A three dimensional ultrasonic imaging system acquires 3D image data from a volumetric region and processes the image data to produce a live 3D image of the volumetric region in a given orientation. A user control can be switched by a user to present the image in a different orientation if desired. Both the anatomy in the 3D image and the image format can be inverted, and the left-right appearance of the 3D image can be reversed with a corresponding front-back reversal of the anatomy.