The refraction is the change of the sound direction on passing from one medium to another. In ultrasound, refraction is due to sound velocity mismatches combined with oblique angles of incidence, most commonly with convex scanheads. When the ultrasound wave crosses at an oblique angle the interface of two materials, through which the waves propagate at different velocities, refraction occurs, caused by bending of the wave beam.

See also Refraction Artifact, Acoustic Shadowing, Acoustic Mismatch, and Duplication Artifact.

Different sound velocities in tissue are causing refraction artifacts. With convex elastomer lens transducers, sound beam refraction at the skin interface can alter the transducer's focusing characteristics and beam profile, cause element to element nonuniformity, and cause phase changes in the acoustic wave. These cumulative refraction induced errors degrade the image quality through distortion and loss of resolution. Because the amount of refraction is proportional to the velocity mismatch, the greater the mismatch, the greater the refraction.

Acoustic mismatch arise at the boundary between two different media where reflection and refraction occur.

See also Snells Law.

Through diffraction and refraction on intersections edge acoustic shadowing can be created. The acoustic shadowing artifact is the loss of information below a dense object because the majority of the sound energy was reflected back by the object.
Shadowing artifacts occur if decreasing of the echo amplitude is not exponential with penetration depth caused by inhomogeneous tissue layers and fluid or air-filled regions. Bone, air, foreign bodies and calcification stop the transmission of sound waves producing a 'sonic shadow' which is a dark region distal to the echogenic obstructing region. This artifact occurs also in objects like e.g. prosthetic valves.

See also Boundary Layer, and Half-Value Layer.

Duplication artifacts can be created through diffraction and refraction on interfaces, also if the acoustical impedances of tissue is too much different and the ultrasound is reflected multiple on tissue layers, where the detected echo does not come from the shortest sound path.

See also Mirror Artifact.