A liver sonography is a diagnostic tool to image the liver and adjoining upper abdominal organs such as the gallbladder, spleen, and pancreas. Deeper structures such as liver and pancreas are imaged at a lower frequency 1-6 MHz with lower axial and lateral resolution but greater penetration. The diagnostic capabilities in this area can be limited by gas in the bowel scattering the sound waves.
The application of microbubbles may be useful for detection of liver lesions and for lesion characterization. Some microbubbles have a liver-specific post vascular phase where they appear to be taken up by the reticuloendothelial system (RES). Dynamic contrast enhanced scans in a similar way as with CT or MRI can be used to studying the arterial, venous and tissue phase.
After a bolus injection, early vascular enhancement is seen at around 30sec in arterialized lesions (e.g., hepatocellular carcinomas (HCC), focal nodular hyperplasia (FNH)). Later enhancement is typical of hemangiomas with gradually filling towards the center. In the late phase at around 90sec, HCCs appear as defects against the liver background. Most metastases are relatively hypovascular and so do not show much enhancement and are seen as signal voids in the different phases.
Either with an intermittent imaging technique or by continuous scanning in a nondestructive, low power mode, characteristic time patterns can be used to differentiate lesions.

See also Medical Imaging, B-Mode, High Intensity Focused Ultrasound, Ultrasound Safety and Contrast Medium.

Albunex and Infoson, used mainly in cardiac evaluations, are first generation one-pass-only contrast agents and have been replaced by the new-generation contrast media. Albunex and Infoson are the same sonicated human serum albumin microbubbles. Infoson is licensed and manufactured in Europe, while Albunex was produced in the USA.
Albunex, an air-filled microbubble with a denatured albumin shell (modified from air-filled albumin microspheres prepared from sonicated 5% human serum albumin), was the first FDA-approved contrast agent, but is no longer in production.
Cardiac shunts and valve regurgitations are often evaluated with Color Doppler Imaging (CDI), which also improved with injections of Albunex, but this agent is pressure-sensitive and does not recirculate. It is effectively a one-pass-only agent, limiting its clinical efficacy.

See also First generation USCA, Echocardiography and Contrast Enhanced Ultrasound.

By Byk-Gulden (now Altana);
The transpulmonary echo contrast agent under development, BY 963, promises to be an excellent ultrasound contrast agent for the noninvasive assessment of left ventricular function. Intravenous administration of BY 963 phospholipid microbubbles improves the reproducibility of e.g. quantitative analysis.

Myomap is an investigational ultrasound contrast agent for assessment of myocardial perfusion and has been tested in animals to determine infarct volumes in cases of coronary artery occlusion. The deposit microbubbles of Myomap consist of air filled human serum albumin microcapsule with a thick and rigid shell.

Quantison, consisting of air-filled microbubbles with stiff and rigid human serum albumin shells, is an investigational ultrasound contrast agent for the assessment of coronary artery disease.
The stiff shell inhibits the bubbles from oscillating and decrease non-linear scattering. Quantison is capable of long lasting cavity contrast and myocardial opacification using intermittent imaging.