Doppler ultrasound is a medical imaging technique for calculating the relative velocity between two points by measuring the frequency shift of a sound wave transmitted from one point to the other, based on the Doppler effect. Continuous or pulsed Doppler is frequently used to examine cardiovascular blood flow. The combination of routine 2D-mode and Doppler ultrasound allows a complete evaluation of the heart's anatomy and function (including the fetal heart). See also Doppler Fluximetry in Pregnancy.
Doppler ultrasound depends on the fact that if a moving object reflects the ultrasound waves, the echo frequencies are changed. A higher frequency is created if the object is moving toward the probe//transducer and a lower frequency if it is moving away from it. How much the frequency is changed depends upon how fast the object is moving. Doppler ultrasound shows the different rates of blood flow in different colors on a monitor in real time.
The major Doppler parameters are the peak systolic velocity and the end-diastolic velocity. The peak systolic velocity ratio compensates the variability between different patients and instrumentations.

Different Doppler and duplex techniques:

The Italian based company is a member of the Bracco Group.
In 1988 Ote-Biomedica Elettronica S.p.A. and the biomedical division of Esacontrol S.p.A. were consolidated into a single company, Esaote Biomedica S.p.A., operating as a division of IRI-Finmeccanica.
In 1987 the company began marketing its products in the United States through Biosound Inc., which it subsequently acquired in 1990.
In the 1990's, the company began to strengthen its presence in Europe, establishing Esaote Biomedica France Sarl and Esaote Biomedica Deutschland GmbH.
In July 1994 business activities and assets of Esaote Biomedica S.p.A. were transferred to the new company Esaote S.p.A.
1995-1998 the Bracco Group becoming the main Esaote shareholder with 50% of the share capital.
In February 1997, Esaote established Esaote China Ltd. located in Hong Kong, and in April 1998 acquired Pie Medical Group, based in Maastricht - The Netherlands, which primarily operates in medical diagnostic ultrasound. Esaote-Pie Medical, is exclusively dedicated to the development and marketing of veterinary diagnostic ultrasound equipment.
GE Healthcare is the exclusive U.S. distributor of devices manufactured by Esaote Biomedica.

'The Esaote Group is a global leader in research, production and marketing of medical diagnostic equipment and related services focused on solving the medical needs of our customers worldwide. With over 16% of its employees actively engaged in Research & Development, Esaote is pursuing new diagnostic technologies to be introduced in international healthcare markets.'

Ultrasound Related Product Lines:
For products dedicated to the veterinarian practice see Esaotes Pie Medical Equipment B.V.
For products distributed in the United States see Biosound Esaote, Inc.

Ultrasound Systems:

EchoGen® is a fluorocarbon-based (dodecafluoropentane) third generation USCA. EchoGen® consists of microbubbles stabilized with surfactants in a phase shift colloid emulsion (perflenapent). EchoGen® requires no preparation, reconstitution, or refrigeration.
Perflenapent emulsion would represent a significant advance in contrast echocardiography caused by effective and long lasting opacification of the left ventricle and enhanced endocardial border delineation.
The persistence of the contrast effect permits interrogation in multiple echocardiographic views, as well as the visualization and localization of myocardial perfusion deficits at rest by producing a negative contrast effect.
October 12, 2000
Sonus Pharmaceuticals, Inc. announced a strategic decision to refocus the Company on the development of its drug delivery and blood substitute products. At the same time, Sonus has withdrawn the NDA (New Drug Application) and discontinued clinical activity for its ultrasound contrast product, EchoGen®.
August 06, 2001
Sonus Pharmaceuticals, Inc. announced that it has entered into an agreement to sell its ultrasound contrast assets for $6.5 million to Amersham plc. As part of the agreement, Sonus has also assigned to Nycomed its interest in the ultrasound contrast patent license agreement entered into with Chugai Pharmaceutical Co. Ltd. and Molecular Biosystems Inc in January 2001.

Echocardiography is the ultrasound examination of the heart. Depending on the used ultrasound system, echocardiograms can be two-dimensional slices or 3D real-time images of the heart. Based on the ultrasound principles the direction and speed of blood flow can be utilized e.g., to diagnose a leaking or stenosed valve or to identify intracardiac shunts.

Different types of echocardiography:
The transthoracic echocardiogram (images are taken through the chest wall) is a non-invasive, highly accurate and quick assessment of the overall health of the heart.
A more invasive method is to insert a specialized scope containing an echocardiography transducer (TEE probe) into the esophagus, and record images from there. The advantages are clearer images, since the transducer is closer to the heart.
Contrast echocardiogram (CE) is already a valuable tool to delineate endocardial borders, direct invasive procedures, detect intracardiac shunts, assess myocardial perfusion and viability, and quantify coronary flow reserve and blood volumes (see also hemoglobin). The mechanism of microbubble CE is based on the physical principles of rarefaction and compression, leading to volume pulsations of microbubbles, and it is this change that results in CE signal.
Stress echocardiograms are echocardiography exams used for detection of coronary artery disease.

See also Diastole, Bicycle Stress Echocardiography, Resistive Index, and M-Mode Echocardiography.

Fetal ultrasound is a safe and non-invasive imaging technique used to visualize and monitor the development of a fetus during pregnancy. It employs high-frequency sound waves to create detailed images of the baby, the placenta, and the uterus. Fetal ultrasound provides valuable information about the baby's growth, organ development, and overall well-being. It is commonly used to determine gestational age, assess fetal anatomy, detect abnormalities, and monitor fetal movements and heart rate. This essential tool enables healthcare professionals to ensure the optimal health of both the mother and the baby throughout the pregnancy.
The FDA (Food and Drug Administration) has established regulations governing ultrasound usage, including specific guidelines for fetal ultrasound examinations. These regulations permit an eight-fold increase in ultrasound intensity for fetal scans. They place considerably responsibility on the user to understand the output measurements, the mechanical index (MI), the thermal index (TI) and to use them in their scanning. The primary safety concern in prenatal diagnostic imaging is temperature rise. It is known that hyperthermia is teratogenic. The efforts of investigators have concentrated on defining the temperature increases and exposure times which may give rise to biological effects and on determining the ultrasound levels which might, in turn, lead to those temperature rises.
In fetal ultrasound, the highest temperature increase would be expected to occur at bone and the thermal index with bone at/near the focus (TIB) would give the 'worst case' conditions. The mechanical index and thermal index must be displayed if the ultrasound system is capable of exceeding an index of 1. The displayed indices are based on the manufacturer's experimental and modeled data. However, an independent study has demonstrated significant discrepancies over declared spatial peak time averaged intensity (I-SPTA) output of up to 400%.

See also ALARA Principle, Pregnancy Ultrasound and Doppler Fluximetry in Pregnancy.