SPI Sample Questions Answers

Comprehensive and Detailed Explanation From Exact Extract:

Ideal imaging transducers have broad bandwidths (allowing multiple frequencies for better axial resolution and flexibility) and a low quality factor (which indicates efficient damping, leading to short pulses and better image quality).

According to sonography instrumentation reference:

“Imaging transducers operate with broad bandwidth and low quality factor to achieve short pulse duration and optimal axial resolution.”

Therefore, the correct answer is B: Broad bandwidth; low quality factor.

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In the tissue-mimicking phantom image, Option D (blue box) is used to evaluate transverse distance measurement accuracy. Phantoms are used to simulate human tissue and provide a standardized way to test the accuracy and precision of ultrasound machines. Transverse distance measurement accuracy is assessed by measuring known distances between targets in the phantom. The blue box (Option D) typically contains targets positioned to specifically test the accuracy of transverse measurements, ensuring that the ultrasound system provides reliable and precise distance readings.

References

ARDMS Sonography Principles and Instrumentation (SPI) Exam Study Guide

"Quality Assurance for Ultrasound Imaging Systems" by AAPM (American Association of Physicists in Medicine)

Comprehensive and Detailed Explanation From Exact Extract:

Each additional focal zone requires extra transmissions per scan line, which slows down frame acquisition, thereby reducing the frame rate.

Principles and Instrumentation state:

"Increasing the number of focal zones lowers frame rate because multiple pulses are needed per scan line for each focal depth."

Increasing PRF (B) allows faster data acquisition.

Decreasing depth (C) shortens round-trip time, increasing frame rate.

Decreasing sector width (D) reduces scan lines, increasing frame rate.

Incorrect color Doppler gain settings can cause the artifact known as bleed or blossoming. When the color Doppler gain is set too high, it can cause the color signal to "bleed" outside the actual boundaries of the blood vessel, leading to an overestimation of the area of flow. This artifact makes it appear as though the blood flow extends beyond the true vessel walls, which can obscure the accurate interpretation of the Doppler image.

References

ARDMS Sonography Principles and Instrumentation (SPI) Exam Study Guide

"Diagnostic Ultrasound: Principles and Instruments" by Frederick W. Kremkau

In the given image of a tissue-mimicking phantom, Option B (yellow box) is used to evaluate axial resolution. Axial resolution refers to the ability of the ultrasound system to distinguish between two structures that are close to each other along the path of the ultrasound beam (i.e., parallel to the beam). The targets in Option B are typically aligned in such a way to test the system's capacity to differentiate between structures that are situated closely together along the beam’s axis.References:

ARDMS Sonography Principles and Instrumentation guidelines

"Sonography: Principles and Instruments" by Joan P. Baker and Marveen Craig

Comprehensive and Detailed Explanation From Exact Extract:

Compression reduces the dynamic range of the returning echoes, which alters how many shades of gray are displayed. It compresses the range of signal amplitudes to fit into the grayscale display range.

According to sonography instrumentation reference:

“Compression alters the dynamic range, adjusting how many shades of gray are displayed to optimize image contrast.”

Therefore, the correct answer is B: The shades of gray displayed.

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Comprehensive and Detailed Explanation From Exact Extract:

Aliasing occurs in pulsed-wave Doppler imaging when the Doppler shift frequency exceeds the Nyquist limit (which is half the pulse repetition frequency, PRF). This results in a wrap-around of the Doppler signal, which appears as a reversal of flow direction (aliasing artifact).

According to standard Principles and Instrumentation references in sonography:

“To eliminate aliasing, the Doppler PRF (scale) should be increased. Increasing the PRF raises the Nyquist limit and therefore allows for higher measurable velocities without aliasing.”

The correct adjustment to correct this aliasing artifact isC: Increase the Doppler pulse repetition frequency. This effectively increases the Nyquist limit and resolves the wrap-around aliasing appearance.

Options A and B (adjusting the spectral Doppler gain) would only change the appearance of the Doppler waveform (i.e., its amplitude and brightness) but would not affect aliasing. Option D (decreasing the PRF) would actually worsen the aliasing by lowering the Nyquist limit.

