Increased ultrasound contrast and decreased microbubble destruction rates with triggered ultrasound imaging

Although transient myocardial contrast imaging has been able to produce visually evident myocardial contrast in animals and humans with very low intravenous doses of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) microbubbles, the mechanism for improved contrast remains unclear. In this study we devised a flow chamber that measured the concentration of PESDA microbubbles that remained after exposure to diagnostic ultrasound pressures of 0.9 to 1.9 MPa and frequencies of 2.0, 2.5, and 3.5 MHz (first and second harmonic for 2.0 MHz), which were delivered at either 30 Hz (frames per second), 0.5 to 1.0 Hz, or without any ultrasound transmission. The videointensity within the flow chamber was also measured at 0, 20, 40, and 100 ml/min flow rates with the flow loop closed (i.e., constant microbubble concentration) with both triggered (0.5 to 1.0 Hz) and conventional (30 Hz) frame rates. The effluent microbubble concentration was significantly larger when PESDA was exposed to either no ultrasound or 0.5 to 1.0 Hz ultrasound. Furthermore, the videointensity of a constant number of microbubbles was significantly greater with 0.5 to 1.0 Hz (triggered) compared with 30 Hz (conventional) frame rates at each transmit frequency. The greatest difference was noted with the lower 2.0 MHz transmit frequency and the 20 ml/min flow rate, especially when a second harmonic receiving frequency was used. We conclude that the mechanism for improved contrast with triggered ultrasound imaging is because of both less microbubble destruction and increased videointensity from a constant number of microbubbles. Lower transducer frequencies and lower flow rates result in the greatest improvement in videointensity with triggered ultrasound transmission.