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.

Fetal ultrasound is a safe and non-invasive imaging technique used to visualize and monitor the development of a fetus during pregnancy. It employs high-frequency sound waves to create detailed images of the baby, the placenta, and the uterus. Fetal ultrasound provides valuable information about the baby's growth, organ development, and overall well-being. It is commonly used to determine gestational age, assess fetal anatomy, detect abnormalities, and monitor fetal movements and heart rate. This essential tool enables healthcare professionals to ensure the optimal health of both the mother and the baby throughout the pregnancy.
The FDA (Food and Drug Administration) has established regulations governing ultrasound usage, including specific guidelines for fetal ultrasound examinations. These regulations permit an eight-fold increase in ultrasound intensity for fetal scans. They place considerably responsibility on the user to understand the output measurements, the mechanical index (MI), the thermal index (TI) and to use them in their scanning. The primary safety concern in prenatal diagnostic imaging is temperature rise. It is known that hyperthermia is teratogenic. The efforts of investigators have concentrated on defining the temperature increases and exposure times which may give rise to biological effects and on determining the ultrasound levels which might, in turn, lead to those temperature rises.
In fetal ultrasound, the highest temperature increase would be expected to occur at bone and the thermal index with bone at/near the focus (TIB) would give the 'worst case' conditions. The mechanical index and thermal index must be displayed if the ultrasound system is capable of exceeding an index of 1. The displayed indices are based on the manufacturer's experimental and modeled data. However, an independent study has demonstrated significant discrepancies over declared spatial peak time averaged intensity (I-SPTA) output of up to 400%.

See also ALARA Principle, Pregnancy Ultrasound and Doppler Fluximetry in Pregnancy.

Breast ultrasound (sonography or ultrasonography) it is an important tool in the characterization of breast lesions, detected with mammography or clinical breast examination. However, a breast sonogram is not approved by the U.S. Food and Drug Administration (FDA) as a screening tool for breast cancer and is used additional to a mammogram.
Ultrasound is useful in guiding needles for fine needle aspiration and core biopsies. Breast ultrasound has optimal contrast resolution, but it lacks the spatial resolution of conventional mammography and cannot provide as much detail as a mammogram image. In addition, ultrasound is unable to show tiny calcium deposits (microcalcifications) that are often early indications of breast cancer.

See also Biopsy, Interventional Ultrasound, Ultrasound Safety, Side Effect and Ultrasound Regulations.

Ultrasonography of the kidneys (renal ultrasound) is part of a complete examination of the abdomen. Ultrasound is used to determine the size, shape, and exact position of the kidneys. Renal ultrasound provides important information regarding kidney function, related blood vessels, kidney stones, renal cysts, tumors, or hydronephrosis (suggestive of obstruction or blockage of the kidney).
The kidneys are scanned on longitudinal and transverse planes. Patients should avoid carbonated drinks such as soda or seltzer the day before, and have a full bladder for the test.
Lithotripsy is a therapeutic ultrasound procedure used to shatter simple stones in the kidney or upper urinary tract.

See also Urologic Ultrasound, Reflux Sonography.

As far as ultrasound is concerned, 4D ultrasound (also referred to as live 3D ultrasound or 4B-mode) is the latest ultrasound technology - the fourth dimension means length, width, and depth over time. 4D Ultrasound takes 3D ultrasound images and adds the element of time to the progress so that a moving three-dimensional image is seen on the monitor. A 4D scan takes the same amounts of time as a 2D or 3D scan; the difference is the ultrasound equipment being used. One advantage of a 4D fetal ultrasound to a 2D-mode is that parents can see how their baby will generally look like. However, there are different opinions over the medical advantages.
To scan a 3D ultrasound image, the probe is swept over the maternal abdomen. A computer takes multiple images and renders the 3D picture. With 4D imaging, the computer takes the images as multiple pictures while the probe is hold still and a 3D image is simultaneously rendered in real time on a monitor.
In most cases, the standard 2D ultrasound is taken, and then the 3D/4D scan capability is added if an abnormality is detected or suspected. The 3D/4D sonogram is then focused on a specific area, to provide the details needed to assess and diagnose a suspected problem. A quick 4D scan of the face of the fetus may be performed at the end of a routine exam, providing the parents with a photo.
See also Obstetric and Gynecologic Ultrasound, Pregnancy Ultrasound, Fetal Ultrasound and Abdominal Ultrasound.