Therefore, the correct choice is toincrease the Doppler PRF.

Edge enhancement is a processing technique used in ultrasound imaging to improve the visibility of the edges of structures.

In image A, the borders of the cystic lesion might appear less defined due to a lack of edge enhancement.

By turning on edge enhancement, the ultrasound system processes the image to accentuate the boundaries, leading to a clearer and more distinct outline of the cystic lesion as seen in image B.

This adjustment reduces the artifact within the cystic lesion by emphasizing the differences in the adjacent tissue interfaces, thus improving the overall image quality.References:

American Registry for Diagnostic Medical Sonography (ARDMS) Sonography Principles and Instrumentation guidelines on image optimization techniques.

Temporal resolution refers to the ability to accurately depict moving structures over time.

A narrow sector width reduces the area being scanned, which increases the frame rate because fewer scan lines are required per frame.

Higher frame rates improve temporal resolution, allowing for better visualization of fast-moving structures.

Other factors like scan depth and the number of focal zones also affect frame rate but typically reduce it when increased, thereby decreasing temporal resolution.References:

ARDMS Sonography Principles and Instrumentation guidelines on factors affecting temporal resolution and frame rate.

Comprehensive and Detailed Explanation From Exact Extract:

Reflection is maximized when the ultrasound beam strikes a tissue interface at 90 degrees (perpendicular). This angle provides optimal return of echoes for imaging.

According to sonography instrumentation reference:

“Maximal reflection occurs when the sound beam strikes a boundary at 90 degrees.”

Therefore, the correct answer is D: Reflection.

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Comprehensive and Detailed Explanation From Exact Extract:

Temporal resolution reflects how quickly frames are updated (frame rate). Reducing the number of scan lines per frame (low line density) decreases acquisition time, thus increasing frame rate and improving temporal resolution.

According to sonography instrumentation reference:

“Lower line density allows for faster frame rates, improving temporal resolution at the expense of spatial resolution.”

Therefore, the correct answer is D: Low line density.

The aperture of a transducer is the active area that emits and receives the ultrasound waves. In a linear array transducer, increasing the aperture (using more elements for transmission and reception) results in a deeper focus because the beam is more tightly focused over a longer distance. This improves lateral resolution at greater depths, as the ultrasound beam maintains a narrower width for a longer distance. It allows for better imaging of deeper structures without sacrificing resolution.

American Registry for Diagnostic Medical Sonography (ARDMS). Sonography Principles and Instrumentation (SPI) Examination Review Guide.

Comprehensive and Detailed Explanation From Exact Extract:

Elevational resolution (slice thickness resolution) refers to the ability to resolve structures perpendicular to the imaging plane and is directly determined by the beam’s thickness in that plane.

Principles and Instrumentation state:

"Elevational resolution is governed by the slice thickness, which depends on the transducer's beam profile and focusing in the elevational dimension."

Beam depth (A) affects penetration.

Beam uniformity ratio (C) is not related.

Beam width (D) affects lateral resolution.

Therefore, the correct answer is B: Beam thickness.

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Overall gain in ultrasound refers to the amplification of all the received echo signals. Increasing the overall gain amplifies the signals, making the entire image brighter. Conversely, decreasing the overall gain reduces the signal amplification, resulting in a darker image. Overall gain adjustment affects the entire image uniformly, unlike time gain compensation (TGC), which adjusts the gain at different depths independently.

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:

Defects in transducer crystals result in missing or weakened signals along the beam path produced by those elements, creating dropout. In array transducers, dropout typically appears as vertical or horizontal dark zones depending on which elements are affected.

According to sonography instrumentation reference:

“Crystal failure results in areas of signal dropout directly beneath the defective elements due to loss of transmitted or received signals.”

Therefore, the correct answer is D: Dropout.

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The tissue-equivalent phantom image with the red oval indicates an area where axial resolution can be evaluated. Axial resolution refers to the ability to distinguish between two structures that are close together along the axis of the ultrasound beam. It is determined by the spatial pulse length (SPL) of the ultrasound wave. In phantoms, this is typically tested by observing the ability to separate closely spaced targets along the beam's path.

