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The DH view is the classic example for mirror image artifact, which requires a strong air–soft tissue interface such as between the lung diaphragm and liver (see Figure 6.13). As a result, the ultrasound machine's software displays the liver and its structures as mirrored into the thoracic cavity (see Chapters 3 and 5).

Common DH view mirror image artifact misinterpretations include the following.

 The liver and gallbladder mirrored into the thorax and mistaken for a diaphragmatic hernia.

 The gallbladder mirrored into the thorax and mistaken for pleural and pericardial effusion, noting that a “partial” mirroring of the gallbladder can occur.

 Ascites mirrored into the thorax can be mistaken for pleural and pericardial effusion, and liver appearing as lung, noting that a “partial” mirroring of ascites can occur.