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Updated: Aug 28, 2026

Aortic Ring Assay
Published on: November 24, 2009
Duplication of the aortic ring. An artifact in echocardiography
1Department of Radiology, Kingston General Hospital, Ontario, Canada.
Abstract:
Duplication or widening of the aortic ring is commonly observed in echocardiography. This imaging artifact arises from refraction of a portion of the sound beam by an unossified costal cartilage in the anterior chest wall. When the cartilage is situated in line with the edge of the aortic ring or just lateral to it, the artifact is produced. Given the anatomy of the costal cartilages, chest wall, and heart, the amount of refraction is calculated and compared with the amount of refraction actually observed in scans. The degree of duplication or widening of the aortic ring depends directly on the curvature of the costal cartilage and the distance between the cartilage and the aortic ring.
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