Attenuation refers to the reduction in the intensity of the ultrasound beam as it travels through tissue. Higher frequency ultrasound beams experience more attenuation because they are absorbed and scattered more than lower frequency beams. This is due to the fact that higher frequency waves have shorter wavelengths and interact more with the small particles in tissues, causing greater energy loss.

Comprehensive and Detailed Explanation From Exact Extract:

Axial resolution improves with shorter spatial pulse length, which is directly related to higher frequency. At shallow depths (such as 2 cm), higher frequency can be used effectively since attenuation is minimal.

Principles and Instrumentation state:

"Axial resolution improves with increasing frequency due to shorter wavelength and pulse length."

Turning off spatial compounding (A) affects speckle reduction.

Harmonics (B) help with resolution but primarily lateral contrast.

Gain (C) affects brightness, not resolution directly.

Therefore, the correct answer is D: Increase frequency.

Comprehensive and Detailed Explanation From Exact Extract:

Acoustic speed error occurs when ultrasound travels through tissues with a speed different from the assumed average propagation speed (1540 m/s). If the actual speed is faster, the system assumes the reflector is closer (shallower) than its true location.

According to sonography instrumentation reference:

“When sound travels through tissue at a speed faster than 1540 m/s, the reflector is displayed closer to the transducer than it actually is. This results in a depth placement error known as acoustic speed error.”

Therefore, the correct answer is B: Acoustic speed error.

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Power Doppler, unlike color Doppler, is less angle dependent because it detects the strength of the Doppler signal rather than the velocity of the blood flow. This means it is more sensitive to detecting low-velocity flow and flow in smaller vessels, regardless of the angle between the ultrasound beam and the flow direction. Color Doppler provides information on flow direction and velocity but is highly dependent on the angle of insonation, making it less reliable when the angle is suboptimal.

ARDMS Sonography Principles and Instrumentation guidelines

Zwiebel, W. J., & Pellerito, J. S. (2017).Introduction to Vascular Ultrasonography. Elsevier.

Comprehensive and Detailed Explanation From Exact Extract:

Persistence averages multiple frames to smooth out random noise fluctuations, reducing the appearance of noise in the image and improving image quality.

According to sonography instrumentation reference:

“Persistence reduces noise by averaging data from consecutive frames, improving signal-to-noise ratio and producing a smoother image.”

Therefore, the correct answer is D: Increase persistence.

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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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Increasing the pulse repetition frequency (PRF) helps to optimize the color Doppler imaging by reducing aliasing.

Aliasing occurs when the PRF is too low to accurately sample the rapid blood flow velocities, leading to incorrect color representation.

By increasing the PRF, the system can more accurately measure higher velocities without distortion, improving the overall quality of the color Doppler image.References:

ARDMS Sonography Principles and Instrumentation guidelines on Doppler imaging and techniques to reduce aliasing.

Comprehensive and Detailed Explanation From Exact Extract:

In linear array transducers, each element controls a vertical portion of the image. If adjacent elements fail, the result is a vertical dropout corresponding directly below the damaged crystals.

According to sonography instrumentation reference:

“Damage to specific elements in a linear array transducer results in vertical dropout directly beneath the malfunctioning crystals.”

Therefore, the correct answer is A: Vertical dark zone directly below the damaged elements.

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Temporal resolution is improved by increasing the frame rate. One way to increase the frame rate is by decreasing the packet size (also known as ensemble length) in color Doppler imaging. The packet size refers to the number of pulses used to determine the Doppler shift at each location. A smaller packet size means fewer pulses are required, which allows for quicker data acquisition and thus a higher frame rate. Increasing the field of view, decreasing transmit frequency, and increasing line density would all decrease the frame rate and thus degrade temporal resolution.

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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Comprehensive and Detailed Explanation From Exact Extract:

Damping reduces the number of cycles per pulse, shortening pulse duration and spatial pulse length, which directly improves axial resolution.

Principles and Instrumentation:

"Axial resolution improves with shorter spatial pulse length, achieved by damping, which limits ringing of the transducer."

Lateral resolution (A) depends on beam width.

