What is the impact of air bubbles in ultrasound gel?

During a diagnostic ultrasound procedure, the presence of air in the path of sound waves is undesirable. Air acts as a sound barrier resulting in poorer resolution of the image.1 When air pockets are present during an ultrasound procedure, sound waves can be blocked from passing into the body.2 Eliminating air between the transducer and the patient’s skin allows for better imaging.3

Ultrasound transmission gel is the medium through which the transducer sends sound waves and receives back the echoing waves. The gel helps make secure contact between the transducer and the patient’s body, preventing pockets of air and increasing acoustic transmission. It is advantageous for a clinician to choose an ultrasound gel with as few air bubbles as possible to allow for the best possible imaging results.  If sound waves are not able to pass properly from, or back to, the transducer, then clouding, degradation or distortion may occur, affecting the quality of the image and potentially affecting the patient’s diagnosis.

During extracorporeal shock wave lithotripsy (ESWL) procedures, the impact of air bubbles is also significant. In one study, the effectiveness of a lithotripsy treatment was greatly improved by eliminating bubbles from the coupling media.4 In another study, the technique used to apply the gel was investigated. This study concluded that lithotripsy results could be improved by applying gel in such a manner as to avoid introducing bubbles during the application of the gel.5

For diagnostic ultrasound and lithotripsy procedures, the selection of a quality gel, with minimal air bubbles, is an important part of the imaging process. NEXT Medical utilizes a proprietary manufacturing method to minimize the presence of air bubbles in our gel products. Furthermore, sonographers who utilize single patient packets, such as Clear Image Singles® Gel, can help reduce the introduction of air bubbles caused by repetitive squeezing and shaking down of gel bottles.

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1 Stern, Beverly. “The Basic Concepts of Diagnostic Ultrasound 1.” Yale-New Haven Teachers Institute. Curriculum Unit 83.07.05. 2013. <http://www.yale.edu/ynhti/curriculum/units/1983/7/83.07.05.x.html> Web.
2 “General Ultrasound Imaging, How is the procedure performed?” Radiological Society of North America, Inc. (RSNA). July 2, 2012. < http://www.radiologyinfo.org/en/info.cfm?pg=genus#part_six> Web.
3 Schreiner, Nicholas. “The Science of Ultrasound Within the Body.” The Board of Trustees at the University of Illinois, College of Engineering. December 15, 2010. <https://wiki.engr.illinois.edu/display/BIOE414/The+Science+of+Ultrasound... Web.
4 Shah TK, Jain A. “Effect of Air Bubbles in the Coupling Medium on Efficacy of Extracorporeal Shock Wave Lithotripsy.” European Urology. 2007 Jun;51(6):1680-6; discussion 1686-7. Epub 2006 Nov 10. <http://www.europeanurology.com/article/S0302-2838(06)01349-2/abstract> Web.
5 Neucks JS, Pishchalnikov YA, Zancanaro AJ, VonDerHaar JN, Williams JC Jr, McAteer JA. “Improved Acoustic Coupling for Shock Wave Lithotripsy.” Urological Research. February 2008, Volume 36, Issue 1, pp 61-66. <http://link.springer.com/article/10.1007%2Fs00240-007-0128-y#> Web.