The role of ultrasonography (US), Doppler US artifacts and elastography in the detection of foreign bodies

Purpose: The aim of the study is to characterize the ultrasound and Doppler ultrasound artifact patterns of foreign bodies and to define the role of elastography in their detection. Material and method: Two in-vitro environments including a lamb leg and a lamb stomach coated with ultrasound gel, were prepared. Twenty-seven foreign bodies grouped as metallic, organic and inorganic were evaluated using the US, Doppler US and elastography imaging modalities. The Bmode US, Doppler US and spectral Doppler US images including their composed artifacts and the elastography findings were recorded. Results: US had detected all the foreign bodies located in both in-vitro environments. Clear and dirty shadowing was observed posteriorly to the foreign bodies and varying degrees of reverberation artifacts were present with 24 of the foreign bodies. Among the foreign bodies, 7 had twinkling artifacts, 23 had edge artifacts and 20 had spectral noise. Using power Doppler US, signals were received from the posterior aspect or the edge of 20 foreign bodies. The reverberation artifacts of the foreign bodies became more apparent in the elastography images. Conclusion: Knowledge of sonographic results along with ultrasound and Doppler ultrasound artifacts plays a key role in the detection and visualization of foreign bodies. Elastography further facilitates the diagnosis of the foreign bodies.