Errors and artifacts in ultrasound elastography

Aim: We present our experience in ultrasound elastography, emphasizing the main sources of errors and artifacts and practical methods for minimizing them.

Results and discussion: The principle of elastography is that tissue compression produces strain (displacement) within the tissue and that the strain is smaller in harder tissue than in softer tissue. Therefore, by measuring the tissue strain induced by compression, we can estimate tissue hardness, which may be useful in diagnosing cancer.

Like any other ultrasound technique, elastography has its errors. During examination, we can obtain different grading on consecutive elastograms because of different reasons like brutal movement of the transducer. That is one of the reasons why this method is considered operator-dependent and subjective.

In our short time experience with this relative new method, we noticed that carotid artery pulsation is useful, but may influence the quality of the thyroid node elastogram.

Conclusions: There are various methods for better analysis of the elastogram such as using certain sections. In our opinion, when interpreting an elastography exam we should take into consideration the most frequent elastogram grading that appears. We consider that with 3D acquisition and automatic analysis of recorded frames we may reduce the subjectivity of elastography.