Ultrasound contrast agents (USCAs) improve the sensitivity of various ultrasound applications. They usually stay within the vascular space and can be injected several times. Nevertheless the contrast enhancement is limited caused by physiologic clearance and bubble destruction.

Different injection techniques to improve the imaging:
Continuous infusion yield a steady-state concentration of the USCAs, greater examination time with optimal enhancement, avoid bloom and possibly other artifacts. Continuous infusion also allows the sonographer to optimize the effective dose individually during the examination.

See also Power Modulation.

Contrast microbubbles can be destroyed by intense ultrasound and the scattered signal level can increase abruptly for a short time during microbubble destruction, resulting in an acoustical flash (sudden increase in echogenicity).
Intermittent imaging with high acoustic output utilizes the properties of contrast microbubbles to improve blood-to-tissue image contrast by imaging intermittently at very low frame rates.
The frame rate is usually reduced to about one frame per second, or it is synchronized with cardiac cycles so that enough contrast microbubbles can flow into the imaging site where most microbubbles have been destroyed by the previous acoustic pulse. Because bubbles are destroyed by ultrasound, controlling the delay time between frames produces images whose contrast emphasizes regions with rapid blood flow rate or regions with high or low blood volume.

A negative bolus is created after microbubble destruction at a specific location by the absence of bubbles.

(HPD) Harmonic power Doppler is currently one of the most sensitive techniques for detecting ultrasound contrast agents. HPD works by transmitting multiple pulses toward the object to be imaged and detecting the pulse-to-pulse changes in the received echo signals.
Second harmonic bandbass filtering is applied to the received signals to exploit the non-linear behavior of scattering from bubbles (clutter). Harmonic power Doppler operates best at high output levels because of increased contrast destruction, and pulse amplitudes close to the maximum allowed are used much of the time.
With a high mechanical index, non-linear propagation of the sound will cause significant harmonic components from tissue, and the contrast agent to tissue ratio will decrease.
Also called Harmonic Power Angio. See also Multiple Frame Trigger.

From Bracco Research S. A., Geneva, Switzerland
BG1135 is a polymer-shelled new ultrasound contrast agent under development. The air-filled microsphere has a rigid, 100 nm thick polymeric shell and a mean diameter of 2.9 μm with 99% less than 8 μm.
The destruction mechanism of BG1135 is unique among microbubbles. The microbubbles of BG1135 appear to acquire a small shell defect, allowing the filling gas to stream out and creating a new gas bubble, but leaving the old shell intact. No significant differences between the diameters of the shells can be measured before and after insonation even though the agent is fragmented.