Reverberation artifacts are produced from the multiple reflections from an object if the acoustical impedances of tissue layers are too much different and the detected echo does not run the shortest sound path because it bounces back and forth between the object and the transducer. In a reverberation artifact, the sound wave is reflected back into the body from the transducer-skin interface.

The scattered echo originates from relatively small, weakly reflective, irregularly shaped objects, and is less angle dependent and less intense. The mathematical treatment of non-specular reflection involves the Rayleigh probability density function (i.e. blood cells).

The various gas microbubble contrast media are generally safe with low toxicity in humans. The tolerance of these agents is much higher than that of most x-ray agents, a reflection perhaps of the higher expectation of safety and convenience for ultrasound.
Extensive preclinical and clinical trials have demonstrated an excellent ultrasound contrast agent safety profile, the main side effect being a mild and transient local discomfort at the injection site which results from the high osmolality of these agents. Each contrast agent has its own profile of adverse effects, but all have been trivial thus far.

See also Ultrasonic Contrast Agents.

An echo is defined as the repetition of a sound by reflection of sound waves from a surface.
Echo types used in ultrasound imaging:
Specular echoes are created from relatively large, regularly shaped objects with smooth surfaces. Specular echoes are relatively intense and angle dependent.
Scattered echoes are created from relatively small, weakly reflective, irregularly shaped objects. Scattered echoes are less angle dependant and less intense.

See also Specular Echo, and Scattered Echo.

Ultrasound physics is based on the fact that periodic motion emitted of a vibrating object causes pressure waves. Ultrasonic waves are made of high pressure and low pressure (rarefactional pressure) pulses traveling through a medium.

Properties of sound waves:

The speed of ultrasound depends on the mass and spacing of the tissue molecules and the attracting force between the particles of the medium. Ultrasonic waves travels faster in dense materials and slower in compressible materials. Ultrasound is reflected at interfaces between tissues of different acoustic impedance e.g., soft tissue - air, bone - air, or soft tissue - bone.
The sound waves are produced and received by the piezoelectric crystal of the transducer. The fast Fourier transformation converts the signal into a gray scale ultrasound picture.

The ultrasonic transmission and absorption is dependend on:
See also Sonographic Features, Doppler Effect and Thermal Effect.