In hepatic steatosis (fatty liver), increased echogenicity can obscure visualization of deeper structures like the common bile duct. Lowering the transducer frequency increases sound wave penetration, allowing better visualization of deep structures despite increased liver echogenicity. Decreasing gain or increasing dynamic range primarily adjusts image brightness and contrast but does not improve penetration.
According to Rumack’s Diagnostic Ultrasound:
“Lower frequency transducers are used to improve penetration and visualization of deeper structures in patients with fatty liver.”
[Reference:, Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017., AIUM Practice Parameter for the Performance of Abdominal Ultrasound Examinations, 2020., —]
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