Echogenic medical devices and methods of fabrication and of use are disclosed. The devices are adapted to be inserted into a patient. The device includes an elongated member including a material having an acoustic impedance different from that of the surrounding medium. The medium includes surrounding biological tissue or fluids surrounding the member when inserted into a passageway of the patient. The acoustic impedance of the elongated member is sufficiently different from the surrounding medium for enhancing an image produced in response to a sonic beam produced from imaging equipment. The elongated member also includes an interface layer of a high density metal of which the deposition on the base material of the member is ion beam assisted. The interface layer includes an outside surface having a plurality of particulate-type, discontinuous curved surfaces of partially spherical indentations formed therein or spheres extending therefrom. The difference between the acoustic impedances of the interface layer and the surrounding medium along with the discontinuous surfaces of the interface layer cooperate in response to a beam from sonic imaging equipment to significantly enhance the image of the medical device member.