(TCD) Transcranial color Doppler sonography allows to evaluate the presence and flow direction of vessels as well as their relationships to surrounding structures.
A disadvantage of cerebrovascular ultrasonography is the attenuation of the ultrasound signal by the skull. The loss of power through the skull is considerable, the signal to noise ratio is poor and so contrast enhanced Doppler imaging is advantageous. The use of ultrasound contrast agents provides a diagnostic window of sufficient duration and imaging quality to improve an evaluation of the cerebral vessels. Contrast TCD also results in visualization of small arteries and veins and greater length of these vessels.

See also A-Mode, Cranial Bone Thermal Index, Transcranial Color Coded Sonography and Transcranial Window.

(UCA / USCA) Ultrasonography is the most commonly performed diagnostic imaging procedure. The introduction of sonographic contrast media into routine practice modifies the use of ultrasound in a variety of clinical applications. USCAs consist of microbubbles filled with air or gases and can be classified according to their pharmacokinetics. Among the blood pool agents, transpulmonary ultrasound contrast agents offer higher diagnostic potential compared to agents that cannot pass the pulmonary capillary bed after a peripheral intravenous injection. In addition to their vascular phase, some USCAs can exhibit a tissue- or organ-specific phase.
The sonogram image quality is improved either by decreasing the reflectivity of the undesired interfaces or by increasing the backscattered echoes from the desired regions.

Different types of ultrasound contrast agents:
Ultrasound contrast agents act as echo-enhancers, because of the high different acoustic impedance at the interface between gas and blood. The enhanced echo intensity is proportional to the change in acoustical impedance as the sound beam crosses from the blood to the gas in the bubbles.

The ideal qualities of an ultrasound contrast agent:
A typical ultrasound contrast agent consists of a thin flexible or rigid shell composed of albumin, lipid, or polymer confining a gas such as nitrogen, or a perfluorocarbon. The choice of the microbubble shell and gas has an important influence on the properties of the agent.
Current generations of microbubbles have a diameter from 1 μm to 5 μm. The success of these agents is mostly dependent on the small size and on the stability of their shell, which allows passage of the microbubbles through the pulmonary circulation. Microbubbles must be made smaller than the diameter of capillaries or they would embolize and be ineffective and perhaps even dangerous.
The reflectivity of these microbubbles is proportional to the fourth power of a particle diameter but also directly proportional to the concentration of the contrast agent particles themselves.
Ultrasound contrast agents produce unique acoustic signatures that allow to separate their signal from tissue echoes and to depict whether they are moving or stationary. This enables the detection of capillary flow and of targeted microbubbles that are retained in tissues such as normal liver.
The new generation of contrast media is characterized by prolonged persistence in the vascular bed which provides consistent enhancement of the arterial Doppler signal. Contrast agents make it also possible to perform dynamic and perfusion studies. Targeted contrast imaging agents are for example taken up by the phagocytic cell systems and thus have liver/spleen specific effects.

See also Ultrasound Contrast Agent Safety, Adverse Reaction, Tissue-Specific Ultrasound Contrast Agent, and Bubble Specific Imaging.

A zone is a focal region of the ultrasound beam. An ultrasound beam can be directed and focused at a transmit focal zone position. The axial length of the transmit focal zone is a function of the width of the transmit aperture.
The field to be imaged is deepened by focusing the transmit energy at progressively deeper points in the body, caused by the beam properties. Typically, multiple zones are used. The main reason for multiple zones is that the transmit energy needs to be greater for points that are deeper in the body, because of the signal's attenuation as it travels into the body.

Beam zones:
The tightest focus and the narrowest beam widths for most conventional transducers are in the mid-field within the zone where the acoustic lens is focused. The ultrasound beam is less well focused and, therefore, wider in the near and far fields which are superficial and deep to the elevation plane focal zone. The beam width is greater in the near and far fields, making lesions in these locations more subject to a partial volume artifact.

See also Derated Quantity.