Contrast resolution (B) relates to dynamic range.

Temporal resolution (C) is tied to frame rate.

Therefore, the correct answer is D: Axial.

Enhancement artifact occurs when an anechoic (or low-attenuation) structure, such as a cyst or fluid-filled structure, allows the ultrasound beam to pass through it with minimal attenuation. As a result, the tissues located distal to this anechoic structure appear brighter (increased echo amplitude) on the ultrasound image because the sound waves are less attenuated by the anechoic structure, leading to higher intensity echoes returning from the distal tissue. This increased brightness beyond the anechoic area is known as enhancement.

ARDMS Sonography Principles and Instrumentation guidelines

Kremkau, F. W. (2015). Diagnostic Ultrasound: Principles and Instruments. Elsevier.

High-Frequency Transducer: These provide better resolution but do not directly cause posterior enhancement.

Low-Frequency Transducer: These provide better penetration but are not the cause of posterior enhancement.

Strongly Attenuating Structure: This would cause acoustic shadowing rather than enhancement.

Weakly Attenuating Structure: Structures that attenuate the ultrasound beam less than the surrounding tissues allow more sound waves to pass through, resulting in increased brightness or "enhancement" behind the structure.

Comprehensive and Detailed Explanation From Exact Extract:

Higher frequencies are more attenuated than lower frequencies. When scanning calcified structures, increasing the frequency enhances attenuation, which makes posterior shadowing more pronounced and visible.

According to sonography instrumentation reference:

“Increasing frequency increases attenuation, thereby enhancing acoustic shadowing posterior to highly attenuating structures such as calcifications or bone.”

Therefore, the correct answer is D: Frequency.

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Comprehensive and Detailed Explanation From Exact Extract:

When sound passes through a structure that attenuates less than surrounding tissue (e.g., fluid-filled cyst), more sound reaches the tissues behind it, causing them to appear brighter. This artifact is called enhancement (or posterior acoustic enhancement).

According to sonography instrumentation reference:

“Posterior enhancement appears as increased echogenicity distal to a weakly attenuating structure due to greater beam intensity reaching deeper tissues.”

Therefore, the correct answer is A: Enhancement.

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When utilizing multiple transmit focal zones, the ultrasound system must perform multiple transmissions at each focal depth. This process requires more time for data acquisition, which in turn decreases the frame rate. A lower frame rate directly impacts temporal resolution, which is the ability to accurately depict moving structures over time. Thus, using multiple focal zones improves lateral resolution but degrades temporal resolution.

The Doppler shift is directly related to the cosine of the angle between the ultrasound beam and the direction of blood flow. As the angle increases from 30 degrees to 60 degrees, the cosine of the angle decreases (cosine of 30 degrees is approximately 0.87, while cosine of 60 degrees is 0.5). Since the Doppler shift is proportional to the cosine of the angle, increasing the angle results in a decreased Doppler shift. This means the measured blood flow velocities will appear lower at a 60-degree angle compared to a 30-degree angle.

American Registry for Diagnostic Medical Sonography (ARDMS). Sonography Principles and Instrumentation (SPI) Examination Review Guide.

Frame rate in color flow Doppler is influenced by several factors, including the imaging depth. Decreasing the depth reduces the time it takes for sound waves to travel to the imaging area and back to the transducer. This allows for more frames to be captured per second, thereby increasing the frame rate. Higher frame rates improve temporal resolution, making it easier to visualize moving structures.

The intensity of an ultrasound beam is measured using a hydrophone. A hydrophone is a specialized device that detects and measures the acoustic pressure of the ultrasound waves in water or tissue-mimicking materials. It is highly sensitive and can measure the variations in pressure, which are used to calculate the intensity and other acoustic parameters of the ultrasound beam.

ARDMS Sonography Principles and Instrumentation guidelines

Hoskins, P. R., Thrush, A., Martin, K., & Whittingham, T. A. (2010). Diagnostic Ultrasound: Physics and Equipment.

Color Doppler imaging is most effective when the angle between the ultrasound beam and the flow of blood is small.

At an angle of 88 degrees, the flow of blood is nearly perpendicular to the ultrasound beam.

