Real-time mode has been developed to present motion like a movie of the body's inner workings, showing this information at a high rate. The special real-time transducer uses a larger sound beam than for A, B or M-modes. A linear array transducer with multiple crystal elements displays real-time compound B-mode images with up to 100 images per second.
At each scan line, one sound pulse is transmitted and all echoes from the surface to the deepest range are received. Then the ultrasound beam moves on to the next scan line position where pulse transmission and echo recording are repeated.

See also Compound B-Mode, Pulse Inversion Doppler, and Frame Averaging.

Most usual ultrasound machines are 2D real-time systems. This types of ultrasound scanners allow to assess both motion and anatomy, including the motion of heart valves, the movement of intestines and lungs and also to guide interventions, like for example a biopsy or a laparoscopic ultrasound.
A standard real-time scanner consists of a mobile console with the monitor on the top and rows of small containers at the bottom to accommodate a variety of scanner probes. The linear, curved or phased array transducers are usually equipped with multiple crystals or in some cases with a moving crystal. A real-time scanner may be e.g., a mechanical scanner or electronic array scanner.

See also Musculoskeletal and Joint Ultrasound.

Transducers used for the real-time mode are different than for the A-mode, B-, or M-modes. A linear array transducer with multiple piezoelectric crystal elements that are different arranged and fired, transmits the needed larger sound beam.
A subgroup of x adjacent elements (8-16; or more in wide-aperture designs) is pulsed simultaneously; the inner elements pulse delayed with respect to the outer elements. The interference of the x small divergent wavelets generates a focused beam. The delay time determining the focus depth of a real-time transducer can be changed during imaging.
Similar delay factors applied during the receiving phase, result in a dynamic focusing effect on the return. This forms a single scan line in the real-time image. To produce the following scan line, another group of x elements is selected by shifting one element position along the transducer array from the previous group. This pattern is then repeated for the groups along the array, in a sequential and repetitive way.

2D ultrasound imaging is a widely used technique in medical imaging that provides two-dimensional visual representations of internal structures. A handheld device known as a probe or transducer contains piezoelectric crystals that emit and receive ultrasound waves which penetrate tissues and bounce back as echoes. The echoes are detected and converted into electrical signals. These signals are processed and displayed on a monitor, creating a real-time 2D grayscale image, with different shades of gray representing various tissue densities. The brighter areas on the image correspond to structures that reflect more ultrasound waves, while darker areas represent structures that reflect fewer waves or are attenuated by intervening tissues. The 2D-mode (or B-mode) provides cross-sectional views of the scanned area, showing a single plane or slice of the scanned area at a time.

Key Features and Uses of 2D Ultrasound:

Comparison with 3D and 4D Ultrasound:
See also Ultrasound Technology, Sonographer, Ultrasound Elastography, Obstetric and Gynecologic Ultrasound.

The definition of imaging is the visual representation of an object. Medical imaging is a broad term that encompasses various imaging modalities and techniques used in the field of medicine to visualize and study the body's anatomy and physiology. It includes both diagnostic and non-diagnostic imaging procedures, where diagnostic imaging specifically refers to the subset of medical imaging techniques that are primarily focused on diagnosing diseases or conditions. Medical imaging techniques are employed to obtain images or visual representations of the internal organs, tissues, and structures, aiding in the diagnosis, treatment, and monitoring of medical conditions.
The field of medical imaging has significantly evolved since the discovery of X-rays by Konrad Roentgen in 1896. Initially, radiological imaging involved focusing X-rays on the body and capturing the images on a single piece of film within a specialized cassette. Subsequent advancements introduced the use of fluorescent screens and special glasses for real-time visualization of X-ray images.
A significant breakthrough came with the application of contrast agents, enhancing image contrast and improving organ visualization. In the 1950s, nuclear medicine studies utilizing gamma cameras demonstrated the uptake of low-level radioactive chemicals in organs, enabling the observation of biological processes in vivo. Currently, positron emission tomography (PET) and single photon emission computed tomography (SPECT) technologies play pivotal roles in clinical research and the diagnosis of biochemical and physiological processes. Additionally, the advent of the x-ray image intensifier in 1955 facilitated the capture and display of x-ray movies.
In the 1960s, diagnostic imaging incorporated the principles of sonar, using ultrasonic waves generated by a quartz crystal. These waves, reflecting at the interfaces between different tissues, were received by ultrasound machines and translated into images through computer algorithms and reconstruction software. Ultrasound (ultrasonography) has become an indispensable diagnostic tool across various medical specialties, with immense potential for further advancements such as targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The first use of ultrasound contrast agents (USCA) dates back to 1968.
Digital imaging techniques were introduced in the 1970s, revolutionizing conventional fluoroscopic image intensifiers. Godfrey Hounsfield's pioneering work led to the development of the first computed tomography (CT) scanner. Digital images are now electronic snapshots represented as grids of dots or pixels. X-ray CT brought about a breakthrough in medical imaging by providing cross-sectional images of the human body with high contrast between different types of soft tissue. These advancements were made possible by analog-to-digital converters and computers. The introduction of multislice spiral CT technology dramatically expanded the clinical applications of CT scans.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements, such as higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI has emerged as a real-time interactive imaging modality capable of providing detailed structural and functional information of the body.
Today, imaging in medicine offers a wide range of modalities, including:

These imaging modalities have become integral components of modern healthcare. With the rapid advancement of digital imaging, efficient management has become important, leading to the expansion of radiology information systems (RIS) and the adoption of Picture Archiving and Communication Systems (PACS) for digital image archiving. In telemedicine, real-time transmission of all medical image modalities from MRI to X-ray, CT and ultrasound has become the standard. The field of medical imaging continues to evolve, promising further innovations and advancements in the future, ultimately contributing to improved patient care and diagnostics.

See also History of Ultrasound Contrast Agents, and History of Ultrasound.