pulses of ultrasound energy are dispersed upon reflection therefrom each of the surfaces 124 126 may also include a plurality of protrusions 128 130 respectively which roughen the surfaces 124 126 to further scatter the ultrasound energy in various directions to deflect the ultrasound energy in a directional stream for better heat transfer and distribution to a desired target area the surfaces 124 126 may be angled with respect to a plane of the piezoelectric element 102 in a preferred embodiment the surface 124 may be angled in a direction opposite that of the surface 126 such that pulses of ultrasound energy which contact these angled surfaces 124 126 are scattered in opposite directions to form a generally circulatory pattern of fluid flow thus the surface 124 agitates the fluid 170 causing it to circulate through the organ without being overwhelmingly directed to a single spot which would otherwise be burned if desired the deflecting elements 104 106 may be formed to absorb a portion of the ultrasound energy and convert it to heat to heat the surrounding fluid 170 the deflecting elements 104 106 may be formed of a thermally conductive ceramic such as aluminum silicone carbride which is manufactured by cps technologies corporation norton mass a thermally conductive material allows for quick heat dissipation for optimal coupling of the ultrasound energy an acoustic impedance of the ceramic should match the acoustic impedance of the fluid 170 it will be understood by those of skill in the art that the closer the two values are to one another the more acoustic energy the deflecting elements 104 will absorb for example the acoustic impedance of ceramic z ceramics u02dc 36 mrayls while the acoustic impedance of a fluid 170.