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Abstract
Contrast echocardiography has become an established technique to enhance endocardial border definition in those with suboptimal images. This has been enabled by newer intravenously administered ultrasound contrast agents that can traverse the pulmonary circulation intact, coupled with ultrasound imaging techniques designed specifically to allow good visualization of these agents in the left ventricular cavity and myocardium. Contrast echocardiography improves the evaluation of left ventricular function providing more accurate and reproducible measurements of volumes and ejection fraction. Contrast use in stress echocardiography improves the feasibility, diagnostic accuracy, and reader confidence in the test. Consequently, contrast agents enhance decision-making, shorten time to diagnosis, and reduce downstream costs in those with difficult acoustic windows. The technique is particularly useful in delineating apical pathology, and may be used to assess cardiac masses and aortic diseases. Myocardial perfusion may also be assessed during resting and stress echocardiography, improving the evaluation of coronary artery disease.
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