The rarefactional pressure is the amplitude of a negative instantaneous sound pressure in an ultrasound beam. Rarefaction is the reduction in pressure of the medium during the acoustic cycle.

See also Mechanical Index.

Rayleigh scattering is the backscattering of ultrasound from blood. The echoes detected from blood are created through interference between scattered wavelets from numerous point scatterers. Rayleigh Scatterers are objects whose dimensions are much less than the ultrasound wavelength. Rayleigh scattering increases with frequency raised to the 4th power and provides much of the diagnostic information from ultrasound. Doubling the ultrasonic frequency makes the echoes from blood 16 times as strong. The intensity of the backscattered echoes is proportional to the total number of scatterers, which means that the echo amplitude is proportional to the square root of the total number of scatterers.
At normal blood flow, the number of point scatterers in blood is proportional to the number of red blood cells. When blood flow is turbulent, or accelerating fast (e.g. in a stenosis), the number of inhomogeneities in the red blood cell concentration will increase.

See also Scattered Echo.

Real-time mode has been developed to present motion like a movie of the body's inner workings, showing this information at a high rate. The special real-time transducer uses a larger sound beam than for A, B or M-modes. A linear array transducer with multiple crystal elements displays real-time compound B-mode images with up to 100 images per second.
At each scan line, one sound pulse is transmitted and all echoes from the surface to the deepest range are received. Then the ultrasound beam moves on to the next scan line position where pulse transmission and echo recording are repeated.

See also Compound B-Mode, Pulse Inversion Doppler, and Frame Averaging.

Most usual ultrasound machines are 2D real-time systems. This types of ultrasound scanners allow to assess both motion and anatomy, including the motion of heart valves, the movement of intestines and lungs and also to guide interventions, like for example a biopsy or a laparoscopic ultrasound.
A standard real-time scanner consists of a mobile console with the monitor on the top and rows of small containers at the bottom to accommodate a variety of scanner probes. The linear, curved or phased array transducers are usually equipped with multiple crystals or in some cases with a moving crystal. A real-time scanner may be e.g., a mechanical scanner or electronic array scanner.

See also Musculoskeletal and Joint Ultrasound.

Transducers used for the real-time mode are different than for the A-mode, B-, or M-modes. A linear array transducer with multiple piezoelectric crystal elements that are different arranged and fired, transmits the needed larger sound beam.
A subgroup of x adjacent elements (8-16; or more in wide-aperture designs) is pulsed simultaneously; the inner elements pulse delayed with respect to the outer elements. The interference of the x small divergent wavelets generates a focused beam. The delay time determining the focus depth of a real-time transducer can be changed during imaging.
Similar delay factors applied during the receiving phase, result in a dynamic focusing effect on the return. This forms a single scan line in the real-time image. To produce the following scan line, another group of x elements is selected by shifting one element position along the transducer array from the previous group. This pattern is then repeated for the groups along the array, in a sequential and repetitive way.