The Doppler signal from any range gate is proportional to the number of red blood cells moving through during the periods of its read out, so the amplitude (or loudness) works as an indicator of the number of blood cell reflectors.
High Doppler amplitudes are generated by large pulsed Doppler or color Doppler imaging range gates and large vessels.

See also Amplitude Map, Color Amplitude Imaging.

(CAI) Color amplitude imaging shows the amplitude of the Doppler signal from moving blood flow. CAI is an ultrasound technique with increased dynamic range and flow sensitivity. The sensitivity of Doppler ultrasound increases markedly in conjunction with the use of vascular contrast agents.

See also Amplitude Map, Amplitude Indicator.

(PWD) Pulsed wave (PW) Doppler is a Doppler ultrasound mode that evaluates blood flow velocities in a range specific area along the length of the sound beam. Measured are changes in received frequency due to relative motion (flow) between a sound source (transducer) and sound receiver (transducer).
PW Doppler produces an audible signal as well as a graphical representation of flow. The Doppler shift produced by moving blood flow is calculated by the ultrasound system.

See also Amplitude Indicator, Pulsed Ultrasound.

(DCPD) Directional color power Doppler combines power (amplitude) of Doppler signal with directional (phase) information to encode direction and variations in blood flow. DCPD is used in analysis of blood flow to assess blood vessel or vascular function.

See also Color Power Doppler, Quadrature Detection, and Directional Indicators.

(MI) The mechanical index is an estimate of the maximum amplitude of the pressure pulse in tissue. It is an indicator of the likelihood of mechanical bioeffects (streaming and cavitation). The mechanical index of the ultrasound beam is the amount of negative acoustic pressure within a ultrasonic field and is used to modulate the output signature of US contrast agents and to incite different microbubble responses.
The mechanical index is defined as the peak rarefactional pressure (negative pressure) divided by the square root of the ultrasound frequency.
The FDA ultrasound regulations allow a mechanical index of up to 1.9 to be used for all applications except ophthalmic (maximum 0.23). The used range varies from 0.05 to 1.9.
At low acoustic power, the acoustic response is considered as linear. At a low MI (less than 0.2), the microbubbles undergo oscillation with compression and rarefaction that are equal in amplitude and no special contrast enhanced signal is created. Microbubbles act as strong scattering objects due to the difference in impedance between air and liquid, and the acoustic response is optimized at the resonant frequency of a microbubble.
At higher acoustic power (MI between 0.2-0.5), nonlinear oscillation occurs preferentially with the bubbles undergoing rarefaction that is greater than compression. Ultrasound waves are created at harmonics of the delivered frequency. The harmonic response frequencies are different from that of the incident wave (fundamental frequency) with subharmonics (half of the fundamental frequency), harmonics (including the second harmonic response at twice the fundamental frequency), and ultra-harmonics obtained at 1.5 or 2.5 times the fundamental frequency. These contrast enhanced ultrasound signals are microbubble-specific.
At high acoustic power (MI greater than 0.5), microbubble destruction begins with emission of high intensity transient signals very rich in nonlinear components. Intermittent imaging becomes needed to allow the capillaries to be refilled with fresh microbubbles. Microbubble destruction occurs to some degree at all mechanical indices. A mechanical index from 0.8 to 1.9 creates high microbubble destruction. The output signal is unique to the contrast agent.