Solid regions have internal ultrasound echoes and are classified as echo poor, hypoechoic or hypoechogenic if there are few internal echoes. Hypoechoic structures appear dark in ultrasound imaging, more homogeneous structures are darker than heterogeneous.
Soft atherosclerotic plaque, liver adenoma or FNH appear with a nodular hypoechogenicity. As metastases close the blood vessels they infiltrate, tumor tissues become hypoechogenic after injection of contrast agent. Muscle appears relatively hypoechoic to tendon fibers, also articular hyaline cartilage appears hypoechoic.

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.

(IVUS) For intravascular ultrasound a small IVUS catheter with a probe is introduced into the artery. The transducer transmits and receives acoustic energy through this catheter. The reflected acoustic energy is used to build a picture of the inside of the vessel. A IVUS image consists of three layers around the lumen, the intima, media and adventitia.
In addition, elastography or palpography could be used to evaluate the local mechanical properties of tissues (e.g. lipid pools in high-risk vulnerable atherosclerotic plaques). These techniques use the deformation caused by the intraluminal pressure generated by the probe.
A high strain region at the lumen vessel wall boundary has 88% sensitivity and 89% specificity for identifying vulnerable plaques. There are high strain values of 1% in soft plaques with increased strain up to 2% at the shoulders of the plaque, while calcified material shows low strain values (0-0.2%). The radial strain in the tissue is obtained by cross-correlation techniques on the radio frequency signal. The strain is color-coded and plotted as a complimentary image to the intravascular ultrasound echogram.

See also Interventional Ultrasound, Vascular Ultrasound.

From Hitachi Medical Systems America Inc.;
The EUB-405 PLUS ultrasound system is a small portable unit and offers extreme dependability and uncompromising image quality. Compatible with a wide range of transducers, this system is a cost effective solution for a variety of clinical settings. A variety of measurements and calculations including distance, area, circumference, volume, are possible.

From Philips Medical Systems;
'The SONOS 5500 has all the advanced features you want in a high-performance ultrasound system. Exceptional image quality, revolutionary contrast imaging tools, unique quantitative techniques, extensive applications, and an intuitive user interface allow the most comprehensive echo exams possible.'

Specifications for this system will be available soon.