An update on contrast echocardiography

Ultrasound contrast agents, used with contrast-specific imaging techniques, have an established role for diagnostic cardiovascular imaging in the echocardiography laboratory. The advent of tissue harmonic imaging, albeit a significant advancement in ultrasound technology, still fail to produce diagnostically useful images in a significant proportion of patients. This therefore, often leads to inaccurate assessment of left ventricular function, neccesitating the use of other more laborious and expensive imaging techniques purely for diagnostic purposes. Historically, contrast agents have not been an integral component of the echocardiography imaging laboratory. However the need for a more robust method for the assessment of left ventricular function facilitated the developement of a unique class of contrast agents composed of microbubbles, which together with ultrasound, produce opacification of the left ventricular cavity, thus enabling accurate quantification of its function. The use of these contrast agents have now gone beyond the assessment of wall motion and function to the assessment of myocardial perfusion. Myocardial contrast echocardiography has enabled the assessment of cardiac anatomy, function and perfusion, all in one sitting, by the bedside. Contrast ultrasound imaging has now been applied to even newer techniques such as real-time three-dimensional echocardiography and is also showing promise in the assessment of carotid ultrasound for intima-media thickness. Contrast agents therefore have a significant role in cardiovascular diagnostics and its use can only improve patient care.