In my experience, there are two types of ultrasonographers—those who tinker a lot with their image settings, and those who prefer to never adjust anything. By the very nature of my job, I’m definitely the former… but both groups can get themselves into trouble. The Tinkerers can go down a rabbit hole and find themselves even further from the results they want, and the Never-Adjusts might be missing a lot of opportunities to optimize their image quality.
If you find yourself unsatisfied with the image you’re getting, here are some tips to start over.
- Do a factory reset. This quick procedure will bring your system back to the default factory settings. Use reset user to only reset the current user, reset all to reset the settings for all users, and reset system to wipe all of your standard settings and delete images and files. When in doubt, simply reset the current user. Here’s how:
- If you’re using the EVO or SA models, you next want to select your exam type. These are factory settings for specific applications, such as small animal abdomen, fetal gender determination, or equine repro. They will give you a good starting point with regard to depth, frequency, gain, and other settings. Here’s how: https://youtu.be/EjzaUnH7M0w
- Check your contact. Perhaps the biggest improvement you can make to your image is to be sure that you have the best possible contact between the transducer surface and the tissue. Hair, air, and debris or contaminants can all interfere with the transducer’s ability to transmit sound waves. For transdermal applications, clip away the hair if possible, wash away dirt and debris, wet the surface of the skin with alcohol or even water, and use an acoustic gel if necessary (admittedly I personally tend to avoid gel when possible because it’s messy and can seem counterproductive as it dries into a sticky film. However, it can be very useful in many applications and should be kept on hand). Trying to overcome poor contact with increases in gain or decreases in frequency can result in a suboptimal image.
- Adjust your depth. Each transducer has a range of depth settings that it will operate within. A general rule of ultrasound is to keep the area of interest within the center of your screen. If you’re evaluating an 3cm ovary near the surface of the probe, for example, there is no need to be scanning at 12cm of depth—this will result in a very small ovary that is difficult to evaluate. On the IBEX models, depth is adjusted by toggling between the four field of view (FOV) settings, and on the EVO and SA models, there is an up and down depth arrow that allows you to select the ideal setting for your exam. Here’s how:
- Adjust your frequency. The caveat here is that while the IBEX line does have broadband or multi-frequency transducers, the frequency is automatically adjusted with the depth when you set your FOV (see #4). This removes the need for a separate adjustment, but it accentuates the need to select the right FOV! On the EVO and SA models, the operating frequency is set independent of the depth. Remember that higher frequencies produce higher resolution images, but lower frequencies penetrate deeper. Start with a relatively high frequency, but decrease it as needed to keep the image from looking too dark in the far field (the bottom part of the screen, further from the probe surface). I suggest reducing your frequency as needed prior to adjusting the gain, to avoid washing out your image. Here’s how: https://youtu.be/RAJLlRSVew8
- On the EVO and SA models, adjust your focal zone. This parameter tells the transducer where to focus the beam to get the crispest image. Set it toward the bottom of the structure you’re examining. Here’s how: https://youtu.be/6iMbd5i1Nlc
- Finally, adjust your gain. I have written about gain before, so feel free to search the blog for additional information. Suffice it to say that while many people will think of gain as the brightness of the image, it’s really an amplification of the echo returning to the probe. Therefore, turning it up too much in an attempt to brighten your image can result in a lack of distinction between tissues of different echogenicities, unnecessary noise in the background, and artifact that makes evaluation and diagnosis difficult. Gain is a very useful tool, but be judicious in its use. Here’s how: https://youtu.be/xba3jBCol3g (example from the IBEX LITE, but all gain adjustment is similar)
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