The backscatter energy is the portion of the incident acoustic power scattered back toward the transducer.

Environmental protection in ultrasound imaging involves adopting practices and technologies that minimize the environmental impact associated with the use of ultrasound equipment and disposables.

Here are some key considerations:

By focusing on energy efficiency, digitalization, waste management, equipment lifespan, and education, healthcare facilities can make significant strides towards reducing their carbon footprint and the environmental impact of ultrasound imaging practices.

See also Ultrasound System Performance, Equipment Preparation, Ultrasound Accessories and Supplies and Sonographer.

The main advantage of ultrasound is that certain structures can be observed without using radiation. However, ultrasound is energy and there are ultrasound safety regulations, because two bioeffects of ultrasound are heat and cavitation. Ultrasound is a mechanical energy in which a pressure wave travels through tissue. Reflection and scattering back to the transducer are used to form the image. As sound energy is transmitted through the tissue, some energy is reflected and some power is absorbed.
Possible physical effects with ultrasound:
The ultrasound safety is based on two indices, the mechanical index (MI) and the thermal index (TI). The WFUMB guidelines state that ultrasound that produces temperature rises of less than 1.5°C may be used without reservation. They also state that ultrasonic exposure causing temperature rises of greater than 4°C for over 5 min should be considered potentially hazardous. This leaves a wide range of temperature increases which are within the capability of diagnostic ultrasound equipment to produce and for which no time limits are recommended. However, it has not been determined that medical ultrasound causes any adverse reaction or deleterious effect.
The American Institute of Ultrasound in Medicine states that as of 1982, no independently confirmed significant biologic effects had been observed in mammalian tissue below (medical usage) 100mW/cm2.

See also Ultrasound Regulations and Ultrasound Radiation Force.

Attenuation is the reduction of power, for example due to the passage through a medium or electrical component. In ultrasound imaging, attenuation means the decrease in amplitude and intensity as a sound wave travels through a medium. In ultrasound attenuation is often characterized as the half-value layer, or the half-power distance. These terms refer to the distance that ultrasound will travel in a particular tissue before its energy is attenuated to half its original value.

Attenuation originates through:
A thick muscled chest wall will offer a significant obstacle to the transmission of ultrasound. Non-muscle tissue such as fat does not attenuate acoustic energy as much. The half-value layer for bone is still less than muscle, that's why bone is such a barrier to ultrasound.

See also Attenuation Coefficient, and Derated Quantity.

(ESWL) Extracorporeal shock wave lithotripsy is a special use of kidney ultrasound, where high intensity focused ultrasound pulses are used to break up calcified stones in the kidney, bladder, or urethra. Pulses of sonic waves pulverize dense renal stones, which are then more easily passed through the ureter and out of the body in the urine. The ultrasound energy at high acoustic power levels is focused to a point exactly on the stone requiring an ultrasound scanning gel for maximum acoustic transmission.
Air bubbles in the ultrasound couplant, regardless of their size, degrade the performance of Lithotripsy and have the following effect:
Air bubbles smaller that 1/4 wavelength cause scattering of the sound waves as omni directional scatterers and less acoustic energy reaches the focal point. The result is less acoustic power at the focal point to disintegrate the kidney stone.
Air bubbles larger than 1/4 wavelength act as reflectors and deflects the acoustic energy off in a different direction. These results in less acoustic energy at the focal point.
Microbubbles dispersed throughout the ultrasound couplant layer change the average acoustic impedance of the gel layer (which reduces the total transmitted energy) and, due to refraction, change the focal point.