(CPS) Contrast pulse sequencing is a technique to exploit contrast agent properties with series of three pulses that differ in phase and amplitude. CPS allows bubble specific imaging with non-linear fundamental and higher order harmonics, low MI, and extremely high microbubble-to-tissue background ratio.

See also Ultrasound Contrast Agent Safety.

Harmonic imaging relies on detection of harmonics of the transmitted frequency produced by bubble oscillation. This method is widely available on ultrasound scanners and uses the same array transducers as conventional imaging. A major limitation of the use of ultrasound contrast agents is the problem that signals from the microbubbles are mixed with those from tissue. Echoes from solid tissue and red blood cells are suppressed by harmonic imaging.
In harmonic mode, the system transmits at one frequency, but is tuned to receive echoes preferentially at double that frequency, and the second harmonic echoes from the place of the bubble. Typically, the transmit frequency lies between 1.5 and 3 MHz and the receive frequency is selected by means of a bandpass filter whose center frequency lies between 3 and 6 MHz.
Color Doppler and real-time harmonic spectral Doppler modes have also been implemented and show a level of tissue motion suppression not available in conventional modes.

See also Harmonic B-Mode Imaging, and Harmonic Power Doppler.

The earliest introduction of vascular ultrasound contrast agents (USCA) was by Gramiak and Shah in 1968, when they injected agitated saline into the ascending aorta and cardiac chambers during echocardiographic to opacify the left heart chamber. Strong echoes were produced within the heart, due to the acoustic mismatch between free air microbubbles in the saline and the surrounding blood.

(AE) Induced acoustic emission is an effect of ultrasound contrast agents, presenting the interaction between the agent and the incident ultrasound wave.
Microbubbles break down in high-amplitude diagnostic ultrasound energy. The bubble rupture produces a transient pressure wave, which results in a characteristic mosaic pattern from tissues containing the agent. It is important to note that the color patterns of induced acoustic emission do not represent flow signals.

Linear scattering occur from specular reflectors or tissue, in which the echo is an accurate copy of the incident ultrasound pulse. If the phase or amplitude of the transmitted sound is altered, the phase or amplitude of the echo will be also altered.
Non-linear scatterers, such as microbubbles, do not follow these rules.