1
ARDMS Breast Questions with 100%
Correct Answers
Transducer frequency selection in breast imaging: Correct Answer: A 7.0 to 12.0
MHz frequency transducer or higher is optimal
Need high frequency transducer for superior axial and lateral resolution (detail)
while maintaining penetration to the chest wall
A broadband (wide frequency range) is optimal
Probe design: Correct Answer: A LINEAR ARRAY is optimal
Produces a rectangular image
Allows direct contact when scanning perpendicular to the chest wall
Accurate measurements can be recorded by avoiding beam divergence
artifact (this is achieve with a rectangular image vs. sector image)
Interventional procedures (i.e. cyst aspiration, biopsy, and needle localization,
etc.) can be accurately guided with a linear array probe
Imaging Depth: Correct Answer: Depth should be sufficient to visualize the
breast tissue from skin to chest wall. Breast size will vary from one patient to the
next. However, an imaging depth between 3 and 6 cm should be adequate.
Focusing: Correct Answer: Multi-focus or variable (adjustable) electronic
focusing will achieve optimal breast detail
:
vPretest - Stuvia US
,2
The use of multiple focal zones will provide excellent resolution the full depth of
the image. This may significantly reduce the frame rate, although. Multiple focal
zones, however, are still recommended.
If a single focus is used, the focal zone should be set at the depth of the area of
interest (such as a mass), or at or below the mammary layer for general
scanning.
Gray scale: Correct Answer: Generally, for breast imaging, a broad gray scale
map or dynamic range is used. This provides a wide range of gray shades to be
displayed, while demonstrating subtle tissue differences. A map with too few
gray shades may not accurately demonstrate low-level echoes with in a cyst or
solid lesions.
Doppler Technique: Correct Answer: In order to optimize doppler imaging, the
sonographer should establish a technique for low velocity flow states. This
includes: low velocity scale, low filter setting, optimal doppler gain setting,
increased PRF for high velocities
Reverberation Correct Answer: Artifactual linear echoes parallel to a strong
interface. Has a distinct "stepladder" or "Venetian blind" appearance
Side or Grating lobe Correct Answer: Secondary sound sources off the main
sound beam that place artifactual echoes within a cyst
Slice Thickness Correct Answer: Unwanted echoes from the thickness of the
sound beam in the elevation plane that place artifacts within a cyst
:
vPretest - Stuvia US
,3
Nipple Shadowing Correct Answer: Shadowing in the subareolar region may be
eliminated by angling the transducer posterior to the nipple or by using the
"rolled nipple" technique
Volume Averaging Correct Answer: Decreases contrast resolution and spatial
resolution (both axial and lateral). Places unwanted echoes within cysts.
Anatomic layer (from superficial to deep) Correct Answer: 1. Skin
2. Subcutaneous layer
3. Mammary layer
4. Retromammary layer
5. Muscle layers (Pectoralis major and minor)
6. Chest wall (ribs and intercostal muscles)
Skin Correct Answer: The skin is composed of the epidermis and the dermis. The
thickness of the skin should measure 0.5 to 2 mm. The skin is slightly thicker in
younger women and thins with age.
Nipple-- consists of dense connective tissue and erectile muscle, contains many
sensory nerve endings, 15 to 20 collecting ducts opening may be seen (each of
which arise from a breast lobe)
:
vPretest - Stuvia US
, 4
Areola-- circular area of dark pigmentation seen around the nipple, consists of
smooth muscle, slightly thicker than the surrounding skin, contains Montgomery
glands-- sebaceous glands seen as small bumps in the areola
Subcutaneous fat (premammary) layer Correct Answer: Lies just beneath the
skin extending to the mammary layer
It is not seen posterior to the nipple
Consists primarily of fat
Amount of fat increases with age, pregnancy, and obesity
Cooper's ligaments appear as prominent structures within the subcutaneous
layer
Superficial Fascia Correct Answer: The breast tissue is completely contained
within the layers of the superficial fascia
At the breast, the superficial fascia divides into the superficial and deep layers
The superficial layer of the superficial fascia is simply known as the superficial
fascia
The superficial fascia is contained within the subcutaneous layer anterior to the
mammary layer
Mammary Layer Correct Answer: The mammary layer is also known as the
Parenchymal or glandular layer
:
vPretest - Stuvia US
ARDMS Breast Questions with 100%
Correct Answers
Transducer frequency selection in breast imaging: Correct Answer: A 7.0 to 12.0
MHz frequency transducer or higher is optimal
Need high frequency transducer for superior axial and lateral resolution (detail)
while maintaining penetration to the chest wall
A broadband (wide frequency range) is optimal
Probe design: Correct Answer: A LINEAR ARRAY is optimal
Produces a rectangular image
Allows direct contact when scanning perpendicular to the chest wall
Accurate measurements can be recorded by avoiding beam divergence
artifact (this is achieve with a rectangular image vs. sector image)
Interventional procedures (i.e. cyst aspiration, biopsy, and needle localization,
etc.) can be accurately guided with a linear array probe
Imaging Depth: Correct Answer: Depth should be sufficient to visualize the
breast tissue from skin to chest wall. Breast size will vary from one patient to the
next. However, an imaging depth between 3 and 6 cm should be adequate.
