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Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Table of Contents. Contrast agents. Contrast imaging modalities. Intermediate and low MI imaging. Contrast administration. Efficacy of contrast agents in echocardiography. Clinical impact—cost-effectiveness. Clinical safety of contrast agents in echocardiography. Protocols for contrast echocardiography.
Roxy Senior , Roxy Senior. Tel: 44 ; Fax: 44 E-mail: roxysenior cardiac-research. Oxford Academic. Harald Becher. Mark Monaghan. Luciano Agati. Jose Zamorano. Jean Louis Vanoverschelde. Petros Nihoyannopoulos. Thor Edvardsen. Patrizio Lancellotti. Select Format Select format. Permissions Icon Permissions. Abstract Contrast echocardiography is widely used in cardiology.
Figure 1. Open in new tab Download slide. Power MI. Type of Imaging. High 0. Figure 2. Patients n. Contrast agent. Type of improvement. Table 4 Efficacy of 2D and 3D contrast echocardiography for assessment of LV volumes, EF or regional wall motion abnormalities—comparison with other imaging modalities.
Comparator agent. Agreement vs. Figure 4. Figure 5. Figure 6. Figure 7. Stress method. Albumin Porter et al. Figure 8. Stress method vasodilator. Patients undergoing coronary angiography. CAD present. Table 7 Myocardial contrast echocardiography with dobutamine or exercise in the assessment of coronary artery disease. Stress method dobutamine or exercise. Figure 9. Follow-up months. Total events n. Hard events n. Table 10 Comparison of various Imaging techniques for the detection of hibernating myocardium.
Figure Risk Category. Substance Class. Low 0. Problem To do Apical swirling good basal contrast Reduce MI Basal attenuation no apical swirling Increase MI contrast infusion wait longer after bolus injection Apical blooming and basal attenuation Reduce infusion rate of contrast wait longer after bolus injection Apical swirling and inhomogeneous contrast in the entire cavity Increase infusion rate of contrast or higher volume of the bolus.
Google Scholar Crossref. Search ADS. Google Scholar PubMed. Detection of coronary artery disease with perfusion stress echocardiography using novel ultrasound imaging agent: two phase 3 international trials in comparison with radionuclide perfusion imaging. Very sensitive for detection of contrast.
Cannot assess wall motion simultaneously Contrast is destroyed. Intermediate a 0. Harmonic imaging Power modulation Power pulse inversion Cadence pulse sequencing Coherent contrast imaging. Wall motion can be assessed in real time Destruction-replenishment modes available.
Simultaneous assessment of perfusion is limited Artefacts from bubble destruction in the near field Less sensitive for contrast detection compared with very low MI contrast imaging modalities. Power modulation Power pulse inversion Cadence pulse sequencing Coherent contrast imaging. Perfusion can be assessed simultaneously Destruction-replenishment modes available. Limited spatial and temporal resolution and dynamic range. Crouse et al.
Grayburn et al. Optison increased visible endocardial border length by 7. Cohen et al. Senior et al. Kitzman et al. Harmonic imaging: uninterpretable wall motion in 4. Reilly et al. Kornblut et al. Nguyen et al. Chen et al. Nanda et al. Nash et al. Costa et al. Makaryus et al. Galema et al. Hundley et al. Nahar et al. Yu Thomson et al. Yong et al. Malm Caiani et al. Corsi et al. Malm et al. Lim et al. Hoffmann et al. Jenkins et al. Mistry et al.
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Hillis et al. Greaves et al. Janardhanan et al. Bolognese et al. Sbano et al. Hickman et al. Huang et al. Gel will be placed on your chest and on a probe. The probe is what makes the sound waves.
The probe will be moved around your chest while you are lying on your side and back. An echocardiogram will take about 1 hour. An echocardiogram with contrast will take an additional 15 to 30 minutes for each saline or Definity.
If you are having an echocardiogram your appointment is in cardiology. Cardiology located in the adult clinic in the Smith Building. You will be directed where to go when you check-in. Masks are required for all patients, visitors, employees and staff.
Thank you. Make an Appointment. Echocardiogram with Contrast Your doctor may also want to use contrast with the echocardiogram.
Preparing for the Test Wear clothing you can remove from the waist up. You will be given a gown to wear. By more clearly defining the endocardial border, LVO improves accuracy and reproducibility in the assessment of LV volumes and LV ejection fraction, particularly in those with lower quality non-contrast images.
The ability to accurately evaluate contractile response in every segment and to have a high level of reader confidence are critical issues in stress echocardiography and when resting echocardiography is used to evaluate for ischemia in a patient with resting chest pain.
Accordingly, LVO plays an important role in stress echocardiography where microbubble contrast can increase the number of interpretable myocardial segments at rest and during stress and reduce the percentage of studies that are technically limited in quality.
Myocardial contrast echocardiography refers to the detection of contrast material present within the myocardial microcirculation.
Quantitative myocardial contrast echocardiography, which relies on kinetic modeling of contrast in the microcirculation, has been used for a variety of applications in ischemic and non-ischemic heart disease. This topic has been reviewed elsewhere and is not included in this brief review. The positive impact that contrast has been shown to have on diagnostic accuracy, cost, reproducibility, and reader confidence in a wide variety of situations has led to practice guidelines from the American Society of Echocardiography regarding its use.
In clinical practice, it is often important to consider the clinical circumstance when deciding on the impact of contrast. For example, contrast may have little role when the primary aim is to evaluate for the presence of a pericardial effusion. On the other hand, issues of reliability, reproducibility, accuracy, and confidence can justify the use of contrast in situations when image quality is adequate but marginal, such as the need to detect a regional wall motion abnormality or exclude an apical thrombus.
The American Society of Echocardiography guidelines on contrast echocardiography provide a detailed description of policies that must be implemented regarding contrast use and the roles of different healthcare providers in this process.
An echocardiography laboratory must possess imaging systems with the specific ultrasound detection algorithms that have been developed for enhancing contrast signal based on their ability to generate non-linear signals. It is also important that quality assurance policies are in place to ensure safety, quality, and efficiency. Ideally, the decision to use contrast should reside with the individual who is acquiring images, most commonly the sonographers, which is a policy that is achievable only in an environment where there is active feedback between sonographers and interpreting physicians.
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