You may observe a mirror image artifact with which imaging mode?

• A. B-mode
• B. Spectral Doppler
• C. Color Doppler
• D. All of the above

Answer: (D)

Mirror image artifact happens when a strong reflector, like the diaphragm or a highly reflective interface, acts like a mirror for the ultrasound waves. Echoes from structures in front of the reflector are returned to the transducer, and because of the way the system interprets these echoes, a duplicate image is created on the other side of the reflector. This ghost image can appear in any imaging mode because all modes rely on the same echo data. In B-mode you’d see a second copy of anatomy mirrored across the reflector; in color Doppler, the mirrored echoes can carry color, producing a ghost signal in the mirror position; and in spectral Doppler, a mirrored Doppler trace can appear at the mirrored location. Since the mechanism affects all modes, mirror image artifact may be observed across B-mode, color Doppler, and spectral Doppler.