Focusing: Correct Answer: Multi-focus or variable (adjustable) electronic
focusing will achieve optimal breast detail
:
vPretest - Stuvia US
,2
The use of multiple focal zones will provide excellent resolution the full depth of
the image. This may significantly reduce the frame rate, although. Multiple focal
zones, however, are still recommended.
If a single focus is used, the focal zone should be set at the depth of the area of
interest (such as a mass), or at or below the mammary layer for general
scanning.
Gray scale: Correct Answer: Generally, for breast imaging, a broad gray scale
map or dynamic range is used. This provides a wide range of gray shades to be
displayed, while demonstrating subtle tissue differences. A map with too few
gray shades may not accurately demonstrate low-level echoes with in a cyst or
solid lesions.
Doppler Technique: Correct Answer: In order to optimize doppler imaging, the
sonographer should establish a technique for low velocity flow states. This
includes: low velocity scale, low filter setting, optimal doppler gain setting,
increased PRF for high velocities
Reverberation Correct Answer: Artifactual linear echoes parallel to a strong
interface. Has a distinct "stepladder" or "Venetian blind" appearance
Side or Grating lobe Correct Answer: Secondary sound sources off the main
sound beam that place artifactual echoes within a cyst
Slice Thickness Correct Answer: Unwanted echoes from the thickness of the
sound beam in the elevation plane that place artifacts within a cyst
:
vPretest - Stuvia US
,3
Nipple Shadowing Correct Answer: Shadowing in the subareolar region may be
eliminated by angling the transducer posterior to the nipple or by using the
"rolled nipple" technique
Volume Averaging Correct Answer: Decreases contrast resolution and spatial
resolution (both axial and lateral). Places unwanted echoes within cysts.
Anatomic layer (from superficial to deep) Correct Answer: 1. Skin
2. Subcutaneous layer
3. Mammary layer
4. Retromammary layer
5. Muscle layers (Pectoralis major and minor)
6. Chest wall (ribs and intercostal muscles)
Skin Correct Answer: The skin is composed of the epidermis and the dermis. The
thickness of the skin should measure 0.5 to 2 mm. The skin is slightly thicker in
younger women and thins with age.
Nipple-- consists of dense connective tissue and erectile muscle, contains many
sensory nerve endings, 15 to 20 collecting ducts opening may be seen (each of
which arise from a breast lobe)
:
vPretest - Stuvia US
, 4
Areola-- circular area of dark pigmentation seen around the nipple, consists of
smooth muscle, slightly thicker than the surrounding skin, contains Montgomery
glands-- sebaceous glands seen as small bumps in the areola
Subcutaneous fat (premammary) layer Correct Answer: Lies just beneath the
skin extending to the mammary layer
It is not seen posterior to the nipple
Consists primarily of fat
Amount of fat increases with age, pregnancy, and obesity
Cooper's ligaments appear as prominent structures within the subcutaneous
layer
Superficial Fascia Correct Answer: The breast tissue is completely contained
within the layers of the superficial fascia
At the breast, the superficial fascia divides into the superficial and deep layers
The superficial layer of the superficial fascia is simply known as the superficial
fascia
The superficial fascia is contained within the subcutaneous layer anterior to the
mammary layer
Mammary Layer Correct Answer: The mammary layer is also known as the
Parenchymal or glandular layer
:
vPretest - Stuvia US
