The wider the ultrasound beam, the more severe the problem with volume averaging and the beam-width artifact, to avoid this, the ultrasound beam can be shaped with lenses.
Different possibilities to focus the beam:

Conventional multi-element transducers are electronically focused in order to minimize beam width. This transducer type can be focused electronically only along the long axis of the probe where there are multiple elements, along the short axis (elevation axis) are conventional transducers only one element wide. Electronic focusing in any axis requires multiple transducer elements arrayed along that axis. Short axis focusing of conventional multi-element transducers requires an acoustic lens which has a fixed focal length.
For operation at frequencies at or even above 10 MHz, quantization noise reduces contrast resolution. Digital beamforming gives better control over time delay quantization errors. In digital beamformers the delay accuracy is improved, thus allowing higher frequency operation. In analog beamformers, delay accuracy is in the order of 20 ns.
Phased beamformers are suitable to handle linear phased arrays and are used for sector formats such as required in cardiography to improve image quality. Beamforming in ultrasound instruments for medical imaging uses analog delay lines. The signal from each individual element is delayed in order to steer the beam in the desired direction and focuses the beam.
The receive beamformer tracks the depth and focuses the receive beam as the depth increases for each transmitted pulse. The receive aperture increase with depth. The lateral resolution is constant with depth, and decreases the sensitivity to aberrations in the imaged tissue. A requirement for dynamic control of the used elements is given. Since often a weighting function (apodization) is used for side lobe reduction, the element weights also have to be dynamically updated with depth.

See also Huygens Principle.

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The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.

The perfect image quality is dependent on some assumptions of the propagation of ultrasound waves in tissues after generating in an imaging system. These assumptions are important for the developing of optimal ultrasound imaging systems.
A lot of steps can be taken to prevent artifacts and to improve image quality, for example beamforming is used to focus the ultrasound beam, and contrast agents decrease the reflectivity of the undesired interfaces or increase the backscattered echoes from the desired regions.

See also Coded Excitation, Validation and Refraction Artifact, Q-Value, Ultrasound Phantom, Dead Zone, Narrow Bandwidth.

The main lobe is the main acoustic transducer beam. There are other, smaller lobes called side lobes that are located around the main lobe.

See also Side Lobe, Grating-lobe Artifact, Beam Steering, Beamforming.