Reverberation artifacts are produced from the multiple reflections from an object if the acoustical impedances of tissue layers are too much different and the detected echo does not run the shortest sound path because it bounces back and forth between the object and the transducer. In a reverberation artifact, the sound wave is reflected back into the body from the transducer-skin interface.

(Z) The acoustic impedance is dependent on the density of the material in which sound is propagated through. When an ultrasonic wave crosses an interface between tissues with different acoustic impedance, the wave divides in 2 components, and the energy of the reflected components directly relates with the acoustic impedance.
The greater the impedance the more dense the material, and the greater the difference in acoustic impedance between two adjacent tissues the more reflective will be their boundary.
The acoustic impedance (the unit is 'Rayl') is the product of the sound velocity and the physical dense.
The acoustic impedance is very high between air or bone and other body tissues, therefore not enough energy crosses these interfaces, and no information can be collected from organs placed behind them.

See also Mirror Artifact, Reverberation Artifact, Cross Talk and Ultrasound Physics.

The mirror artifact is similar to the reverberation artifact. Mirror image artifacts (mirroring) can occur if the acoustical impedances of the tissue is too much different and the ultrasound is reflected multiple times on tissue layers. The echo detected does not come from the shortest sound path, the sound is reflected off an angle to another interface so that like a real mirror, the artifact shows up as the virtual object.
An empyema or lung abscess can be simulated by a mirror image artifact of a hepatic cyst. This liver lesion can appear like a lesion within the lung because the wave is reflected off the diaphragm back into the liver. The angle of reflection is equal to the angle of incidence. The sound pulse hits the interfaces within the liver lesion and is reflected back to the diaphragm once again with an angle of reflection equal to the angle of incidence and then back to the transducer.
Also by a pelvic ultrasound scan the sound can be reflected off the rectal air at an angle so that the deep wall of an artifactual cyst represents the mirror image of the inferior and anterior walls of the bladder. Mirror image artifacts can cause other strange appearances such as invasion of a transitional cell carcinoma through the bladder wall.
Also called Cross Talk.