When the angle is close to 90 degrees, the Doppler shift (frequency change) approaches zero, resulting in little to no color being visualized on the Doppler image.

Thus, to obtain a color signal, the angle should be optimized to be as close to 0 degrees as possible, with 60 degrees being the practical limit for accurate Doppler measurements.References:

ARDMS Sonography Principles and Instrumentation guidelines on Doppler angle and its effect on Doppler imaging.

Comprehensive and Detailed Explanation From Exact Extract:

Axial resolution is determined by the spatial pulse length (SPL). A longer SPL means that structures closer together along the beam axis are more likely to overlap in the returning echoes, degrading axial resolution.

According to sonography instrumentation reference:

“Axial resolution is inversely related to spatial pulse length. Increasing SPL worsens the ability to distinguish closely spaced structures along the beam axis.”

Therefore, the correct answer is B: Degraded axial resolution.

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86

Based on the table in this image, what is the sensitivity?

A white square with black numbers and a white square with black numbers Description automatically generated

A. 32/33

B. 32/35

C. 45/46

D. 45/48

Answer: B

Comprehensive and Detailed Explanation From Exact Extract:

Sensitivity measures the test's ability to correctly identify true positives. It is calculated using the formula:

Sensitivity = True Positives / (True Positives + False Negatives)

From the table:

True Positives (TP) = 32 (Noninvasive test positive & Gold Standard positive)

False Negatives (FN) = 3 (Noninvasive test negative but Gold Standard positive)

Thus:

Sensitivity = 32 / (32 + 3)

Sensitivity = 32 / 35

According to sonography instrumentation reference:

“Sensitivity represents the proportion of actual positive cases correctly identified by the test.”

Therefore, the correct answer is B: 32/35.

At what Doppler angle to flow is the maximum Doppler shift frequency acquired?

A. 90 degrees

B. 60 degrees

C. 30 degrees

D. 0 degrees

Answer: D

Comprehensive and Detailed Explanation From Exact Extract:

The Doppler equation shows that the frequency shift is proportional to the cosine of the Doppler angle. The maximum value of cosine (cos 0° = 1) occurs at 0 degrees — meaning the beam is parallel to flow. At this angle, the full velocity component is measured.

According to sonography instrumentation reference:

“The maximum Doppler shift is obtained when the ultrasound beam is parallel (0 degrees) to blood flow.”

Therefore, the correct answer is D: 0 degrees.

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Comprehensive and Detailed Explanation From Exact Extract:

Continuous wave (CW) Doppler can measure very high velocities without aliasing because it does not have a Nyquist limit like pulsed-wave Doppler.

Principles and Instrumentation state:

"Aliasing is eliminated in continuous wave Doppler since it does not rely on sampling and has no upper velocity limit."

Output power (A) affects signal strength, not aliasing.

Higher frequency (B) increases aliasing susceptibility.

Decreasing PRF (C) actually worsens aliasing.

Therefore, the correct answer is D: Using continuous wave Doppler ultrasound.

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Comprehensive and Detailed Explanation From Exact Extract:

Color aliasing occurs when the Doppler shift exceeds the Nyquist limit, which is determined by the pulse repetition frequency (PRF). A low PRF reduces the Nyquist limit, making aliasing more likely.

According to sonography instrumentation reference:

“Aliasing occurs in color Doppler imaging when the Doppler shift frequency exceeds half of the PRF (Nyquist limit). A low PRF increases the likelihood of aliasing.”

Therefore, the correct answer is A: Low pulse repetition frequency.

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The maximum Doppler shift that can be detected without aliasing is determined by the Nyquist limit, which is half of the pulse repetition frequency (PRF). If the PRF is 3 kHz, the Nyquist limit is3????????????2=1.5????????????23kHz​=1.5kHz. Therefore, the maximum Doppler shift that can be detected without aliasing is 1.5 kHz. Aliasing occurs when the Doppler shift exceeds this limit, causing an incorrect representation of the velocity.

