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ARDMS SPI Exam
Sonography Principles and Instrumentation (Page 6 )

Updated On: 7-Feb-2026
Page 6 of 44
PDF with 215 Questions

Which color Doppler setting can be optimized to eliminate low-frequency Doppler shifts without having any effect on higher Doppler frequency shifts?

  1. Gain
  2. Scale
  3. Wall filter
  4. Persistence

Answer(s): C

Explanation:

The wall filter is used in color Doppler and spectral Doppler imaging to eliminate low-frequency Doppler shifts caused by tissue motion or vessel wall movement. Adjusting the wall filter removes these low-frequency signals without affecting higher-frequency Doppler shifts that represent blood flow. Other settings like gain, scale, and persistence do not selectively filter out low-frequency shifts in the same manner.


Reference:

American Registry for Diagnostic Medical Sonography (ARDMS) Sonography Principles and Instrumentation guidelines.



Which change improves temporal resolution during color flow imaging?

  1. Increase field of view
  2. Decrease transmit frequency
  3. Decrease packet size
  4. Increase line density

Answer(s): C

Explanation:

Temporal resolution is improved by increasing the frame rate. One way to increase the frame rate is by decreasing the packet size (also known as ensemble length) in color Doppler imaging. The packet size refers to the number of pulses used to determine the Doppler shift at each location. A smaller packet size means fewer pulses are required, which allows for quicker data acquisition and thus a higher frame rate. Increasing the field of view, decreasing transmit frequency, and increasing line density would all decrease the frame rate and thus degrade temporal resolution.


Reference:

American Registry for Diagnostic Medical Sonography (ARDMS) Sonography Principles and Instrumentation guidelines.



What does this image demonstrate?

  1. Presence of flow
  2. Direction of flow
  3. Color aliasing
  4. Color inversion

Answer(s): C

Explanation:

Color aliasing in Doppler ultrasound occurs when the velocity of blood flow exceeds the Nyquist limit, causing the color display to wrap around and display high velocities incorrectly as the opposite direction. This phenomenon is characterized by a mix of colors that indicate flow in both directions at the same location. In the provided image, there is a clear presence of color aliasing, as evidenced by the abrupt color change across the vessel, which is not consistent with normal flow patterns.


Reference:

American Registry for Diagnostic Medical Sonography (ARDMS) Sonography Principles and Instrumentation guidelines.



Which artifact is seen as a result of an increase in echo amplitude in the tissue located distal to an anechoic structure?

  1. Mirror image
  2. Reverberation
  3. Comet tail
  4. Enhancement

Answer(s): D

Explanation:

Enhancement artifact occurs when an anechoic (or low-attenuation) structure, such as a cyst or fluid- filled structure, allows the ultrasound beam to pass through it with minimal attenuation. As a result, the tissues located distal to this anechoic structure appear brighter (increased echo amplitude) on the ultrasound image because the sound waves are less attenuated by the anechoic structure, leading to higher intensity echoes returning from the distal tissue. This increased brightness beyond the anechoic area is known as enhancement.


Reference:

ARDMS Sonography Principles and Instrumentation guidelines

Kremkau, F. W. (2015). Diagnostic Ultrasound: Principles and Instruments. Elsevier.



What is an advantage of power Doppler over color Doppler?

  1. Accurate velocity information
  2. Increased frame rate
  3. Diminished flash artifact
  4. Less angle dependent

Answer(s): D

Explanation:

Power Doppler, unlike color Doppler, is less angle dependent because it detects the strength of the Doppler signal rather than the velocity of the blood flow. This means it is more sensitive to detecting low-velocity flow and flow in smaller vessels, regardless of the angle between the ultrasound beam and the flow direction. Color Doppler provides information on flow direction and velocity but is highly dependent on the angle of insonation, making it less reliable when the angle is suboptimal.


Reference:

ARDMS Sonography Principles and Instrumentation guidelines

Zwiebel, W. J., & Pellerito, J. S. (2017). Introduction to Vascular Ultrasonography. Elsevier.



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