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An adaptive anisotropic diffusion algorithm based on edge estimate is proposed for medical ultrasound image. The algorithm makes full use of edge information and gradient difference in the horizontal and vertical directions, uses GHAD method to set gradient threshold for two directions, overcomes the poor robustness of traditional gradient threshold. The improved diffusion coefficient ameliorates traditional coefficient’s shortcomings of convergence and edge smoothing. Compared with other similar methods, experiments show that the proposed algorithm has better performance for noise removal (PSNR) and edge-preservation (FOM). 