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3D ultrasound images are updated in rapid succession, to create 4D ultrasound pictures. The fourth dimension is time, which adds movement and doppler study Used to evaluate blood flow and pressure within a blood vessel, Bounces high-frequency sound waves off blood cells in motion and records changes in frequency of the sound waves as they echo back to a transducer probe. The data is converted into a visual representation of how fast and in what direction blood is flowing.