Soft elastic hydrogel couplants for ultrasonography

Couplants play significant roles in ultrasonography. To ensure imaging quality, it is critical to maintain conformal contact of the couplant with both the skin surface and the ultrasound probe in clinical applications. In addition, either the probe or the couplant should not deform the skin surface significantly, which will result in an overestimated modulus of the tissue for elastography imaging. However, existing liquid gel couplants cannot bear external compressive force, while existing solid gel couplants cannot maintain a conformal contact with skin surface. Especially, the nonconformal contacts and deformation become more severe on body parts of locally high curvatures such as skin tumors, fingers, and elbows. Here we report a bilayer design of couplant for ultrasonography, composing of a stiff layer and a compliant layer of hydrogels. The bilayer hydrogel pad enables it to bear external compression, allowing the probe to move smoothly, conforming high curvature parts and releasing stress concentration. Our clinical experiments further show high quality imaging of thyroid nodules, skin tumors in elbows and fingers using the bilayer hydrogel pad, which represents a promising alternative for a range of applications in ultrasonic diagnosis. •A bilayer hydrogel is proposed to replace the liquid couplant in ultrasonography.•Clinical tests show improvement in ultrasonography quality using bilayer hydrogels.•High curvature part of body can be imaged ultrasonically using bilayer hydrogels.•Bilayer hydrogel relieves tissue stress concentration resulting from external compression.