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.

Reflection of the sound beam occurs when it hits a boundary between materials having different acoustic impedance. The reflection (echo) is the portion of a sound that is returned from the boundary. The reflection time (the time taken for the wave to return to the probe) can be used to determine the depth of the object.
The reflection within the body produces the ultrasound image, but should be minimized at an ultrasound couplant to skin boundary where the couplant acts as an acoustic window through which the image is seen. The amount of sound waves, which are reflected back at the interface between two tissues is depend on the angle of incidence and the difference between the acoustic impedance values of the two tissues.
If the difference is great, a large part of the sound waves will be reflected back. If too much sound is reflected back and not enough waves are remaining to be able to penetrate the tissue, the imaging will be poor.
If the difference is small, a small amount will be reflected back. Enough sound signal remains to continue with ultrasound imaging.
If the ultrasound beam meets a rough surface or small object, the beam is scattered in all directions and only a small amount will be received by the probe.

See also False Distance Artifact, Target Strength, and Snells Law.

The first step in a transcranial Doppler (TCD) examination is to localize a cranial acoustic window where the ultrasound beam can penetrate without being excessively attenuated.

There are three main transcranial acoustic windows, used for the sound beam in cerebrovascular ultrasonography to overcome the skull barrier:
A complete TCD examination incorporates these windows allowing the visualization of the complete cerebral circulation.

A transducer is a device, usually electrical or electronic, that converts one type of energy to another. Most transducers are either sensors or actuators. A transducer (also called probe) is a main part of the ultrasound machine. The transducer sends ultrasound waves into the body and receives the echoes produced by the waves when it is placed on or over the body part being imaged.
Ultrasound transducers are made from crystals with piezoelectric properties. This material vibrates at a resonant frequency, when an alternating electric current is applied. The vibration is transmitted into the tissue in short bursts. The speed of transmission within most soft tissues is 1540 m/s, producing a transit time of 6.5 ms/cm. Because the velocity of ultrasound waves is constant, the time taken for the wave to return to the transducer can be used to determine the depth of the object causing the reflection.
The waves will be reflected when they encounter a boundary between two tissues of different density (e.g. soft tissue and bone) and return to the transducer. Conversely, the crystals emit electrical currents when sound or pressure waves hit them (piezoelectric effect). The same crystals can be used to send and receive sound waves; the probe then acts as a receiver, converting mechanical energy back into an electric signal which is used to display an image. A sound absorbing substance eliminates back reflections from the probe itself, and an acoustic lens focuses the emitted sound waves. Then, the received signal gets processed by software to an image which is displayed at a monitor.
Transducer heads may contain one or more crystal elements. In multi-element probes, each crystal has its own circuit. The advantage is that the ultrasound beam can be controlled by changing the timing in which each element gets pulsed. Especially for cardiac ultrasound it is important to steer the beam.
Usually, several different transducer types are available to select the appropriate one for optimal imaging. Probes are formed in many shapes and sizes. The shape of the probe determines its field of view.
Transducers are described in megahertz (MHz) indicating their sound wave frequency. The frequency of emitted sound waves determines how deep the sound beam penetrates and the resolution of the image. Most transducers are only able to emit one frequency because the piezoelectric ceramic or crystals within it have a certain inherent frequency, but multi-frequency probes are also available.
See also Blanking Distance, Damping, Maximum Response Axis, Omnidirectional, and Huygens Principle.

Conventional, CT and MR imaging technologies are limited in their availability, to depict soft tissue, or to show dynamic activity, like cardiac muscle contractility and blood flow. Easy applicability, real-time sonography and biopsy facilitation are important advantages in veterinarian medicine. Veterinary ultrasound has a very high sensitivity to show the composition of soft tissues, but the low specificity is a disadvantage. High ultrasound system performance includes Doppler techniques, contrast enhanced ultrasound, 3D ultrasound, and tissue harmonic imaging to improve resolution.
Technical and physical requirements of veterinary ultrasound are the same as in human ultrasonography. The higher the sound frequency, the better the possible resolution, but the poorer the tissue penetration. Image quality is depended of the ultrasound equipment. For example, a 10 MHz transducer is excellent for imaging of superficial structures; a 3.5 or 5.0 megahertz transducer allows sufficient penetration to see inner structures like the liver or the heart. In addition, the preparation and performing of the examination is similar to that of humans. The sound beam penetrates soft tissue and fat well, but gas and bone impede the ultrasonic power. Fluid filled organs like the bladder are often used as an acoustic window, and an ultrasound gel is used to conduct the sound beam.