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.

Echoes of deep lying structures within the body do not always come from the latest emitted sound pulse and can produce an aliasing artifact. Aliasing lowers the frequency components when the pulse repetition frequency is less than 2 times the highest frequency of a Doppler signal. This artifact can be problematical at Spectral or Color Doppler examinations.
Aliasing of the data displayed in pulsed wave technology is utilized as a benefit in determining transitions from laminar to turbulent flow.

See also Ultrasound Imaging Modes.

The dimension of the ultrasound beam and the transducer array are the origin of the beam width artifact or volume averaging artifact. When the ultrasound beam is wider than the diameter of the lesion being scanned, normal tissues which lie immediately adjacent to the lesion arc included within the beam width, and their echotexture is averaged in with that of the lesion.
Thus, what appears to be the echogenicity of the lesion is really that of the lesion plus the averaged normal tissues. Because of volume averaging, cystic lesions may falsely appear to be solid, and some subtle solid lesions may become impossible to distinguish from surrounding normal tissue and, therefore, not identified at all.

See also Ultrasound Picture and Vector Array Transducer.

Cross talk is an ultrasound artifact in which strong sound signals in one directional channel leak into another, appearing as a mirror image of the spectral display on the opposite side of the baseline. Cross talk distinguishes the condition of undesired crossover of transmitted sound waves into the receiving transducer in a continuous wave Doppler system.
Also called Mirror 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.