What are the important types of artefacts seen on echocardiography?

Some of the important types of artefacts seen during echocardiography are attenuation artefacts, also known as acoustic shadowing, sidelobe artefacts, reverberation artefacts and multiple reflection artefacts. Attenuation artefacts are typically caused by ribs and other bony structures. Lower energy side beams of ultrasound known as sidelobes can reflect off lateral structures and get mapped to the central image, causing sidelobe artefacts. Multiple reflections from strong reflectors of ultrasound like pericardium and pleura can cause mirror images of structures being imaged. Continuing repetitions of internal reflections can cause reverberation artefacts, typically in case of prosthetic valves.

Ultrasound lung comets or B lines, also known as comet tail artefacts are also a type of reverberation artefacts. There are seen in heart failure when the lung is water loaded, with interstitial fluid.