Comprehensive and Detailed Explanation From Exact Extract:

Axial resolution refers to the ability to distinguish two structures that are located along the path of the ultrasound beam. It is directly related to the spatial pulse length (SPL), which is the product of the number of cycles per pulse and the wavelength. A shorter SPL leads to better axial resolution.

According to sonography instrumentation reference:

“Axial resolution improves as spatial pulse length decreases because shorter pulses can better differentiate structures lying close together along the beam axis.”

Therefore, the correct answer is B: Spatial pulse length.

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Comprehensive and Detailed Explanation From Exact Extract:

The end-diastolic velocity represents the lower velocity portion of the Doppler waveform. The wall filter (or high-pass filter) removes low-frequency Doppler shifts from the spectral display. When the wall filter is increased, it filters out these low-velocity signals — including diastolic flow components. According to sonography Principles and Instrumentation reference materials:

"The wall filter eliminates low-velocity signals from the Doppler spectrum. Increasing the wall filter may completely eliminate end-diastolic velocities, especially in low-resistance arterial flow."

Therefore, the correct answer is D: Increased wall filter.

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Comprehensive and Detailed Explanation From Exact Extract:

In phased arrays, transmit focus is electronically controlled by varying the timing (delays) of the activation of elements.

Principles and Instrumentation state:

"Electronic focusing is achieved by introducing varying time delays to individual elements, allowing beam focusing at different depths."

Mechanical rotation (A) applies to older mechanical probes.

Matching layers (B) and acoustic lens impedance (C) do not control focusing electronically.

Therefore, the correct answer is D: Adjusting relative delay times of the array elements.

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The wall filter, also known as the high-pass filter, is used in Doppler ultrasound to remove low-frequency signals, which are typically associated with clutter artifacts. Clutter artifacts can be caused by tissue motion or vessel wall movement, and they appear as low-frequency signals that can obscure the desired blood flow signals. By increasing the wall filter setting, these low-frequency signals are filtered out, thus reducing the clutter artifact and providing a clearer depiction of the blood flow.

American Registry for Diagnostic Medical Sonography (ARDMS). Sonography Principles and Instrumentation (SPI) Examination Review Guide.

In the provided image, data below the baseline represents blood flow moving away from the transducer, which can indicate retrograde flow. When using spectral Doppler, the baseline separates flows towards and away from the transducer. Aliasing occurs when the velocity of blood flow exceeds the Nyquist limit, causing the display to wrap around and appear on the opposite side of the baseline. This phenomenon is common in high-velocity flow situations and results in part of the flow being displayed below the baseline. Retrograde flow further supports this, as it shows blood moving in the opposite direction to the expected flow.

Comprehensive and Detailed Explanation From Exact Extract:

Temporal resolution refers to the system's ability to accurately track moving structures over time (i.e., frame rate). Temporal resolution improves when:

The number of focal zones is reduced (fewer focal zones = faster frame rate).

The imaging depth is reduced (shallower depth = faster frame rate).

According to sonography instrumentation references:

“Fewer focal zones and shallow imaging depth optimize temporal resolution by decreasing the time required for each frame, resulting in a higher frame rate.”

Therefore, the correct answer is C: Fewer focal zones and shallower depth.

55

Which region of this image from a sector phantom is evaluating the dead zone?

A close-up of a ultrasound Description automatically generated

A. Region A

B. Region B

C. Region C

D. Region D

Answer: A

Comprehensive and Detailed Explanation From Exact Extract:

The dead zone in ultrasound refers to the shallow area immediately beneath the transducer where no useful data can be collected due to the transducer's ring-down and the time required for the system to switch from transmit to receive mode.

In a sector phantom image, the area closest to the transducer (superficial portion) is used to evaluate the dead zone. In this image, Region A is located at the top of the image, closest to the transducer surface.

According to sonography instrumentation reference:

“The dead zone is assessed by evaluating the area immediately beneath the transducer. This area is used to test the system's near-field performance and transducer surface integrity.”

Therefore, the correct answer is A: Region A.

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Comprehensive and Detailed Explanation From Exact Extract:

Spectral Doppler aliasing occurs when the Doppler frequency shift exceeds the Nyquist limit. The Doppler shift is proportional to the cosine of the Doppler angle. Increasing the Doppler angle (moving closer to 90 degrees) reduces the cosine value, thus reducing the Doppler shift frequency and helping to avoid aliasing.

