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APPENDIX Ultrasound Artifacts: A Virtual Chapter

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FIG. A.51 Artifactual Vascular Flow. Power Doppler ultrasound vocal fremitus can be used to distinguish a mural nodule from a fat-luid

level. The lipid layer is not attached to the cyst wall, so the fremitus artifact will not pass through it. On the other hand, true papillary lesions that

are attached to the cyst wall will vibrate and transmit the fremitus artifact on power Doppler; having the patient hum in a deep voice creates a

color artifact on power Doppler ultrasound. 21 (See Chapter 21, Fig. 21.26.)

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FIG. A.52 Color Streaking Artifact. (A) This complicated cyst contains loating punctate echoes that move posteriorly while being scanned,

creating a scintillating appearance on gray-scale sonography. (B) Power Doppler ultrasound pushes the echoes posteriorly faster and with more

energy than does the gray-scale beam. The echoes move fast enough that color persistence creates the appearance of “color streaking” artifact. 21

(See Chapter 21, Fig. 21.21.)

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