Purpose　Guided　waves　generated　from　bone　cortex　inevitably　act　on　microbubbles　flowing　through　skeletal　muscle　capillaries　in　contrast-enhanced　ultrasound　(CEUS)　and　might　influence　the　image　quality.　However,　the　action　mechanism　underlying　the　guided　waves　influence　is　still　unknown,　especially　under　contrast　pulse-inversion　transmission　mode.　This　study　aimed　to　clarify　the　influence　of　guided　waves　on　pulse-inversion　CEUS,　which　was　investigated　via　in　vitro　infusion　experiments.　Method　Tibia　guided　waves　were　detected　at　pulse-inversion　transmission　and　then　characterized　by　using　a　short-time　Fourier　transform　energy　distribution.　Using　results　at　normal　incidence　as　a　baseline,　the　influence　of　guided　wave　dispersion　on　the　contrast　and　resolution　of　pulse-inversion　CEUS　was　investigated　at　an　oblique　incidence　through　continuous　microbubbles　infusion　experiments　in　a　vessel-tibia　flow　phantom.　Results　Frequency-dispersive　property　of　tibia　guided　waves　was　observed　at　phases　0　degrees　and　180　degrees,　which　improved　the　contrast　of　CEUS　and　reduced　its　resolution.　Pulse-inversion　CEUS　balanced　the　contrast　enhancement　and　resolution　degeneration　induced　by　guided　waves.　By　contrast,　contrast-to-tissue　ratio　of　pulse-inversion　CEUS　increased　by　up　to　109.1　+/-　13.2%　(P　＜　0.05)　due　to　guided　waves　and　its　resolution　was　up　to　0.9　+/-　0.1　times　that　of　baseline.　Conclusions　Alterations　of　contrast　and　resolution　in　pulse-inversion　CEUS　induced　by　guided　waves　might　provide　an　additional　assessment　for　the　capillary　perfusion　in　the　skeletal　muscle　near　the　bone　cortex.