Figure 1

Illustration of destruction-reperfusion sequence. During continuous infusion of the contrast agent, microbubble destruction is obtained by applying pulses at high mechanical index (high ultrasound intensity). Microcirculation replenishment is then observed. All images represent renal contrast-enhanced ultrasonography (CEUS), the left part of the image shows contrast-image mode imaging and the right part the standard (B-mode) image. (a) Immediately after the flash; (b) during replenishment (2 seconds after the flash); (c) at full replenishment (6 seconds after the flash); (d) sequence analysis with Sonotumor^®: a region of interest was drawn (yellow line) in the largest possible area of renal cortex closer to the ultrasound probe. The software generates a time intensity curve. This curve is used to generate CEUS-derived parameters.