Superb Micro - vascular Imaging ( SMI ) : Clinical Advantages of a Novel US Flow Technique in Pe - diatric Diagnostic Imaging

During blood flow evaluation in young children, assessment of subtle blood flow is limited by motion artefacts when using conventional US blood flow methods (color Doppler imaging, power Doppler imaging, and advanced dynamic flow), in particular for evaluation of respiratory fluctuating organs or in restless non-sedated children. In the conventional methods, a wall filter is usually employed to remove motion artifacts, which resulting in reduction not only of motion artifacts but also of low velocity flow components. In contrast, Superb Microvascular Imaging (SMI) provides excellent blood flow images because it uses a new adaptive algorithm that effectively separates blood flow signals from overlying tissue motion artifacts. The algorithm removes only motion artifacts while preserving low velocity blood blow components without sacrificing high resolution and high frame-rate image quality. Attention should be paid to the pitfall, that high velocity blood flow signals might be overlooked on SMI. Because SMI is specifically adjusted to demonstrate low velocity blood flow signals in the manufacturer default, high velocity blood flow signals are relatively weak and might be overlooked. Therefore, the combination of both conventional methods and SMI is highly recommended in evaluation of blood flow in clinical application. In conclusion, SMI is particularly useful in evaluation of non-sedated children.