Fundamentals of Ultrasound: Parameter Adjustment of Ultrasound Images

During bedside ultrasound examinations, the ideal image is the primary guarantee for detecting abnormalities. The selection of proficient probes, as well as the adjustment and optimization of images, can significantly enhance the quality of acquired images, thereby facilitating more accurate ultrasound diagnosis. Previously, we introduced the imaging modes of ultrasound. Today, we will primarily discuss the parameter adjustments required under different imaging modes.

Common parameter adjustment for B mode

Gain

The degree of increase in the intensity of ultrasonic echo signal is visually represented as the brightness of the image on the ultrasound image. 

Increasing the gain makes the image brighter, presenting more information, but also increasing the noise;

decreasing the gain makes the image darker, presenting insufficient information, but suppressing the noise.

Too low
too high
Focus

The focus aims to converge and narrow the beam emitted by the probe, thereby enhancing the lateral resolution of the acoustic beam. The focal point is typically placed in the region of interest. An increased number of focal points can improve the overall lateral resolution of the acoustic field, but it significantly reduces the frame rate, making it unsuitable for observing rapidly moving organs.

Depth

Deep depth adjustment: The image will be reduced in size, affecting observation and diagnosis;

 shallow depth adjustment: The image will be enlarged, with a corresponding decrease in resolution. 

The appropriate depth should be selected based on the proximity of the observed tissue, organ, or lesion to the mid-field of the image area.

Dynamic range

Reducing the dynamic range enhances image contrast and sharpness, but it diminishes the display of useful information, impairing observation and judgment.

Increasing dynamic range: Reducing image contrast enhances image detail, though it provides more information. However, decreased contrast may impair the observation of certain lesions and result in indistinct boundaries between tissues and lesions.

Common parameter adjustment for C mode

Gain

Total gain: Adjusts the sensitivity of blood flow signals, with the gain value displayed in real-time on the image parameter area of the screen. 

Image quality: Excessive gain obscures the image with chaotic color spots, while insufficient gain may lead to loss of blood flow signals. During actual adjustment, the optimal setting is to clearly distinguish red and blue blood flow without color aliasing.

PRF – Pulse Repetition Frequency

Adjust the pulse repetition frequency (PRF) to modify the display range of blood flow velocity or frequency. Effects: A larger velocity scale indicates a higher measurable blood flow velocity, while a smaller velocity scale corresponds to a lower measurable blood flow velocity. The maximum value of the velocity scale is influenced by the pulse repetition frequency, sampling depth, and emission frequency.

Sampling Frame

Sampling frame size: A smaller sampling frame results in a higher frame rate, while a larger sampling frame can display more blood flow information. The sampling frame size is clinically adjusted according to actual needs. 

Sampling frame deflection angle: Generally, clinical adjustments are made by slightly deflecting the sampling frame to obtain better blood flow visualization.

Common parameter adjustment in PW mode

Angle of deflection

In the PW mode of linear array probe, the emission direction of deflected ultrasound is adjusted to minimize the angle between it and the blood vessel, thereby enhancing spectral visualization.

Sampling volume

The excessive sampling volume results in the acquisition of a large amount of intravascular blood flow signals.The non-blood flow motion interference signal increased, and the spectrum was wide.

The volume of blood sample is too small, the velocity distribution range of red blood cells contained in the sample is reduced, and the spectrum is too narrow.

Baseline

The horizontal line at the bottom of the PW spectrum is called the baseline, representing zero blood flow velocity. Adjusting the baseline position upward or downward can optimize the spectrum display.
Taking the SonoMaxx transpalmar carotid ultrasound as an example: Connect the transpalmar ultrasound device, select preset values, initiate the scan, adjust the depth to position the image at the center of the screen, and adjust the total gain to achieve appropriate image brightness. Additionally, perform segmented gain adjustment (i.e., time gain compensation), adjust the focus position to enhance local display clarity, apply color flow, and modify the size and angle of the sampling frame. Adjust the pulse frequency to ensure adequate blood flow filling. Click the PW mode, adjust the sampling gate to set the Doppler angle below 60 degrees, and perform baseline adjustment to ensure complete spectrum display.
The fundamental principle in performing ultrasound scanning is to select the highest possible frequency for optimal penetration, aiming for maximum intensity without excessive attenuation, optimal depth without excessive penetration, and flexible parameter adjustments to achieve high-quality imaging.

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