Flash-phase images to detect coronary artery stenosis: a novel finding during contrast-echocardiography

Flash-replenishment sequences are commonly used during contrast stress-echocardiography to detect regions subtended by significant coronary artery disease, which show slower replenishment compared with normal regions at peak stress. We have discovered that the images obtained during the first part of the sequence, made by a series of high mechanical index (MI) impulses (called 'flash' impulses), can in fact portend substantial information on myocardial perfusion independently by the analysis of the following replenishment phase. We describe this novel finding in a paradigmatic case. Flash-replenishment sequences are commonly used during contrast stress-echocardiography to detect regions subtended by significant coronary artery disease, which show slower replenishment compared with normal regions at peak stress. We have discovered that the images obtained during the first part of the sequence, made by a series of high-MI impulses (called 'flash' impulses), can in fact portend substantial information on myocardial perfusion independently by the analysis of the following replenishment phase. We describe this novel finding in a paradigmatic case.