The effect of medium coupling on propagation of elastic waves is a general concern in a variety of engineering and bio-medical applications. Although some theories and analytical models are available for describing waves in multi-layered engineering structures, they do not focus on canvassing ultrasonic waves in human bones with coupled soft tissues, where the considerable differences in acoustic impedance between bone and soft tissue may pose a challenge in using these models (the soft tissues having an acoustic impedance around 80% less than that of a typical bone). Without proper treatment of this coupling effect, the precision of quantitative ultrasound (QUS) for clinical bone assessment can be compromised. The coupling effect of mimicked soft tissues on the first-arriving signal (FAS) and second-arriving signal (SAS) in a series of synthesized soft-tissue-bone phantoms was investigated experimentally and calibrated quantitatively. Understanding of the underlying mechanism of the coupling effect was supplemented by a dedicated finite element analysis. As revealed, the medium coupling impacts influence on different wave modes to different degrees: for FAS and SAS, the most significant changes take place when the soft tissues are initially introduced, and the decrease in signal peak energy continues with increase in the thickness or elastic modulus of the soft tissues, but the changes in propagation velocity fluctuate within 5% regardless of further increase in the thickness or elastic modulus of the soft tissues. As an application, the calibrated effects were employed to enhance the precision of SAS-based QUS when used for predicting the simulated healing status of a mimicked bone fracture, to find prediction of healing progress of bone fracture based on changes in velocity of the FAS or the SAS is inaccurate without taking into account the effect of soft tissue coupling, entailing appropriate compensation for the coupling effect.
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