(PII) Pulse inversion imaging (also called phase inversion imaging) is a non-linear imaging method specifically made for enhanced detection of microbubble ultrasound contrast agents. In PII, two pulses are sent in rapid succession into the tissue; the second pulse is a mirror image of the first. The resulting echoes are added at reception. Linear scattering of the two pulses will give two echoes which are inverted copies of each other, and these echoes will therefore cancel out when added.
Linear scattering dominates in tissues. Echoes from linear scatterers such as tissue cancel, whereas those from gas microbubbles do not. Non-linear scattering of the two pulses will give two echoes which do not cancel out completely due to different bubble response to positive and negative pressures of equal magnitude. The harmonic components add, and the signal intensity difference between non-linear and linear scatterers is therefore increased. The resulting images show high sensitivity to bubbles at the resolution of a conventional image.
In harmonic imaging, the frequency range of the transmitted pulse and the received signal should not overlap, but this restriction is less in pulse inversion imaging since the transmit frequencies are not filtered out, but rather subtracted. Broader transmit and receive bandwidths are therefore allowed, giving shorter pulses and improved axial resolution, hence the alternative term wideband harmonic imaging. Many ultrasound machines offer some form of pulse inversion imaging.

See also Pulse Inversion Doppler, Narrow Bandwidth, Dead Zone, Ultrasound Phantom.

Sonazoid™ is an ultrasound contrast agent (UCA) consisting of stabilized gas microbubbles in an aqueous suspension. Sonazoid™ has overcome the stability problems of first generation USCA and can produce myocardial perfusion images. Myocardial imaging using ultrasound contrast agents provides diagnosis of chronic heart disease and assessment of the coronary arteries and of the coronary blood flow reserve.
Sonazoid™ is taken up by healthy Kupffer cells in the liver and spleen, but break down in high amplitude ultrasound imaging modes such as color Doppler imaging. The bubble rupture produces a transient pressure wave, which results in a characteristic mosaic color pattern from tissues containing the microbubbles (induced acoustic emission). Liver tumors without Kupffer cells will not display the mosaic pattern and can therefore be identified easily.

The source level is the acoustic power (sound pressure) in decibels (dB) referenced to 1.0 microPascal measured at 1 meter from the sound source transmitted through a unit area in a specified direction.
The unit of intensity is watt per square meter, but source level is commonly given as a relative intensity in dB.

Stress echocardiograms are used for detection of coronary artery disease, or to determine the cardiac performance. Stress echocardiograms are less performed to evaluate pulmonary artery pressures, pulmonary hypertension or the significance of valvular heart disease.
Stress increases the degree to which the heart contracts. After a myocardial infarction there will be a region of the heart muscle that contracts abnormal at rest. This area may worsen with stress. A coronary artery blockage most often do not impairs the function of the heart at rest. With stress, a region of the heart does not receive enough blood to work effectively and wall motion abnormalities occur. The echocardiographer compares rest and exercise and can determine the presence and severity of a coronary artery blockage.

Stress echocardiograms involve:
A bicycle stress echocardiogram involves transthoracic echocardiography performed at the rest baseline and after or during different stages of physical exercise.
A dobutamine stress echocardiography uses the drug dobutamine instead physical exercise.
Transthoracic echocardiograms are routinely performed during stress and rest.
Cardiovascular stress represents a minimal risk to the patient.

See also Transesophageal Echocardiography, Echocardiography, M-Mode, Curved Transducer, Doppler Ultrasound, History of Ultrasound and History of Ultrasound Contrast Agents.

Submicron ultrasound contrast agents are gas-filled, double-walled microspheres with a diameter smaller than 1 μm that rupture when exposed to ultrasound energy at megahertz frequencies. These agents differ from traditional ultrasound contrast microbubbles in that the submicron bubbles may serve as extravascular agents. They are small enough to travel through the lymphatic system and to be extravasated from tumor neovasculature. The detection of these agents is limited by their hard shell, which requires high-pressure ultrasound insonation for shell rupture and excitation of the gas bubble. After shell rupture, the gas diffuses rapidly from submicron sized agents. The optimal processing of each echo is important.