Artifacts in Echocardiography

Artifacts are common during routine ultrasound and should be identified accurately in order to perform an adequate assessment during echocardiography. Some of the common ones are

1. Suboptimal image quality -  this is commonly observed in obese patients or those with chronic lung disease

2. Reverberation artifact – Occurs due to two simultaneous specular reflections off structures, which occurs a few times before it returns back to the transducer. It appears like a series of dense parallel reflected lines on ultrasound. Reverberation artifacts are commonly seen due to prosthetic heart valves.

3. Acoustic shadowing – This is seen when ultrasound waves are reflected off structures that possess a higher acoustic impedance and that do not allow waves to propagate further beyond these structures. Prosthetic valves and calcification are a common cause.

4. Lateral resolution - When a single ultrasound beam reflects off 2 structures that are close to each other and equidistant from the probe, the image displayed may show some degree of overlap, and thus distortion. It can be seen with pacing wires. This can be corrected by narrowing the focus. 

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