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Current real-time volumetric scanners use a 2-D array to scan a pyramidal volume consisting of many sector scans stacked in the elevation direction. This scan format is primarily useful for cardiac imaging to avoid interference from the ribs. However, a real-time rectilinear volumetric scan with a wider field of view close to the transducer could prove more useful for abdominal, breast, or vascular imaging. In previous work, computer simulations of very sparse array transducer designs in a rectilinear volumetric scanner demonstrated that a Mills cross array showed the best overall performance given current system constraints. Consequently, a 94/spl times/94 Mills cross array including 372 active channels operating at 5 MHz has been developed on a flexible circuit interconnect. In addition, the beam former delay software and scan converter display software of the Duke volumetric scanner were modified to achieve real-time rectilinear volumetric scanning consisting of a 30-mm/spl times/8-mm/spl times/60-mm scan at a rate of 47 volumes/s. Real-time rectilinear volumetric images were obtained of tissue-mimicking phantoms, showing a spatial resolution of 1 to 2 mm. Images of carotid arteries in normal subjects demonstrated tissue penetration to 6 cm.