Standard scanners allow visualizing microbubbles on conventional gray scale imaging in large vascular spaces. In the periphery, more sensitive techniques such as Doppler or non-linear gray scale modes must be used because of the dilution of the microbubbles in the blood pool. Harmonic power Doppler (HPD) is one of the most sensitive techniques for detecting ultrasound contrast agents.
Commonly microbubbles are encapsulated or otherwise stabilized to prolong their lifetime after injection. These bubbles can be altered by exposure to ultrasound pulses. Depending on the contrast agent and the insonating pulse, the changes include deformation or breakage of the encapsulating or stabilizing material, generation of free gas bubbles, reshaping or resizing of gas volumes.
High acoustic pressure amplitudes and long pulses increase the changes. However, safety considerations limit the pressure amplitude and long pulses decrease spatial resolution. In addition, lowering the pulse frequency increases destruction of contrast bubbles. However, at low insonation power levels, contrast agent particles resist insonation without detectable changes. Newer agents are more reflective and will usually allow gray scale imaging to be used with the advantages of better spatial resolution, fewer artifacts and faster frame rates.

Feasible imaging methods with advantages in specific acoustic microbubble properties:
Resonating microbubbles emit harmonic signals at double their resonance frequency. If a scanner is modified to select only these harmonic signals, this non-linear mode produces a clear image or trace. The effect depends on the fact that it is easier to expand a bubble than to compress it so that it responds asymmetrically to a symmetrical ultrasound wave. A special array design allows to perform third or fourth harmonic imaging. This probe type is called a dual frequency phased array transducer.

See also Bubble Specific Imaging.

A microbubble shell, designed to reduce diffusion into the blood, can be stiff (e.g., denatured albumin) or more flexible (phospholipid), varying in thickness from 10-200 nm.
The shell stabilizes against dissolution and coalescence with additional materials at the gas-liquid interface. This material can be an elastic solid shell that enhances stability by supporting a strain to counter the effect of surface tension. Also a surfactant, or a combination of two or more, improves the stability by a high reduction of the surface tension at the interface. Current ultrasound contrast agents are micron-sized bubbles with a stabilizing shell.

Microbubbles filled with air or inert gases are used as contrast agents in ultrasound imaging. Compression and rarefaction created by an ultrasound wave insonating a gas-filled microbubble along with the mechanical index of the ultrasonic beam lead to volume pulsations of the bubbles, and it is this change that results in the signal enhancement.
Microbubbles have diameters from 1 μm to 10 μm and a thin flexible or rigid shell composed of albumin, lipid, or polymer confining a gas such as nitrogen, or a perfluorocarbon. These microbubbles can cross the pulmonary capillaries and have a serum half-life of a few minutes. Microbubbles in the 1-10 μm range have their resonance at the frequencies used in diagnostic ultrasound (1−15MHz). Smaller bubbles resonate at higher frequencies. Caused by this coincidence, they are such effective reflectors.
The intrinsic compressibility of microbubbles is approximately 17,000 times more than water, and they are very strong scatterers of ultrasound. Under acoustic pressure the vibrating bubble radius may have a conventional linear response or a harmonic non-linear response. Microbubbles usually increase the Doppler signal amplitude by up to 30 dB.

The array of elements of microconvex probe is curved with a certain radius. Microconvex probes have a much smaller contact surface, which improves the coupling between the transducer and the skin surface even in complicated areas as the supraclavicular or jugular fossa. Microconvex probes, with large aperture and selection of transmission frequencies are also used in gynecological diagnostic.

See also Transvaginal Echography, Endocavitary Echography and Transrectal Ultrasonography.

The mirror artifact is similar to the reverberation artifact. Mirror image artifacts (mirroring) can occur if the acoustical impedances of the tissue is too much different and the ultrasound is reflected multiple times on tissue layers. The echo detected does not come from the shortest sound path, the sound is reflected off an angle to another interface so that like a real mirror, the artifact shows up as the virtual object.
An empyema or lung abscess can be simulated by a mirror image artifact of a hepatic cyst. This liver lesion can appear like a lesion within the lung because the wave is reflected off the diaphragm back into the liver. The angle of reflection is equal to the angle of incidence. The sound pulse hits the interfaces within the liver lesion and is reflected back to the diaphragm once again with an angle of reflection equal to the angle of incidence and then back to the transducer.
Also by a pelvic ultrasound scan the sound can be reflected off the rectal air at an angle so that the deep wall of an artifactual cyst represents the mirror image of the inferior and anterior walls of the bladder. Mirror image artifacts can cause other strange appearances such as invasion of a transitional cell carcinoma through the bladder wall.
Also called Cross Talk.