Reflux is the backward flow of fluids. For example, reflux of blood with proximal limb compression is an indicator of venous valvular incompetence.

See also Reflux Sonography.

Reflux sonography, as an alternative to micturating cystography (MCU), evaluates vesico-ureteral reflux (VUR), a common problem in children. Contrast enhanced pulse-inversion imaging shows best results. During the instillation of an ultrasound contrast agent into the bladder, (as for a conventional MCU) the lower ureters and renal pelves are scanned transabdominally as the bladder is filled to stimulate micturition.
Advantages for reflux sonography are a high sensitivity and the avoidance of X-rays. A disadvantage is the poorer depiction of the posterior urethra. However, for girls and for all follow-up studies, the ultrasound MCU has become standard in many pediatric ultrasound departments.

See also Urologic Ultrasound, Kidney Ultrasound, Ultrasound Safety, Ultrasound Imaging Modes.

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.

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.

Reject is a time gain compensation control that allows the sonographer to reduce the returning signal from more shallow structures in the body.