Comprehensive and Detailed Explanation From Exact Extract:
An anechoic structure (such as a cyst or fluid-filled space) allows ultrasound waves to pass through with minimal attenuation. As a result, more sound energy reaches tissues distal to the structure, producing a bright area known as posterior acoustic enhancement or increased echogenicity.
The sonography Principles and Instrumentation documents state:
"Posterior acoustic enhancement occurs distal to fluid-filled structures due to reduced attenuation through the anechoic medium, allowing increased beam intensity to reach deeper tissues."
Reduced penetration (A) and increased attenuation (B or C) would not produce enhancement.
Reduced attenuation (D) is the correct mechanism.
Therefore, the correct answer is D: Reduced attenuation through the structure.
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Question # 25
What is the primary reason lateral resolution varies at different depths?
Comprehensive and Detailed Explanation From Exact Extract:
Lateral resolution is determined by the beam width perpendicular to the ultrasound beam’s axis. As depth increases, the beam width changes due to beam divergence after the focal point. Narrower beams (better focusing) provide improved lateral resolution at specific depths.
According to sonography instrumentation reference:
“Lateral resolution depends on the width of the ultrasound beam. The narrower the beam at a particular depth, the better the lateral resolution.”
Therefore, the correct answer is A: Beam width.
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Question # 26
What is associated with a weakly attenuating structure?
Comprehensive and Detailed Explanation From Exact Extract:
A weakly attenuating structure allows ultrasound waves to pass through with minimal loss of energy. Because of this, structures located posterior to the weakly attenuating region appear brighter than expected — this is known as distal (posterior) enhancement. This artifact is most commonly observed when scanning fluid-filled structures such as cysts, the bladder, or the gallbladder.
Official sonography instrumentation reference states:
“When sound waves encounter a structure that attenuates sound minimally (low attenuation), more sound energy reaches deeper tissues. This results in increased echo amplitude from structures located distal to the weak attenuating structure, creating the appearance of distal enhancement.”
Therefore, the correct answer is D: Distal enhancement.
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Question # 27
What occurs when the pulse repetition frequency is less than twice the Doppler shift frequency?
Comprehensive and Detailed Explanation From Exact Extract:
Aliasing happens in Doppler ultrasound when the Doppler shift frequency exceeds half of the pulse repetition frequency (the Nyquist limit). When PRF is too low for the measured Doppler shift, the signal wraps around, producing aliasing.
According to sonography instrumentation reference:
“Aliasing occurs when the Doppler shift frequency exceeds one-half the pulse repetition frequency (Nyquist limit). This results in incorrect display of flow direction and velocity.”
Therefore, the correct answer is C: Aliasing.
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Question # 28
What is the purpose of applying compression to the received signals?
Comprehensive and Detailed Explanation From Exact Extract:
The primary purpose of compression is to reduce the dynamic range of received echoes, making the image more visually interpretable by adjusting contrast without losing diagnostic information.
According to sonography instrumentation reference:
“Compression reduces the dynamic range of the signal amplitudes to fit within the display range of the monitor while preserving important differences in tissue echogenicity.”
Therefore, the correct answer is D: Reduce the dynamic range.
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Question # 29
Which artifact causes a simple cyst to appear to contain debris?
Comprehensive and Detailed Explanation From Exact Extract:
Slice thickness (elevational resolution artifact) occurs when the ultrasound beam partially includes surrounding tissue above or below the scan plane, falsely appearing as internal echoes within an otherwise anechoic cyst.
Principles and Instrumentation:
"Slice thickness artifact occurs when off-axis echoes are included in the imaging slice, falsely creating internal echoes in cystic structures."
Refraction (A) causes displacement.
Enhancement (B) causes posterior brightening.
Range ambiguity (D) produces incorrect depth placement.
Therefore, the correct answer is C: Slice thickness.
M-mode (Motion mode) is used in ultrasound to measure and display the movement of structures over time.
This mode is particularly useful in cardiac imaging to assess the motion of heart walls and valves.
M-mode provides a one-dimensional view of the motion of tissues and is often used in conjunction with 2D imaging for a comprehensive assessment.
It is essential in evaluating the dynamic function of organs, especially in cardiology, where precise measurements of cardiac structures' movement are crucial.References:
ARDMS Sonography Principles and Instrumentation guidelines on modes of ultrasound imaging and their clinical applications.
Temporal resolution refers to the ability of an ultrasound system to distinguish between events occurring closely in time. It is primarily affected by the frame rate, which is the number of frames displayed per second. One of the main factors that influence the frame rate is the display depth. The deeper the imaging depth, the longer it takes for the ultrasound pulses to travel to the target and back, thus reducing the frame rate and temporal resolution. Shallower imaging depths allow for higher frame rates and better temporal resolution.
References
ARDMS Sonography Principles and Instrumentation (SPI) Exam Study Guide
"Diagnostic Ultrasound: Principles and Instruments" by Frederick W. Kremkau
Comprehensive and Detailed Explanation From Exact Extract:
Power Doppler detects the strength (amplitude) of returning Doppler signals, which reflects the presence of flow regardless of direction or velocity. It is more sensitive to low-velocity flow and is less angle-dependent than conventional color Doppler.
Principles and Instrumentation state:
"Power Doppler displays the amplitude of Doppler shifts, representing the presence of flow. It does not display direction or velocity."
Laminar flow (A) and velocity (C) are not specifically measured by power Doppler.
Viscosity (D) cannot be assessed by Doppler ultrasound.
Therefore, the correct answer is B: Presence of flow.
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Question # 33
Which adjustment resulted in the change from image A to image B?
Increased Transmit Frequency: This would generally improve the resolution of the image but does not directly correlate to the changes seen in the provided image link.
Increased Scale: Adjusting the scale changes the velocity range displayed but does not directly affect the speckle or noise reduction.
Decreased Color Gain: Reducing the color gain can decrease the amount of color noise, making the blood flow regions more defined, which aligns with the change observed from image A to image B.
Decreased Acoustic Power: This reduces the overall intensity of the ultrasound beam, affecting penetration depth and overall brightness but is less likely to result in the specific improvements seen.
[References:, "Understanding Ultrasound Physics" by Sidney K. Edelman, ARDMS Sonography Principles and Instrumentation study materials, , , ]