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MACHINE OPTIMISATION

Now that you know how the US machine works and the common artifacts you may encounter, you can optimise your machine settings to always get a great image. A poor image will mean you will make mistakes in your US diagnosis, or you may miss things that you should be seeing. 

The key things you need to always optimise each time you place a probe on a patient are:

1. Optimal frequency

2. Optimal focus

3. Optimal depth

4. Optimal gain

You can change other settings to further refine your imaging, but the above four are required for all scans.

FREQUENCY

Always choose the correct frequency for the structure you are imaging. Use the highest frequency possible. For superficial structures use a high frequency; for deep structures use a lower frequency transducer. With this, choosing the machine setting to what you are imaging may also be helpful eg the MSK vs venous setting in the linear probe. The MSK setting allows better imaging of nerves and anisotropy.

FOCUS

The focus should be set to just below the structure you are imaging. In this way the structure will be located in the focal zone of the US beam and have the best lateral resolution. 

DEPTH

The structure you are imaging should fill the screen.

GAIN

The gain should be adjusted so that fluid filled structures are anechoic (black) and highly reflective structures like bone are hyperechoic (white). If necessary, adjust the near and far gain. 

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