"My images don't look good" ...what does that mean?

"My images don't look good" ...what does that mean?

By Doug Keenen

Being able to troubleshoot diagnostic ultrasound systems successfully not only requires electrical knowledge and basic troubleshooting skills, but also requires understanding exactly what it is you

are seeing when looking at an ultrasound image. The very first time I ever saw an ultrasound image, it simply looked like a grey blob on the screen. Understanding what a good image looks like compared to a poor image is vital in troubleshooting. The ability to properly scan yourself and visualize different anatomical structures is necessary to be able to diagnose difficult problems. It will also impress the sonographer and gain their confidence that you know how to scan yourself properly.

Understanding what is meant by “my images don’t look good” requires some detective work along with good scanning ability.

1. You may hear descriptions like grainy or wormy to describe the image. Ask specific questions. Is it only the 2D image or do the color doppler and pw doppler displays look


2. Is the image poor on one specific probe? Probes are one of the highest failure items on an ultrasound system, always try to rule out the probe as quickly as possible – this will save you time and a lot of headaches.

3. Don’t forget about the probe connector ports. There could be a piece of dust blocking the contacts on pinless connectors or damaged contacts on standard connectors. Also, check to make sure the probe is tightly seated on the probe connectors.

4. Pick up a probe and start scanning yourself in front of the sonographer and ask him/her to point out exactly what they are experiencing as being poor image quality. If you both are unable to see it at that moment, ask to see a previous study that shows the problem – this is critical for you to determine what is happening, for intermittent issues.

5. Finally, keep in mind that if you have an inexperienced sonographer, you may want to check to make sure they are picking the correct preset for the type of study they are performing. They may have accidentally picked the wrong preset for a specific study.

So, if you need to get more proficient at scanning yourself, plan on spending at least an extra 15 minutes every time you are doing a PM or evaluating a service issue to scan yourself. Learn how to visualize your carotid artery, thyroid, liver and kidneys. Properly scanning your
heart can be challenging as well. Don’t be afraid to ask your ultrasound technologists for some help in scanning yourself. They usually will be more than happy to help you, time permitting, and it will be well worth it because they will have more confidence in your abilities to troubleshoot image quality issues.

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