Purpose or Case Report: To create a three dimensional (3D) ultrasound (US) bowel phantom that simulates bowel sonographic characteristics to aid in education for bowel scanning techniques and for microbubble contrast utilization in bowel.
Methods & Materials: A pliable 3D bowel US model composed of silicone (Ecoflex® 00-35, Smooth-On) was made containing a central lumen and a false lumen within the wall. Multiple materials of various consistencies for simulating bowel content including Play-Doh®(Hasbro), Play-Doh® in water, Kinetic Sand™ (Spin Master), Kinetic Sand™ in water, Flarp Putty® (Ja-Ru), polyvinyl acetate in water (Elmer’s® glue), support material in water (Support 705®, Connex 500) and Metamucil® in water were tied-off into nitrile gloves separately. These were placed individually into the central lumen of the synthetic bowel in a tub of water and a sonographer with 17 years experience scanned the bowel using a Philips EpiQ-7G to evaluate the sonographic characteristics. Microbubbles (Lumason®, Bracco Diagnostics Inc) were then injected into the false lumen and rescanned. A numerical grading system was developed ranging from 4 to 12 to determine the optimal material. The criteria assessed on US included: visualization and imaging quality of the bowel wall(s), ± sonographic artifact and presence of echogenicity on B-mode and signal intensity on contrast mode. The luminal material with the highest score was deemed the optimal material.
Results: Materials ranged from a score of 6 to 12. The Play-Doh®, support material and Elmer’s® glue each had the lowest scores of 6 due to poor image quality, extensive artifact and poor visualization of the bowel walls and Lumason® on contrast mode. The Kinetic Sand™ had a score of 7 and was better at visualizing the lateral bowel wall. The Metamucil® and Flarp Putty® had scores of 8 and 9 respectively, with complete visualization of the bowel wall and little artifact but both materials had increased echogenicity on B-mode. Play-Doh® in water and Kinetic Sand™ in water had the highest scores, 12 and 11 respectively. These materials demonstrated no artifact from luminal content with optimal image quality of the bowel wall. Yet, the Play-Doh® in water scored the highest due to best Lumason® visualization in the bowel wall.
Conclusions: The preliminary data shows Play-Doh® dissolved in water results in optimal sonographic characteristics for use in a 3D US bowel phantom. Such a phantom model will serve as a valuable training tool for grayscale and contrast enhanced bowel US evaluation.