An ultrasound imaging system includes a cine buffer in which image frames produced during an examination are stored. A processor is programmed to select one or more image frames from the cine buffer for presentation to an operator for approval and inclusion in a patient record or other report. The operator can accept the proposed image frames or can select one or more other image frames from the cine buffer. The processor may select image frames at spaced intervals in the cine buffer for presentation. Alternatively, the processor compares image frames in the cine buffer with one or more target image frames. Image frames that are similar to the target image frames are presented to the operator to confirm. Alternatively, image frames can be selected by the processor that contain a specific feature or that are similar to image frames that were previously selected by the operator when performing a particular type of examination.