Cannot find DICOM attribute (0020,4000 [Image Comments])

I am writing a script using pydicom to automatize ultrasound medical reports.

However, I cannot find the 0020,4000 [Image Comments] attribute. I have tried with different images from different ultrasound machines and also with dcmdump from dcmtk with no success.

Any help would be appreciated.

The dicom object and the image sample follow below:

(0008, 0008) Image Type                          CS: ['ORIGINAL', 'PRIMARY', '', '0011']
(0008, 0016) SOP Class UID                       UI: Ultrasound Image Storage
(0008, 0018) SOP Instance UID                    UI: 1.2.840.113619.2.98.5380.1578912657.0.12421
(0008, 0020) Study Date                          DA: '20200113'
(0008, 0021) Series Date                         DA: '20200113'
(0008, 0023) Content Date                        DA: '20200113'
(0008, 002a) Acquisition DateTime                DT: '20200113142223.000'
(0008, 0030) Study Time                          TM: '141605'
(0008, 0031) Series Time                         TM: '141639'
(0008, 0033) Content Time                        TM: '142223'
(0008, 0050) Accession Number                    SH: '20080940/17'
(0008, 0060) Modality                            CS: 'US'
(0008, 0070) Manufacturer                        LO: 'GE Vingmed Ultrasound'
(0008, 0080) Institution Name                    LO: 'XXXXXXXXXXXXXXXXXX'
(0008, 0090) Referring Physician's Name          PN: ''
(0008, 1010) Station Name                        SH: 'VIVID7-AB'
(0008, 1030) Study Description                   LO: 'Ecocardiografia Doppler'
(0008, 1050) Performing Physician's Name         PN: 'Default'
(0008, 1070) Operators' Name                     PN: 'ADM'
(0008, 1090) Manufacturer's Model Name           LO: 'Vivid7'
(0008, 2111) Derivation Description              ST: '[EMGDCM] Lossless Compression (JPEG p14), Selection Value = 1, Point Transform = 0, compression ratio = 3.417266'
(0010, 0010) Patient's Name                      PN: 'XXXXXXXXXXXXXXXXXX'
(0010, 0020) Patient ID                          LO: 'XXXXXXXXXXXX'
(0010, 0030) Patient's Birth Date                DA: '19770609'
(0010, 0040) Patient's Sex                       CS: 'F'
(0018, 1020) Software Version(s)                 LO: 'Vivid7:4.2.0'
(0018, 6011) Sequence of Ultrasound Regions   1 item(s) ---- 
   (0018, 6012) Region Spatial Format               US: 1
   (0018, 6014) Region Data Type                    US: 2
   (0018, 6016) Region Flags                        UL: 0
   (0018, 6018) Region Location Min X0              UL: 80
   (0018, 601a) Region Location Min Y0              UL: 8
   (0018, 601c) Region Location Max X1              UL: 556
   (0018, 601e) Region Location Max Y1              UL: 391
   (0018, 6020) Reference Pixel X0                  SL: 238
   (0018, 6022) Reference Pixel Y0                  SL: -8
   (0018, 6024) Physical Units X Direction          US: 3
   (0018, 6026) Physical Units Y Direction          US: 3
   (0018, 602c) Physical Delta X                    FD: 0.04603580745589702
   (0018, 602e) Physical Delta Y                    FD: 0.04603580745589702
   (0018, 6030) Transducer Frequency                UL: 1702
   (0018, 6032) Pulse Repetition Frequency          UL: 4000

---

(0020, 000d) Study Instance UID                  UI: 1.2.826.0.1.3680043.2.97.1.1.1516127677.2001031016198050
(0020, 000e) Series Instance UID                 UI: 1.2.840.113619.2.98.5380.1578912657.0.12310
(0020, 0010) Study ID                            SH: '20080940/17'
(0020, 0011) Series Number                       IS: "0002"
(0020, 0013) Instance Number                     IS: "0013"
(0020, 0020) Patient Orientation                 CS: ''
(0028, 0002) Samples per Pixel                   US: 3
(0028, 0004) Photometric Interpretation          CS: 'RGB'
(0028, 0006) Planar Configuration                US: 0
(0028, 0010) Rows                                US: 434
(0028, 0011) Columns                             US: 636
(0028, 0100) Bits Allocated                      US: 8
(0028, 0101) Bits Stored                         US: 8
(0028, 0102) High Bit                            US: 7
(0028, 0103) Pixel Representation                US: 0
(0038, 0010) Admission ID                        LO: '2131087'
(0040, 0275)  Request Attributes Sequence   1 item(s) ---- 
   (0040, 0007) Scheduled Procedure Step Descriptio LO: 'Ecocardiografia Doppler'
   (0040, 0008)  Scheduled Protocol Code Sequence   1 item(s) ---- 
      (0008, 0100) Code Value                          SH: 'US'
      (0008, 0102) Coding Scheme Designator            SH: 'EXUS'
      (0008, 0104) Code Meaning                        LO: 'US'
      ---------
   (0040, 0009) Scheduled Procedure Step ID         SH: 'EXUS252375'
   (0040, 1001) Requested Procedure ID              SH: '20080940/17'
   ---------
(7fe0, 0010) Pixel Data                          OB: Array of 242300 elements

Following is the sample image:

The attribute you mentioned in question (0020,4000 [Image Comments]) does not exist in the dataset you post. So, you cannot locate it if you are trying to find it using toolkit. Also, it is Type 3 attribute with the dataset you are working with which means it is fully optional.

Looking at the image you post, I do not think this is what you are looking for. The text on the image is not loaded from this attribute. Most probably, it is part of pixel data or it is stored as DICOM Text Overlay in dataset.