(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.

Harmonic B-mode imaging takes advantage of the non-linear oscillation of microbubbles. During harmonic imaging, the sound signal is transmitted at a frequency of around 1.5 to 2.0 MHz and received at twice this frequency. The microbubbles also reflect waves with wavelengths different from the transmitted one, the detectors can be set to receive only the latter ones and create only images of the contrast agent.
Using bandpass filters the transmitted frequency is separated from the received signal to get improved visualization of vessels containing ultrasound contrast agents (USCAs). The signal to noise ratio during the presence of microbubbles in tissue is four- to fivefold higher at the harmonic compared with the basic frequency.
Using harmonic B-mode imaging, harmonic frequencies produced by the ultrasound propagation through tissue have to be taken into account. The tissue reflection produces only a small amount harmonic energy compared to USCAs, but has to be removed by background subtraction for quantitative evaluation of myocardial perfusion.

See also Non-linear Propagation.

(THI) Tissue harmonic imaging (also called native harmonic imaging) is a signal processing technique which addresses ultrasound limitations like penetration and resolution. Tissue harmonic imaging reduces noise and clutter by improving signal to noise ratio and resolution. The signal penetration in soft tissue increases as the transmit frequency is decreased, by simultaneous decreased image resolution. As an ultrasound wave propagates through the target media a change occurs in the shape and frequency of the transmitted signal. The change is due to the normal resistance of tissue to propagate sound energy. This resistance and the resulting signal change is called a harmonic oscillation.
For harmonic imaging the input frequency doubles the output frequency, for example a transmit frequency of 3.0 MHz. which would provide maximum penetration will return a harmonic frequency of 6.0 MHz. The returning higher frequency signal has to only travel one direction to the probe. The advantages of high frequency imaging and the one-way travel effect are decreased reverberation, beam aberration, and side lobes, as well as increased resolution and cystic clearing.

(CHI) Contrast harmonic imaging is an ultrasound technique to improve the measurement of blood perfusion or capillary blood flow. Based on the nonlinear properties of contrast agents, CHI transmits at the fundamental frequency but receives at the second harmonic. Contrast enhanced echo signals contain significant energy components at higher harmonics (bubbles acts as harmonic oscillators), while tissue echoes do not. Caused by that contrast signal can be separated from tissue echoes by the characteristic signal.
In combination with the pulse inversion technique, CHI promises very high contrast agent sensitivity with high spatial resolution.

See also Ultrasound Contrast Agent Safety and Hemoglobin.

Standard scanners allow visualizing microbubbles on conventional gray scale imaging in large vascular spaces. In the periphery, more sensitive techniques such as Doppler or non-linear gray scale modes must be used because of the dilution of the microbubbles in the blood pool. Harmonic power Doppler (HPD) is one of the most sensitive techniques for detecting ultrasound contrast agents.
Commonly microbubbles are encapsulated or otherwise stabilized to prolong their lifetime after injection. These bubbles can be altered by exposure to ultrasound pulses. Depending on the contrast agent and the insonating pulse, the changes include deformation or breakage of the encapsulating or stabilizing material, generation of free gas bubbles, reshaping or resizing of gas volumes.
High acoustic pressure amplitudes and long pulses increase the changes. However, safety considerations limit the pressure amplitude and long pulses decrease spatial resolution. In addition, lowering the pulse frequency increases destruction of contrast bubbles. However, at low insonation power levels, contrast agent particles resist insonation without detectable changes. Newer agents are more reflective and will usually allow gray scale imaging to be used with the advantages of better spatial resolution, fewer artifacts and faster frame rates.

Feasible imaging methods with advantages in specific acoustic microbubble properties:
Resonating microbubbles emit harmonic signals at double their resonance frequency. If a scanner is modified to select only these harmonic signals, this non-linear mode produces a clear image or trace. The effect depends on the fact that it is easier to expand a bubble than to compress it so that it responds asymmetrically to a symmetrical ultrasound wave. A special array design allows to perform third or fourth harmonic imaging. This probe type is called a dual frequency phased array transducer.

See also Bubble Specific Imaging.