One of the major diagnostic objectives in using an ultrasound contrast agent in the liver is to detect flow in the circulation at a level that is lower than would otherwise be possible. The echoes from blood associated with such flow — in the sinusoids for example — exist in the midst of echoes from the surrounding solid structures of the liver parenchyma, echoes which are almost always stronger than even the contrast-enhanced blood echo. When they can be seen, blood vessels in a nonenhanced image have a low echo level, so that an echo-enhancing agent actually lowers the contrast between blood and the surrounding tissue, making the lumen of the blood vessel less visible.


Contrast Agent Ultrasound Contrast Agent Pulse Inversion Harmonic Imaging Harmonic Mode 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Apfel RE, Holland CK (1991) Gauging the likelihood of cavitation from short-pulse, low-duty cycle diagnostic ultrasound. Ultrasound Med and Biol 17:175–185Google Scholar
  2. Becher H (1997) Second harmonic imaging with Levovist: initial clinical experience. In: Cate FT, deJong N (eds) Second European Symposium on Ultrasound Contrast Imaging. Book of Abstracts. Erasmus Univ, Rotterdam p 24Google Scholar
  3. Becher H, Burns PN (2000) Handbook of Contrast echocardiography. Springer-Verlag Berlin, Scholar
  4. Bleeker H, Shung K, Barnhart J (1990) On the application of ultrasonic contrast agents for blood flowmetry and assessment of cardiac perfusion. J Ultrasound Med 9:461–471Google Scholar
  5. Brennan CE (1995) Cavitation and bubble dynamics. Oxford University Press, New YorkGoogle Scholar
  6. Burns PN, Powers JE, Fritzsch T (1992) Harmonic imaging: a new imaging and Doppler method for contrast enhanced ultrasound. Radiology 185:142Google Scholar
  7. Burns PN, Powers JE, Hope Simpson D, Uhlendorf V, Fritzsch T (1993) Harmonic contrast enhanced Doppler as a method for the elimination of clutter - In vivo duplex and color studies. Radiology 189:285Google Scholar
  8. Burns PN, Powers JE, Hope Simpson D, Brezina A, Kolin A, Chin CT, Uhlendorf V, Fritzsch T (1994) Harmonic power mode Doppler using microbubble contrast agents: an improved method for small vessel flow imaging. Proc IEEE UFFC:1547–1550Google Scholar
  9. Burns PN, Wilson SR, Muradali D, Powers JE, Fritzsch T (1996a) Intermittent US harmonic contrast enhanced imaging and Doppler improves sensitivity and longevity of small vessel detection. Radiology 201:159Google Scholar
  10. Burns PN, Wilson SR, Muradali D, Powers JE, Greener Y (1996b) Microbubble destruction is the origin of harmonic signals from FS069. Radiology 201:158Google Scholar
  11. Burns PN, Wilson SR, Hope Simpson D (2000) Pulse inversion imaging of liver blood flow: An improved method for characterization of focal masses with microbubble contrast. Invest Radiol 35:58–71CrossRefGoogle Scholar
  12. Child SZ, Hartman CL, Schery LA, Carstensen EL (1990) Lung damage from exposure to pulsed ultrasound. Ultrasound Med and Biol 16:817–825CrossRefGoogle Scholar
  13. Chin CT, Burns PN (1997) Predicting the acoustic response of a microbubble population for contrast imaging. In: Proc. IEEE Ultrason. Symp., pp 1557–1560Google Scholar
  14. Dayton PA, Morgan KE, Klibanov AL, Brandenburger GH, Ferrara KW (1999) Optical and acoustical observations of the effects of ultrasound contrast agents. IEEE Transaction on Ultrasonics, Ferroelectrics, and Frequency Control 46:220–232CrossRefGoogle Scholar
  15. de Jong N (1997) Physics of microbubble scattering. In: Nanda NC, Schlief R, Goldberg BB (eds) Advances in echo imaging using contrast enhancement. Kluwer Academic Publishers, Dubai pp 39–64CrossRefGoogle Scholar
  16. Everbach EC, Makin IRS, Francis CW, Meltzer RS (1998) Effect of acoustic cavitation on platelets in the presence of an echo-contrast agent. Ultrasound Med and Biol 24:129–136CrossRefGoogle Scholar
  17. Hamilton MF, Blackstock DT (1998) Nonlinear acoustics. Academic Press, San DiegoGoogle Scholar
  18. Holland CK, Roy RA, Apfel RE, Crum LA (1992) In vitro detection of cavitation induced by a diagnostic ultrasound system. IEEE Trans. IEEE Transaction on Ultrasonics, Ferroelectrics, and Frequency Control 29:95–101CrossRefGoogle Scholar
