title: Blood flow assessment by ultrasound-induced destruction of echocontrast agents using harmonic power Doppler imaging: which parameters determine contrast replenishment curves?
abstract: OBJECTIVE
  To evaluate the feasibility of flow determinations by contrast replenishment using harmonic power Doppler imaging (H-PDI).
  
  
  BACKGROUND
  The application of indicator dilution principles on contrast echocardiography is limited by numerous methodical problems. Recently, a new method was introduced that relies on ultrasound-mediated microbubble destruction and evaluation of the contrast replenishment.
  
  
  METHODS
  Definity, a perfluorocarbon-derived contrast agent under development, was continuously infused into a steady flow phantom and H-PDI registrations were performed within a silicone tube (d = 8 mm). Replenishment interval between destruction and imaging frame was varied from 0.04-2 seconds. Nonlinear curve fitting was performed using an exponential mathematical model.
  
  
  RESULTS
  Strong linear correlation between contrast dose and maximum signal intensity as well as between flow and the slope variable beta of the replenishment curve was found for all settings (r > 0.96). Maximum signal intensity and contrast replenishment rate were found to be a function of emission power and were significantly influenced by depth and focus position.
  
  
  CONCLUSIONS
  The feasibility of flow assessment using replenishment curves obtained by H-PDI was demonstrated. However, in experimental conditions, flow analysis was severely influenced by ultrasound system settings and imaging conditions such as emission power, sound field geometry, and investigation depth. For a clinical use of this promising approach, algorithms that take specific system settings and imaging conditions into account have to be found. Imaging modalities that enable a most homogeneous scan field are best suited for the assessment of contrast replenishment.
authors.affiliation: Department of Cardiology, University of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Köster
authors.forename: T
authors.initials: T
authors.lastname: Schlosser
authors.forename: C
authors.initials: C
authors.lastname: Pohl
authors.forename: C
authors.initials: C
authors.lastname: Lentz
authors.forename: S
authors.initials: S
authors.lastname: Lohmaier
authors.forename: C
authors.initials: C
authors.lastname: Veltmann
authors.forename: S
authors.initials: S
authors.lastname: Kuntz-Hehner
authors.forename: H
authors.initials: H
authors.lastname: Omran
authors.forename: B
authors.initials: B
authors.lastname: Lüderitz
authors.forename: H
authors.initials: H
authors.lastname: Becher
authors.forename: K
authors.initials: K
authors.lastname: Tiemann
mesh_terms: D003287:Contrast Media; D015150:Echocardiography, Doppler / Q000379:methods*; D008962:Models, Theoretical; D019047:Phantoms, Imaging; D012039:Regional Blood Flow
chemical_list: D003287:Contrast Media