Filtering based on Singular Value Decomposition (SVD) provides substantial separation of clutter, flow and noise in high frame rate ultrasound flow imaging. The use of SVD as a clutter filter has greatly improved techniques such as vector flow imaging, functional ultrasound and super-resolution ultrasound localization microscopy. The removal of clutter and noise relies on the assumption that tissue, flow and noise are each represented by different subsets of singular values, so that their signals are uncorrelated and lay on orthogonal sub-spaces. This assumption fails in the presence of tissue motion, for near-wall or microvascular flow, and can be influenced by an incorrect choice of singular value thresholds. Consequently, separation of flow, clutter and noise is imperfect, which can lead to image artefacts not present in the original data. Temporal and spatial fluctuation in intensity are the commonest artefacts, which vary in appearance and strengths. Ghosting and splitting artefacts are observed in the microvasculature where the flow signal is sparsely distributed. Singular value threshold selection, tissue motion, frame rate, flow signal amplitude and acquisition length affect the prevalence of these artefacts. Understanding what causes artefacts due to SVD clutter and noise removal is necessary for their interpretation.

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