Presentation
Patient presenting for routine liver screening.
Patient Data
Age: 70 years
Gender: Female
From the case:
Ring down artifact
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There is both ring down artifact and "dirty shadowing" from the gas in the duodenum. The ring down occurs more centrally in the cluster of gas bubbles with an echogenic step-ladder appearance. The dirty shadowing is on either side of the ring down.
From the case:
Ring down artifact
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The yellow arrows point to the ring down artifact.
Case Discussion
Gas can cause both "dirty shadowing" or "ring down artifact", depending on the interaction of the sound beam with the gas bubbles.
If the sound beam encounters a tetrahedron of bubbles at the correct orientation, then the reverberation created by this structure creates the classic "stepladder" appearance of ring down artifact.
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