Imagent® is an injectable suspension for intravenous administration during a sonogram. This diagnostic contrast agent for enhancement of ultrasound images contains perflexane lipid microspheres. Imagent® US is indicated in the assessment of heart function and perfusion, as well as the detection of tumors and blood flow abnormalities by using gray scale, color Doppler, and harmonic ultrasound imaging techniques.
During the course of its development, the brand name for this product has changed from Imagent to Imavist (between August 2000 and March 2002) back to Imagent. The manufacturer's 06/03/02 press release announcing FDA approval refers to the product as 'Imagent (formerly Imavist),' and the approval notice and monograph posted at the FDA site refers to the product as Imagent.
Jointly developed by Alliance Pharmaceutical Corp and Bayer Schering Pharma AG (Germany). Source: PR Newswire - 10/10/96, 03/31/98, 10/13/99, 03/13/01, 10/08/01; FDA approvals - 05/31/02; Alliance Pharmaceutical press release - 06/03/02.
Currently the production of Imagent® is discontinued.

(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.

From Bayer Schering Pharma AG:
Available in Europe since 1996 and in Japan since 1999. Currently, the marketing situation is unclear.
Levovist® is a first generation USCA consisting of galactose (milk sugar) ground into tiny crystals whose irregular surfaces act as nidation sites on which air pockets form when it is suspended in water, much as soda water bubbles form at small irregularities on the surface of the glass. A trace of palmitic acid is added as a surfactant to stabilize the resultant microbubbles. When Levovist® dissolves in blood, air trapped inside the galactose is released as free gas bubbles. These bubbles have a weak encapsulating shell and are easily destroyed by ultrasound.
Different contrast ultrasonography methods have been developed since the introduction of Levovist®. Initially, Levovist® was an echo contrast medium for improving sensitivity in color Doppler and Power Doppler examinations, but was found to suffer from significant blooming, making it difficult to observe small blood vessels. However, Levovist® improves the accuracy of echocardiographic examinations in such indications as assessment of left ventricular function.
In addition to their vascular phase, some ultrasound contrast agents (USCAs) can exhibit a tissue- or organ-specific phase. Levovist® can accumulate within the liver and the spleen for up to 20 min once it has disappeared from the blood pool and improves the detectability of focal liver lesions and allows more reliable control of interventional tumor treatments. Varied types of information can be obtained by applying contrast imaging at different times after the injection using Levovist® in both the arterial phase and the late organ-specific phase.
1 g Levovist® granules contain 999 mg D-galactose and 1 mg palmitic acid.
Brand names in other countries: Levovist/Levograf

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.

(ESWL) Extracorporeal shock wave lithotripsy is a special use of kidney ultrasound, where high intensity focused ultrasound pulses are used to break up calcified stones in the kidney, bladder, or urethra. Pulses of sonic waves pulverize dense renal stones, which are then more easily passed through the ureter and out of the body in the urine. The ultrasound energy at high acoustic power levels is focused to a point exactly on the stone requiring an ultrasound scanning gel for maximum acoustic transmission.
Air bubbles in the ultrasound couplant, regardless of their size, degrade the performance of Lithotripsy and have the following effect:
Air bubbles smaller that 1/4 wavelength cause scattering of the sound waves as omni directional scatterers and less acoustic energy reaches the focal point. The result is less acoustic power at the focal point to disintegrate the kidney stone.
Air bubbles larger than 1/4 wavelength act as reflectors and deflects the acoustic energy off in a different direction. These results in less acoustic energy at the focal point.
Microbubbles dispersed throughout the ultrasound couplant layer change the average acoustic impedance of the gel layer (which reduces the total transmitted energy) and, due to refraction, change the focal point.