2026 ARDMS Valid SPI Exam Registration

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ARDMS SPI Exam Syllabus Topics:

TopicDetails
Topic 1
  • Apply Doppler Concepts: This section of the exam measures skills of Vascular Sonographers and evaluates understanding and application of Doppler ultrasound principles. It includes knowledge of Doppler angle, flow dynamics, and color and spectral Doppler imaging. The section also covers eliminating aliasing, interpreting waveforms, applying continuous and pulsed wave Doppler, and optimizing Doppler gain and scale to accurately measure blood flow and velocity within vessels.
Topic 2
  • Perform Ultrasound Examinations: This section of the exam measures skills of Sonographers and covers how to conduct ultrasound procedures while ensuring patient safety and diagnostic accuracy. It includes understanding of imaging protocols, ergonomics, patient care, and the interaction between sound and tissue. Candidates are expected to demonstrate abilities to manage patient encounters, apply 3D
  • 4D and contrast imaging concepts, identify and correct artifacts, and follow confidentiality and privacy standards throughout the scanning process.
Topic 3
  • Provide Clinical Safety and Quality Assurance: This section of the exam measures skills of Clinical Ultrasound Supervisors and focuses on maintaining safety and quality standards in ultrasound practice. It includes infection control protocols, transducer and machine integrity checks, and quality assurance testing using tissue-mimicking phantoms. The section also requires familiarity with statistical parameters like sensitivity and specificity to evaluate diagnostic performance and ensure consistent, reliable imaging outcomes.
Topic 4
  • Optimize Sonographic Images: This section of the exam measures skills of Diagnostic Medical Sonographers and assesses their ability to enhance image quality using advanced optimization techniques. It includes understanding axial, lateral, elevational, and temporal resolution, as well as manipulating gain, depth, magnification, and dynamic range. Examinees are expected to apply harmonic imaging, spatial compounding, and gray-scale techniques to produce clear, accurate diagnostic images.
Topic 5
  • Manage Ultrasound Transducers: This section of the exam measures skills of Ultrasound Technicians and focuses on the management and proper use of different types of transducers. It evaluates knowledge of transducer components, frequency selection, and application of various 2D, 3D, 4D, and nonimaging transducer concepts. Candidates must show they can choose the appropriate transducer for specific examinations and make necessary frequency adjustments to ensure image quality.

ARDMS Sonography Principles and Instrumentation Sample Questions (Q147-Q152):

NEW QUESTION # 147
Which control determines the amount of amplification occurring in the receiver?

Answer: D

Explanation:
Overall gain controls the amplification of all the received ultrasound signals uniformly. This adjustment affects the brightness of the entire image by increasing or decreasing the amplification of the echoes returning from all depths. It is a primary control for adjusting image brightness. The overall gain should be set to an appropriate level to ensure that the ultrasound image is neither too bright (over-gained) nor too dark (under- gained), allowing for optimal visualization of the anatomical structures.
American Registry for Diagnostic Medical Sonography (ARDMS). Sonography Principles and Instrumentation (SPI) Examination Review Guide.


NEW QUESTION # 148
The ability to resolve two separate reflectors perpendicular to the path of the beam describes which type of resolution?

Answer: B

Explanation:
Lateral resolution describes the ability of an ultrasound system to distinguish between two structures that are side by side (perpendicular to the path of the ultrasound beam). This type of resolution depends on the beam width; narrower beams provide better lateral resolution. As the ultrasound beam travels deeper into the tissue, it generally widens, which can reduce lateral resolution. Techniques such as focusing the beam can help improve lateral resolution at specific depths by narrowing the beam width.
Reference:
American Registry for Diagnostic Medical Sonography (ARDMS). Sonography Principles and Instrumentation (SPI) Examination Review Guide.


NEW QUESTION # 149
Which image demonstrates appropriate spectral Doppler gain?

Answer: D

Explanation:
Option B demonstrates appropriate spectral Doppler gain. Appropriate gain settings ensure that the Doppler signal is adequately amplified without introducing excessive noise or artifacts. In Option B, the spectral waveform is clearly visible with distinct borders, and the background noise is minimal. In contrast, other options might show either under-gained (too little signal) or over-gained (excessive noise and signal) images, making it difficult to accurately interpret the spectral Doppler information. Reference:
ARDMS Sonography Principles and Instrumentation guidelines
"Understanding Ultrasound Physics" by Sidney K. Edelman


NEW QUESTION # 150
Which color Doppler artifact is visualized in this image?

Answer: C

Explanation:
The color Doppler image shows an artifact where high-velocity blood flow exceeds the Nyquist limit, resulting in color wrap-around or aliasing. This artifact is visualized as a mosaic pattern of colors that abruptly change, indicating that the velocity exceeds the color Doppler scale's maximum. Aliasing occurs when the sampling rate (pulse repetition frequency) is insufficient to accurately capture the high velocities, causing the display to cycle back to lower velocities.
Reference:
ARDMS Sonography Principles & Instrumentation Guidelines
Hagen-Ansert SL. Textbook of Diagnostic Ultrasonography. 8th ed. St. Louis, MO: Mosby; 2017.


NEW QUESTION # 151
Which system control adjusts amplification of signals as a function of depth?

Answer: D

Explanation:
Time Gain Compensation (TGC), also known as Depth Gain Compensation (DGC), is used to adjust the amplification of ultrasound signals based on their depth. As ultrasound waves travel deeper into the tissue, they become weaker due to attenuation. TGC compensates for this attenuation by progressively increasing the gain for deeper echoes, ensuring that structures at different depths appear with similar brightness on the ultrasound image. This function is critical for creating a uniform image and accurately visualizing deeper anatomical structures.
Reference:
American Registry for Diagnostic Medical Sonography (ARDMS). Sonography Principles and Instrumentation (SPI) Examination Review Guide.


NEW QUESTION # 152
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