medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1623medvis-1623Research ArticleМАЛЫЙ ТАЗSMALL PELVISУльтразвуковой артефакт реверберации: помощь или помеха при исследовании матки и эндометрия? Обзор литературы и собственные наблюденияUltrasound reverberation artifact: help or hindrance in the examination of the uterus and endometrium?https://orcid.org/0000-0001-8929-6001ОзерскаяИ. А.OzerskayaI. A.

Озерская Ирина Аркадиевна – доктор мед. наук, профессор, профессор кафедры ультразвуковой диагностики факультета непрерывного медицинского образования медицинского института ФГАОУ ВО “Российский университет дружбы народов имени Патриса Лумумбы (РУДН)” Минобрнауки России, Москваhttps://orcid.org/0000-0001-8929-6001

Irina A. Ozerskaya – MD, Doct. of Sci. (Med.), Professor, Professor of the Department of Ultrasound Diagnostics, Faculty of Continuing Medical Education of the Medical Institute, Peoples' Friendship University of Russia named after Patrice Lumumba (RUDN University), Moscowhttps://orcid.org/0000-0001-8929-6001

ozerskaya_usd@mail.ruhttps://orcid.org/0000-0002-1198-8187КазарянГ. Г.KazaryanG. G.

Казарян Гаяне Геворковна – канд. мед. наук, заведующая отделением ультразвуковой диагностики ООО “Медскан”, Москваhttps://orcid.org/0000-0002-1198-8187

Gayane G. Kazaryan – MD, Cand. of Sci. (Med.), Head of the department of ultrasound, LLC “Medskan”, Moscowhttps://orcid.org/0000-0002-1198-8187

kazaryan@medscannet.ruhttps://orcid.org/0009-0004-3548-7944МинашкинаЕ. В.MinashkinaE. V.

Минашкина Елена Владимировна – врач ультразвуковой диагностики ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), Москва;врач ультразвуковой диагностики ООО “МедИнСервис”, центр репродукции и генетики “Нова клиник”, Москваhttps://orcid.org/0009-0004-3548-7944

Elena V. Minashkina – Physician of Ultrasonographic Diagnostics, Sechenov First Moscow State Medical University (Sechenov University); Physician of Ultrasonographic Diagnostics, Center for Reproduction and Genetics “Nova Clinic”, MedInService LLC, Moscowhttps://orcid.org/0009-0004-3548-7944

as1199@list.ruhttps://orcid.org/0009-0006-4845-3561АрбузовЮ. О.ArbuzovYu. O.

Арбузов Юрий Олегович – врач ультразвуковой диагностики ООО “Клиника лечения боли “МЕДИКА”, Санкт-Петербургhttps://orcid.org/0009-0006-4845-3561

Yury O. Arbuzov – Physician of Ultrasonographic Diagnostics, Pain Treatment Clinic MEDICA LLC, Saint Petersburghttps://orcid.org/0009-0006-4845-3561

dr.arbuzov44@gmail.comФГАОУ ВО “Российский университет дружбы народов имени Патриса Лумумбы” Минобрнауки РоссииРоссияPeoples' Friendship University of Russia named after Patrice LumumbaRussian FederationООО “Медскан”РоссияLLC “Medskan”Russian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет); Центр репродукции и генетики “Нова Клиник”РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University); Nova Clinic Center for Reproduction and GeneticsRussian FederationООО “Клиника лечения боли “МЕДИКА”РоссияPain Treatment Clinic MEDICA LLCRussian Federation20260506202630297109Copyright © Озерская И.А., Казарян Г.Г., Минашкина Е.В., Арбузов Ю.О., 20262026Озерская И.А., Казарян Г.Г., Минашкина Е.В., Арбузов Ю.О.Ozerskaya I.A., Kazaryan G.G., Minashkina E.V., Arbuzov Y.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1623Цель исследования

Цель исследования: обобщить современные данные о физической природе артефакта реверберации и его влиянии на качество ультразвукового изображения матки и эндометрия, включая изменения показателей трехмерной допплерографии (VI, FI, VFI).

Материал и методы

Материал и методы. Выполнен аналитический обзор 85 публикаций в базах PubMed, Scopus и e-Library за 1982–2025 гг., посвященных артефактам ультразвуковой визуализации, физике реверберации и применению 3D-ангиосканирования при исследовании матки и эндометрия.

Результаты

Результаты. Артефакт реверберации обусловлен многократным отражением ультразвуковых волн между акустически плотными границами и проявляется серией параллельных эхосигналов, идущих дистальнее истинной структуры. В В-режиме он может имитировать утолщение эндометрия или внутриполостные включения, а при цветовом и энергетическом допплеровском картировании создавать ложные зоны кровотока. Исследований влияния реверберации на показатели VI, FI и VFI не обнаружено, однако теоретически артефакт способен завышать значения VI и VFI за счет появления ложных цветовых вокселей.

Заключение

Заключение. Реверберация является не только источником диагностических ошибок, но и потенциальным диагностическим ориентиром. Знание механизмов ее возникновения, контроль настроек допплеровских режимов и стандартизация протоколов 3D-ангиосканирования позволяют повысить точность оценки морфологических и гемодинамических характеристик матки и эндометрия. Необходимы дальнейшие исследования, направленные на количественную оценку влияния артефактов на сосудистые индексы.

Objective

Objective: To summarize current knowledge on the physical nature of reverberation artifact and its impact on the quality of uterine and endometrial ultrasound imaging, including possible effects on three-dimensional power Doppler indices (VI, FI, VFI).

Materials and methods

Materials and methods. An analytical review of 85 publications in the PubMed, Scopus and eLibrary databases for 1982–2025, devoted to ultrasound imaging artifacts, reverberation physics and the use of 3D Power Doppler for endometrial assessment.

Results

Results. Reverberation artifact results from multiple reflections of ultrasound waves between acoustically dense interfaces, producing a series of parallel echoes distal to the true structure. In B-mode, it may mimic endometrial thickening or intracavitary lesions; in color or power Doppler imaging, it can generate false flow signals. No direct quantitative studies evaluating the effect of reverberation on VI, FI, VFI were identified. However, theoretically, reverberation may lead to overestimation of VI and VFI due to the appearance of spurious color voxels.

Conclusion

Conclusion. Reverberation should be regarded not only as a source of diagnostic error but also as a potential diagnostic clue. Understanding its mechanisms, optimizing Doppler settings, and standardizing 3D Power Doppler protocols improve the accuracy of morphological and hemodynamic assessment of the uterus and endometrium. Further quantitative studies are warranted to determine the degree of artifact influence on vascular indices.

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The authors declare that there are no conflicts of interest present.