Contrast echocardiography: Applications and limitations

Echocardiography is one of the most commonly used noninvasive imaging modalities in cardiology. Its portability, lack of ionizing radiation, excellent temporal and spatial resolution, and low cost make echocardiography an attractive technology. However, a significant proportion of patients have suboptimal images that decrease the diagnostic utility of echocardiography. One method to enhance the assessment of cardiac structure and function involves the administration of microbubble contrast agents. Capitalizing on interactions between microbubbles and ultrasound, imaging modalities that were specifically designed to enhance microbubble signal while suppressing tissue signal have been developed. These modalities can be used for either left ventricular opacification or myocardial perfusion imaging. The current applications of contrast echocardiography, along with the safety and limitations of the technology will be reviewed.