According to sonography instrumentation reference:

“Increasing the Doppler angle reduces the Doppler shift frequency, thus decreasing the likelihood of aliasing in spectral Doppler.”

Therefore, the correct answer is A: Increase Doppler angle.

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Comprehensive and Detailed Explanation From Exact Extract:

Lateral resolution depends on beam width, which is narrowest at the focal zone. Therefore, positioning the focal zone at the area of interest improves lateral resolution.

According to sonography instrumentation reference:

“Lateral resolution is primarily determined by beam width, which is narrowest at the focus. Optimal lateral resolution occurs at the focal zone.”

Therefore, the correct answer is B: Focal zone.

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Comprehensive and Detailed Explanation From Exact Extract:

Write magnification acquires new data over the smaller field of view with a higher number of scan lines, improving spatial resolution.

Principles and Instrumentation state:

"Write magnification rescans the selected region with new data acquisition, increasing the number of pixels and improving resolution."

Post-processing (A) applies to read magnification.

Larger pixel size (C) would decrease resolution.

Write magnification improves, not decreases (D), spatial resolution.

Therefore, the correct answer is B: New data acquisition.

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Comprehensive and Detailed Explanation From Exact Extract:

Damping material is applied to the back of the piezoelectric crystal to absorb energy and shorten the pulse duration. Shorter pulse durations reduce spatial pulse length, which directly improves axial resolution by enabling better separation of structures along the beam path.

According to sonography instrumentation reference:

“Greater transducer damping results in shorter pulse duration and improved axial resolution but reduces sensitivity.”

Therefore, the correct answer is D: Improved axial resolution.

Comprehensive and Detailed Explanation From Exact Extract:

A tissue-mimicking phantom contains small targets at known separations to evaluate the system’s axial resolution, lateral resolution, depth calibration, and more.

Principles and Instrumentation state:

"Tissue-mimicking phantoms assess spatial resolution (axial, lateral), depth accuracy, and penetration performance."

Hydrophones (B) measure acoustic pressure.

Beam profilers (C) assess beam characteristics.

Doppler phantoms (D) test Doppler function.

Therefore, the correct answer is A: Tissue-mimicking phantom.

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Changing the displayed depth control directly affects the pulse repetition frequency (PRF). When the depth setting is increased, the ultrasound system needs more time to send and receive echoes from deeper structures, resulting in a lower PRF. Conversely, decreasing the depth allows for a higher PRF since the time required for the sound waves to travel to and from the structures is shorter. PRF is crucial for determining the maximum detectable velocity in Doppler ultrasound without aliasing.References:

ARDMS Sonography Principles and Instrumentation guidelines

"Understanding Ultrasound Physics" by Sidney K. Edelman

Comprehensive and Detailed Explanation From Exact Extract:

The key advantage of pulsed wave Doppler is range resolution, meaning the operator can select a specific depth (sample volume) for measuring velocities. Continuous wave Doppler does not provide this capability, as it samples velocities along the entire beam path.

According to sonography instrumentation reference:

“Pulsed wave Doppler allows selection of sample volume depth, providing range resolution which continuous wave Doppler lacks.”

Therefore, the correct answer is B: Ability to select sample depth.

105

What adjustment is needed to optimize the image below?

A close-up of a medical scan Description automatically generated

A. Increase wall filter

B. Steer the box

C. Decrease scale

D. Raise focal zone

Answer: B

Comprehensive and Detailed Explanation From Exact Extract:

In the displayed image, the color box is not aligned parallel to the direction of blood flow in the vessel. Color Doppler is angle-dependent; when the color box is not properly steered to align with flow, the Doppler shift is reduced, and less color filling occurs. Steer the box to align the ultrasound beam more parallel to flow to maximize Doppler shift and improve color filling.

According to sonography instrumentation reference:

“Steering the color box aligns the Doppler beam with blood flow direction, optimizing the Doppler angle and improving flow visualization.”

Therefore, the correct answer is B: Steer the box.

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