Contrast echocardiography for detection of myocardial perfusion abnormalities : A clinical perspective

Myocardial contrast echocardiography (MCE) is a well-established imaging technique in the assessment of patients with known or suspected coronary artery disease. The use of ultrasound contrast agents has optimized the evaluation of left ventricular function and, moreover, permits simultaneous assessment of the myocardial perfusion. This technique utilizes microbubbles that remain in the intravascular space and the contrast intensity reflects the concentration of the microbubbles in the myocardium. A homogeneous opacification of the myocardium after destruction of the microbubbles during high-power imaging is regarded as normal perfusion and absence of CAD. If the replenishment rate is reduced, this is suggestive of significant CAD. In comparison with other techniques, MCE shows comparable sensitivity, specificity, and diagnostic accuracy while it is an easy-to-perform bedside technique that can be a valuable tool for the clinician.