  19. Hope Simpson D, Chin CT, Burns PN (1999) Pulse inversion doppler: a new method for detecting nonlinear echoes from microbubble contrast agents. IEEE Transactions UFFC 46:372–382CrossRefGoogle Scholar
  20. Kono Y, Moriyasu F, Nada T, Suginoshita Y, Matsumura T, Kobayashi K, Nakamura T, Chiba T (1997) Gray scale second harmonic imaging of the liver: a preliminary animal study. Ultrasound Med Biol 23(5):719–726CrossRefGoogle Scholar
  21. Miller DL, Gies RA, Chrisler WB (1997) Ultrasonically induced hemolysis at high cell and gas body concentrations in a thin-disk exposure chamber. Ultrasound Med and Biol 23:625–633CrossRefGoogle Scholar
  22. Miller DL, Thomas RM (1995) Ultrasound contrast agents nucleate inertial cavitation in vitro. Ultrasound Med Biol 21:1059–1065CrossRefGoogle Scholar
  23. Miller MW, Miller DL, Brayman A (1996) A review of in vitro bioeffects of inertial ultrasonic cavitation from a mechanistic perspective. Ultrasound Med and Biol 22:1131–1154CrossRefGoogle Scholar
  24. Mulvagh SL, Foley DA, Aeschbacher BC, Klarich KK, Seward JB (1996) Second harmonic imaging of an intravenously administered echocardiographic contrast agent: visualization of coronary arteries and measurement of coronary blood flow. J Am Coll of Cardiol 27:1519–1525CrossRefGoogle Scholar
  25. Neppiras EA, Nyborg WL, Miller PL (1983) Nonlinear behavior and stability of trapped micronsized cylindrical gas bubbles in an ultrasound field. Ultrasonics 21:109–115CrossRefGoogle Scholar
  26. Ophir J, Parker KJ (1989) Contrast agents in diagnostic ultrasound [published erratum appears in Ultrasound Med BioI 1990;16(2):209]. Ultrasound Med Biol 15:319–333CrossRefGoogle Scholar
  27. Plesset MS (1949) The dynamics of cavitation bubbles. J Appl Mech 16:272–282Google Scholar
  28. Poritsky H (1951) The collapse or growth of a spherical bubble or cavity in a viscous fluid. In: Sternberg E (ed) First U.S. National Congress on Applied Mechanics, Washington DC, pp 813–821Google Scholar
  29. Porter TR, Xie F (1995) Transient myocardial contrast after initial exposure to diagnostic ultrasound pressures with minute doses of intravenously injected microbubbles. Demonstration and potential mechanisms. Circulation 92:2391–2395Google Scholar
  30. Porter TR, Xie F, Kricsfeld D, Armbruster RW (1996) Improved myocardial contrast with second harmonic transient ultrasound response imaging in humans using intravenous perfluorocarbon-exposed sonicated dextrose albumin. Journal of the American College of Cardiology 27:1497–1501CrossRefGoogle Scholar
  31. Rayleigh L (1917) On the Pressure Developed in a Liquid During the Collapse of a Spherical Cavity. Philosophy Magazine Series 6:94–98CrossRefGoogle Scholar
  32. Taylor KJ, Burns PN, Wells PNT (1996) Clinical Applications of Doppler Ultrasound. New York: Raven PressGoogle Scholar
  33. Tiemann K, Lohmeier S, Kuntz S, Koster J, Pohl C, Burns P, Porter TR, Nanda NC, Luderitz B, Becher H (1999) Real-time contrast echo assessment of myocardial perfusion at low emission power: first experimental and clinical results using power pulse inversion imaging. Echocardiography 16:799–809CrossRefGoogle Scholar
  34. Uhlendorf V, Hoffmann C (1994) Nonlinear acoustical response of coated microbubbles in diagnostic ultrasound. Proc IEEE Ultrasonics Symp: 1559–1562Google Scholar
  35. Uhlendorf V, Scholle F-D (1996) Imaging of spatial distribution and flow of microbubbles using nonlinear acoustic properties. Acoustical Imaging 22:233–238CrossRefGoogle Scholar
  36. Williams AR, Kubowicz G, Cramer E (1991) The effects of the microbubble suspension SHU 454 (Echovist) on ultrasound-induced cell lysis in a rotating tube exposure system. Echocardiography 8:423–433CrossRefGoogle Scholar
  37. Wilson SR, Burns PN (2001) Liver Mass Evaluation With Ultrasound: The impact of microbubble contrast agents and pulse inversion imaging. Sem in Liver Dis 21:147–161CrossRefGoogle Scholar
  38. Wilson SR, Burns PN, Muradali D, Wilson J, Lai X (2000) Harmonic Hepatic Ultrasound with Microbubble Contrast Agent: Initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 215:153–161Google Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • P. N. Burns

There are no affiliations available

Personalised recommendations