Intravenous myocardial contrast echocardiography for the diagnosis of coronary artery disease.
OBJECTIVE
Myocardial contrast echocardiography is a recently developed technique that permits the noninvasive assessment of myocardial perfusion. Myocardial contrast enhancement from microbubbles characteristically reflects the myocardial blood volume. The analysis of microbubble kinetics using quantitative myocardial contrast echocardiography permits the evaluation of myocardial blood flow both at rest and during pharmacological stress.


RESULTS
Myocardial contrast echocardiography has been shown to have good concordance with single photon emission computed tomography for the localization of perfusion abnormalities. As a result of its better spatial resolution and the fact that it tracks myocardial blood flow changes, it seems to have higher sensitivity for the detection of angiographically significant coronary artery disease, while maintaining similar specificity to single photon emission computed tomography. Low mechanical index imaging techniques (real-time myocardial contrast echocardiography) have the advantage of permitting simultaneous analysis of wall motion and perfusion, which is particularly important during dobutamine stress. Myocardial perfusion analysis using real-time myocardial contrast echocardiography has been shown to have higher sensitivity and diagnostic accuracy than wall motion analysis for the detection of coronary artery disease. Quantitative myocardial contrast echocardiography seems to overcome the expertise requirements for appropriate interpretation of myocardial perfusion images, and may have been demonstrated to be an accurate supplemental technique for estimating the severity of coronary artery disease.


CONCLUSIONS
Recent technological advances have positioned myocardial contrast echocardiography as a safe and feasible technique for the evaluation of myocardial perfusion. The analysis of myocardial perfusion using myocardial contrast echocardiography has higher diagnostic accuracy than wall motion analysis for detecting coronary artery disease.
Tsutsui
Jeane M
JM
Department of Internal Medicine, Section of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska 68198-1165, USA.
Kusler
Monique
M
Porter
Thomas R
TR
D003287:Contrast Media / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D007275:Injections, Intravenous; D012680:Sensitivity and Specificity
D003287:Contrast Media