Distortions of ultrasonic field introduced by the rib cage in echocardiography

In ultrasonic examination of the heart, the anatomy and motion of heart structures can be observed by placing the ultrasonic transducer over an intercostal window adjacent to the sternum. The ultrasonic beam may be reflected, refracted, or scattered from its path by the ribs and soft tissues before reaching the target of interest. This interaction between the tissues and ultrasound beam, which introduces significant changes in ultrasonic beam characteristics, may result in considerable degradation of the lateral resolution of the ultrasonic system, determined largely by the beam width. In this paper, the effect of rib cage on the beam characteristics is examined. It is shown that the rib cage can produce severe distortions of the ultrasonic beam, namely, asymmetry in beam cross-section, alteration in beam diameter, and deflection of the beam from its central path. It is also demonstrated that this distortion is dependent upon transducer diameter, width of the intercostal window, and transducer angulation relative to the breast plate.