Myocardial Perfusion Imaging With Contrast Ultrasound

Abstract

This report reviews the development and clinical application of myocardial perfusion imaging with myocardial contrast echocardiography (MCE). This includes the development of microbubble formulations that permit the detection of left ventricular contrast from venous injection and the imaging techniques that have been invented to detect the transit of these microbubbles through the microcirculation. The methods used to quantify myocardial perfusion during a continuous infusion of microbubbles are described. A review of the clinical studies that have examined the clinical utility of myocardial perfusion imaging with MCE during rest and stress echocardiography is then presented. The limitations of MCE are also discussed.

Assessment of tissue perfusion by contrast-enhanced ultrasound

“…Reversible myocardial perfusion defects (Fig. 8) are those that become evident during physical or pharmacological stress and disappear during resting [61,62]. The same technique may be applied in the detection of damaged but viable myocardium ("hibernating myocardium") [63,64] as dysfunctional segments demonstrating contrast enhancement have better recovery of wall motion than segments with no reflow.…”

Ultrasound and Microbubbles for Coronary Artery Recanalization in Acute Myocardial Infarction

“…1,2 The application of high mechanical index (MI) pulses through diagnostic transducers may result in cavitation of microbubbles and allow the analysis of backfilling of myocardial perfusion contrast, facilitating the assessment of myocardial perfusion. [3][4][5][6] Additionally, the destruction of microbubbles by ultrasound may have therapeutic applications, such as drug delivery to specific locations or to accelerate the dissolution of thrombi, also known as sonothrombolysis.…”

Timing of high intensity pulses for myocardial cavitation-enabled therapy

“…Myocardial contrast echocardiography provides the capability of perfusion imaging with ultrasound [1,2]. Contrast agents, which consist of suspensions of stabilized microbubbles, are injected intravenously and increase the echogenicity of the myocardium.…”