Petroleum Jelly as an Alternative Coupling Agent to Reduce Umbrella Artifacts in Ultrasound Superficial Scans

Abstract

Umbrella artifacts, caused by air bubbles in ultrasound gels, can compromise the diagnostic accuracy especially superficial ultrasound scans. This study investigated whether petroleum jelly, a commonly available alternative, could reduce these artifacts than standard ultrasound gel. Materials and methods: A cross-sectional study was conducted from September 2022 to February 2023, including only adult patients (18-40 years old) with normal BMI. Patients were prospectively recruited using a random sampling method and informed consent was obtained. Patients with a history of eczema, surgery, or chronic diseases were excluded. Total scores of overall image quality based on high contrast spatial resolution (HCSR), signal-to-noise ratio (SNR), image contrast, and homogeneity were compared between petroleum-jelly based and ultrasound gel-based images using a paired t-tests. The presence of umbrella artifacts was assessed using McNemar’s test. Results: A total of 88 patients with 45 males (51.1%) and 43 females (48.9%) participated in this study. Petroleum jelly-based images demonstrated slightly lower image quality compared to ultrasound gel-based images (17.75±1.72 vs. 17.35±1.30; P = 0.018), with an overall mean difference score of 0.40 (95% CI; 0.07, 0.73). However, the umbrella artifacts were significantly reduced with petroleum jelly (n = 2, 2.27%) compared to ultrasound gel (n = 9, 10.23%) (P = 0.039). Conclusion: Petroleum jelly shows potential as an alternative coupling agent, significantly reducing umbrella artifacts, despite slightly lower image quality. Its potential application in resource-limited settings needs further investigation and optimisation for broader clinical use.