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Observed medical ultrasound images are degraded representations of the true tissue reflectance. The specular reflections at boundaries between regions of different tissue types are blurred, and the diffuse scattering within such regions also contains speckle. This reduces the diagnostic value of such images. In order to remove both blur and speckle, the authors develop a maximum a posteriori deconvolution algorithm for two-dimensional (2-D) ultrasound radio frequency (RF) images based on a new Markov random field image model incorporating spatial smoothness constraints and physical models for specular reflections and diffuse scattering. During stochastic relaxation, the algorithm alternates steps of restoration and segmentation, and includes estimation of reflectance parameters. The smoothness constraints regularize the overall procedure, and the algorithm uses the specular reflection model to locate region boundaries. The resulting restorations of some simulated and real RF images are significantly better than those produced by Wiener filtering.