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Superb Micro-vascular Imaging (SMI)

Seeing the unseen

SMI is a technology that expands the range of visible blood flow and provides visualization of low microvascular flow never seen before with ultrasound. By enabling detailed visualization of vascular flow signals, SMI supports users during their clinical decision-making processes, reducing routine use of invasive methods.

The advantages of SMI

  • High frame rates
  • High resolution
  • High sensitivity
  • Less motion artifacts

Technology

Traditional color Doppler imaging removes clutter from the images by suppressing low velocity components resulting in a loss of flow in tiny vessels.
SMI is a powerful and intelligent algorithm that effectively separates flow signals from overlaying tissue motion artifacts, while preserving even the subtle low-flow components with detail and definition.
SMI analyzes clutter motion and uses an adaptive algorithm to identify and remove tissue motion and reveal true blood flow. This results in a high resolution ultrasound image in which minute flow signals and low velocity flow can be depicted.

Three modes of SMI

Monochrome mode (mSMI) reveals the fine blood flow patterns with high sensitivity by removing anatomical background information.

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Color-coded SMI (cSMI) demonstrates flow and grayscale information with high temporal and spatial resolution simultaneously.

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Smart 3D with SMI provides a well-defined rendered image of the blood flow network within the liver.

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Evolution of SMI

SMI is an innovative ultrasound technology introduced in 2014.
In 2017, “iSMI” was introduced, allowing simultaneous processing of multiple signals to maintain both noise reduction and high frame rates, even when the ROI is expanded. In 2021, the technology evolved into “SMI Generation 4,” which extended the flow velocity range from low to high speed flows. This advancement enabled high velocity motion artifacts to be reduced and expanded the application of SMI to include the visualization of high velocity blood flow.
In 2025, SMI achieved further progress in visualizing low-velocity blood flow, marking a new stage in its development and expanding its clinical potential.

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SMI Angio mode

Seeing the unseen – in finer detail

Building on SMI, Aplio’s new SMI Angio mode delivers superior blood flow visualization, offering finer detail and enhanced separation of flow in small, closely adjacent vessels, supporting more accurate assessment and increased diagnostic confidence in a wide range of use cases.

Conventional SMI

SMI Angio mode

Technology

SMI Angio mode further improves blood flow visibility compared with conventional SMI.
As a result, adjacent blood flows can be clearly separated, enhancing the visualization of fine vessels.

In addition, a newly applied statistical method for blood flow signal processing, together with an increased number of analysis frames, further improves sensitivity.

Features

1.Enhanced visualization of blood flow
SMI Angio mode improves the visualization of blood flow in small vessels by providing finer separation of individual small vessels.

2.Increased blood flow sensitivity
By incorporating statistical analysis across frame transitions and adjusting observation timing, SMI Angio mode enhances the signal-to-noise ratio, resulting in improved sensitivity to blood flow.

3.Preservation of core SMI capabilities
SMI Angio mode is built on the core capabilities of SMI, such as the ability to detect low velocity blood flow while maintaining high frame rates and without the need of contrast agent. Users can adjust both the real-time focusing mode and the sensitivity focusing mode.

Clinical Images

SMI proves to be useful in many clinical applications and anatomical regions.

 

SMI

SMI Angio mode

Notable Awards

2015 The Japanese Society of Ultrasonics in Medicine
The 15th technology awards for Superb Micro-vascular Imaging (SMI)

2024 The Japanese Society of Ultrasonics in Medicine
The 24th technology awards for SMI Generation 4 (SMI Gen4)

Education and Resources

Do we really need Microvascular flow imaging?

Prof. Jiro Hata
Kawasaki Medical School, Okayama, Japan   

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White Paper

Interview report and Case study

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Marilyn Zelesco, Lead Sonographer

Portal Vein Thrombosis

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163 KB
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Makoto Wada, MD, PhD

Applications of diagnostic ultrasound systems in the field of orthopaedics

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2 MB
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Akihiro Narita, MD, PhD
Norifumi Sawamukai, MD, PhD


Clinical value of Superb Micro-vascular Imaging and ultra-high frequency linear transducer in musculoskeletal ultrasound: 

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241 KB
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Ultrasound assessment of Burns

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233 KB

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