Utilizing Contrast Echocardiography in Practice

Contrast echocardiography describes a variety of imaging approaches that rely on the detection of acoustically active contrast agents, usually in the form of encapsulated microbubbles that remain within the vascular space. In the clinical setting, contrast echocardiography has most commonly been used to improve image quality to enhance diagnostic performance and confidence. Frequent situations when contrast is used as an adjunct to routine echocardiography are for the better detection of ventricular endocardial borders or for the detection of intracavitary masses or thrombus. Contrast echocardiography can also be used to detect physiologic or pathophysiologic features that cannot be evaluated with noncontrast echocardiography, such as for the assessment of myocardial perfusion. This chapter focuses on the methods used for performing contrast echocardiography, composition and safety of ultrasound contrast agents, and circumstances where the use of contrast during echocardiography has been shown to improve patient care or healthcare costs.