Adult Echocardiography Practice Exam

What artifact is demonstrated in a parasternal long axis image when observing echocardiographic findings?

1. Reverberation artifact

2. Comet tail

3. Ring down artifact

4. Acoustic speckle

The correct answer is: Ring down artifact

The ring down artifact is characterized by the appearance of a hyperechoic line with a series of echoes that diminish in intensity over time. This artifact typically arises from structures that reflect ultrasound waves continuously, such as air or gas bubbles that are located adjacent to solid structures. In a parasternal long axis image, particularly when examining the heart's left ventricle and adjacent structures, ring down artifacts are frequently observed in the presence of complex interfaces. For instance, if there is a small pocket of air or gas close to a cardiac structure, the ultrasound can produce these characteristic lines which may mislead the interpretation of the underlying anatomy. This understanding of the ring down artifact is essential in echocardiography, as it can demonstrate specific findings related to the positioning of various structures in relation to the heart, which aids clinicians in making accurate assessments and diagnoses. Identifying this artifact helps differentiate it from other common artifacts like reverberation or acoustic speckle, which present differently and have different implications for image interpretation.