Different sound velocities in tissue are causing refraction artifacts. With convex elastomer lens transducers, sound beam refraction at the skin interface can alter the transducer's focusing characteristics and beam profile, cause element to element nonuniformity, and cause phase changes in the acoustic wave. These cumulative refraction induced errors degrade the image quality through distortion and loss of resolution. Because the amount of refraction is proportional to the velocity mismatch, the greater the mismatch, the greater the refraction.

Duplication artifacts can be created through diffraction and refraction on interfaces, also if the acoustical impedances of tissue is too much different and the ultrasound is reflected multiple on tissue layers, where the detected echo does not come from the shortest sound path.

See also Mirror Artifact.

Enhancement artifacts occur if decreasing of the echo amplitude is not equal with penetration depth caused by inhomogeneous tissue layers and fluids like cysts or air-filled regions. The enhancement artifact appears as a hyperintense (hyperechoic) signal. The attenuation of the ultrasound wave in fluids is much lower as the attenuation in other tissues, therefore tissues distal to fluid are enhanced. Artificial enhancement may also be found distal to a homogeneous solid tumor surrounded by adipose tissue, due to the comparatively high attenuation in fat.

See also Boundary Layer, and Half-Value Layer.

The dimension of the ultrasound beam and the transducer array are the origin of grating-lobe artifacts (also called side lobe artifact). Grating lobes as side lobes are off-axis secondary ultrasound beams projecting at predictable angles to the main lobe. Side lobes are too small to produce important artifacts.

See also Apodization, and Subdicing.

Interference artifacts occur if decreasing of the echo amplitude is not exponential with penetration depth caused by inhomogeneous tissue layers and fluid or air-filled regions. If ultrasound waves have opposite phases, i.e. if the phase difference is 180°, their amplitudes will always be in opposite directions and their sum is a weaker wave. This is destructive interference and artifacts occur.