifacts Not enough just to know that something is an artifact. What is the physics behind it
10 ARTIFACTS That s our goal today.
11 ARTIFACTS My Classification Easy Difficult Impossible
12 DATING My Classification Easy Difficult Impossible
13 ARTIFACTS Causes: violation of assumptions equipment malfunction or design physics of US operator error
14 ARTIFACTS Error in imaging: not real missing reflectors improper size, shape, brightness, position ALL ultrasound images contain artifacts!
15 BASIC ASSUMPTIONS ASSUME ASS U ME
16 BASIC ASSUMPTIONS sound travels in a straight line reflections only arise from structures along the beam s main axis sound travels exactly 1540 meters/second imaging plane is extremely thin sound travels directly to a reflector and back
17 BASIC ASSUMPTIONS sound travels in a straight line
18 BASIC ASSUMPTIONS reflections only arise from structures along the beam s main axis
19 sound travels exactly 1540 meters/sec BASIC ASSUMPTIONS
20 BASIC ASSUMPTIONS imaging plane is extremely thin
21 BASIC ASSUMPTIONS imaging plane is extremely thin
22 BASIC ASSUMPTIONS sound travels directly to a reflector & back
23 ARTIFACTS appear & disappear depending on the view disappear when corrective measures are taken actual anatomy remains visible if obvious artifact remains, call a service person
24 ARTIFACTS My Classification Easy common identify explain
25 Bovie Cautery Interference
26 SHADOWING a hypoechoic region appearing beneath a structure with abnormally high attenuation
27 SHADOWING - MS
28 SHADOWING - TVR
29 WHAT CAUSES THIS ARTIFACT?
30 REVERBERATION
31 REVERBERATION
32 Main Bang Artifact - Herbie
33 ARTIFACTS? Change depth
34 ARTIFACTS?
35 ARTIFACTS? Change depth Change transducer frequency See in more than one view
36 ARTIFACTS?
37 COMET TAIL
38 GSW Upper Chest DUKE: Adams
39 Comet Tail Artifact
40 Bioptome Comet Tail
41 St. Jude Valve
42 Shadowing & Comet Tail
43 Shadowing & Comet Tail
44 ARTIFACTS My Classification Difficult easy identify but explaining?? I m sorry Can be applied to dating
45 Edge Shadow Artifact a hypoechoic region appearing beneath the edge of a curved structure
46 Edge Shadow Artifact
47 Side Lobes Grating Lobes sound directed off-axis 2 nd copy of reflector along side of true anatomy real artifact
48 Side Lobes Grating Lobes
49
50 Grating Lobe
51 Grating Lobe
52 Cor Triatriatum
53 Cor Triatriatum???
54 SPEED ERRORS when sound travels at speeds other than 1,540 m/s, reflectors are placed at incorrect depths when speed is greater than 1,540 reflectors appear too shallow on the image when speed is less than 1,540 reflectors appear too deep on the image
55 Rib or Lung Interference
56 Starr-Edwards MVR
57 Starr-Edwards Valve
58 Starr-Edwards MVR
59 MIRROR IMAGE
60 MIRROR IMAGE
61 MIRROR IMAGE
62 REFRACTION
63 Double Ao - Refraction
64 Double Ao - Refraction
65 Double LV - Refraction
66 DOPPLER ARTIFACTS pulsating vessel walls and moving structures (heart) can create small Doppler shifts clutter color flash or ghosting appears in early systole due to heart motion wall filters eliminate color from small Doppler shifts that arise from structure motion
67 Ghosting Artifact
68 Ghosting Artifact
69 ARTIFACTS My Classification Easy Difficult Impossible Weird things not explained by physics (Don t mention dating / women)
70 Breast Implant
71 PDA Doppler Artifact
72 ? Artifact in the Ao
73 ? Artifact disproved by contrast
74 Multiple Artifacts (4)
75 ARTIFACTS In all Images Most can be explained If you think its real change depth or xducer & document in more than one view.
76 Duke ER The End DUKE: Adams
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