Tissue-specific ultrasound contrast agents improve the image contrast resolution through differential uptake. The concentration of microbubble contrast agents within the vasculature, reticulo-endothelial, or lymphatic systems produces an effective passive targeting of these areas. Other contrast media concepts include targeted drug delivery via contrast microbubbles.
Tissue-specific ultrasound contrast agents are injected intravenously and taken up by specific tissues or they adhere to specific targets such as venous thrombosis. These effects may require minutes to several hours to reach maximum effectiveness. By enhancing the acoustic differences between normal and diseased tissues, these tissue-specific agents improve the detectability of abnormalities.
Some microbubbles accumulate in normal hepatic tissue; some are phagocytosed by Kupffer cells in the reticuloendothelial system and others may stay in the sinusoids. Liver tumors without normal Kupffer cells can be identified by the lack of the typical mosaic color pattern of the induced acoustic emission. The hepatic parenchymal phase, which may last from less than an hour to several days, depending on the specific contrast medium used, may be imaged by bubble-specific modes such as stimulated acoustic emission (color Doppler using high MI) or pulse inversion imaging.

The traveling ultrasonic wave causes a low-level ultrasound radiation force when this energy is absorbed in tissues (absorbed dose). This force produces a pressure in the direction of the beam and away from the transducer. It should not be confused with the oscillatory pressure of the ultrasound wave itself. The pressure that results and the pressure gradient across the beam are very low, even for intensities at the higher end of the range of diagnostic ultrasound. Mechanical effects like radiation forces lead to stress at tissue interfaces. The effect of the force is manifest in volumes of fluid where streaming can occur with motion within the fluid. The fluid velocities which result are low and are unlikely to cause damage.
The effects of ultrasound radiation force (also called Bjerknes Forces) were first reported in 1906 by C. A. and V. F. K. Bjerknes, when they observed the attraction and repulsion of air bubbles in a sound field.
While incompressible objects do experience radiation forces, compressible objects driven at their resonant frequency experience far larger forces and can be observably displaced by low-amplitude ultrasound waves. A microbubble driven near its resonance frequency experiences a large net radiation force in the direction of ultrasound wave propagation. Ultrasound pulses of many cycles can deflect resonant microbubbles over distances on the order of millimeters.
In addition to primary radiation force, which acts in the direction of acoustic wave propagation, a secondary radiation force for which each individual bubble is a source and receptor causes the microspheres to attract or repel each other. The result of this secondary force is that a much larger concentration of microbubbles collects along a vessel wall than might otherwise occur.

See also Acoustically Active Lipospheres.

From Bracco Research SA, Geneva, Switzerland,
BR14 is a new experimental ultrasound contrast agent, consisting of bubbles containing a high molecular weight filling gas enclosed by a flexible phospholipid monolayer shell a few nanometers thick.
This agent shows significant non-linear scattering and agent modification even at low insonation pressures, the detection pulses used did not destroy the contrast bubbles. The results obtained with HPD before the release burst show that the BR14 bubbles are efficient scatterers that can be modified and, thus, detected by low power insonation.

Ultrasound waves are reflected when there is a change in acoustic impedance. The larger the change, the more ultrasound is reflected. Microbubbles have an enormous difference in acoustic impedance as compared to surrounding fluid due to the large differences in density, elasticity and compressibility.
At low acoustic power (mechanical index less than 0.1), the mechanism of ultrasound reflection is that of Rayleigh scattering and the microbubbles may be regarded as point scatterers. The scattering strength of a point scatterer is proportional to the sixth power of the particle radius and to the fourth power of the ultrasound frequency;; the echogenicity of such contrast agent is therefore highly dependent upon particle size and transmit frequency. The backscattered intensity of a group of point scatterers is furthermore directly proportional to the total number of scatterers in the insonified volume. The concentration of the contrast medium is of importance.

See also Backscatter Energy, Cross-section Scattering.

Bubble destruction describes the microbubble shell rupture by ultrasound pulses. The bubble destruction increases with increasing peak negative pressure and decreasing frequency. The mechanical index is an indicator for the effectiveness of microbubble destruction. Contrast enhanced ultrasound relies on bubble rupture to detect bubbles in small vessels.

See also Negative Bolus.