Artefakte in der Sonografie und ihre Bedeutung für die internistische und gastroenterologische Diagnostik – Teil 1: B-Mode-Artefakte

Zusammenfassung

Artefakte (Bildfehler) in der Sonografie sind mit den physikalischen Eigenschaften des Ultraschalls untrennbar verbunden und entstehen durch Interaktion der Ultraschallwellen mit Gewebestrukturen sowie Fremdkörpern während ihrer Ausbreitung im Körper. Sie können einerseits stören und die diagnostische Aussage erschweren, gelegentlich auch Fehldiagnosen begünstigen, andererseits aber auch diagnostisch hilfreich sein. Artefakte werden durch Reflektion, Absorption, Streuung, Brechung und Beugung von Wellen im menschlichen Körper erzeugt und entstehen bei der Ultraschallbildgebung, da die als konstante Größen angenommenen Parameter wie Schallgeschwindigkeit, geradlinige Schallausbreitung, Dämpfung usw. häufig von den tatsächlichen Parametern abweichen. Auch unzureichende Geräteeinstellungen können ursächlich für Artefakte sein. Kenntnisse über die Entstehung, Vermeidung und Interpretation von Artefakten sind elementare Voraussetzung für die korrekte klinische Befundung von Ultraschallbildern. Teil 1 der Übersicht stellt die physikalischen Grundlagen von Artefakten sowie die wichtigsten B-Bild-Artefakte dar. Daraus resultierende Fehlerquellen und diagnostische Interpretationsmöglichkeiten werden dargestellt.

Abstract

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues and with foreign bodies. On the one hand, they may be distracting and may lead to misdiagnosis. On the other hand, they may be diagnostically helpful. Ultrasound imaging suffers from artifacts, because in reality, parameters assumed to be constant values, such as sound speed, sound rectilinear propagation, attenuation, etc., are often different from the actual parameters. Moreover, inadequate device settings may cause artifacts. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review comments on the physics of artifacts and describes the most important B-mode artifacts. Pitfalls, as well as diagnostic chances resulting from B-mode artifacts, are discussed.

Schlüsselwörter

Artefakte - Ultraschall - M-Mode - Schallschatten - Spiegelartefakt - Reverberation

Key words

artifacts - ultrasound - B-mode - ultrasound shadow - mirror artifact - reverberation

^* Geteilte Erstautorenschaft.

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