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.

The perfect image quality is dependent on some assumptions of the propagation of ultrasound waves in tissues after generating in an imaging system. These assumptions are important for the developing of optimal ultrasound imaging systems.
A lot of steps can be taken to prevent artifacts and to improve image quality, for example beamforming is used to focus the ultrasound beam, and contrast agents decrease the reflectivity of the undesired interfaces or increase the backscattered echoes from the desired regions.

See also Coded Excitation, Validation and Refraction Artifact, Q-Value, Ultrasound Phantom, Dead Zone, Narrow Bandwidth.

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.

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.

Retrolenticular afterglow could occur through diffraction and refraction on interfaces. A circular object may act as a lens to the ultrasound beam, showing an artifact region of increased echogenicity.