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Bubbles in echocardiography: climbing the learning curve

M. Schneider*

Bracco Research SA, Geneva, Switzerland

* Correspondence: Dr. M. Schneider, Bracco Research SA, 31, Route de la Galaise, 1228 Plan-les-Ouates, Geneva, Switzerland.

Abstract

The past few years have seen the rapid development of novel imaging modes tuned to the specific detection of microbubbles; these include harmonic 13-mode, phase or pulse inversion, power modulation, coherent contrast imaging, and recently power pulse inversion. These contrast-specific imaging modes, combined with insonation at low incident pressure, result in greatly enhanced contrast between the vessels that contain the ultrasound contrast agent and the surrounding tissues, rendering perfusion defects highly visible. SonoVue (Bracco, Milan, Italy) is a new echocontrast agent with outstanding stability. Thanks to their very flexible shell, the SonoVue microbubbles are able to generate strong harmonics even when insonated at extremely low mechanical index (MI). The present review illustrates the different modalities of contrast bubble insonation (at high and low MI), which allow visualization of fixed defects and ischaemic or infarcted areas of the myocardium in real-time.

Key Words: Low mechanical index • microbubbles • myocardial perfusion • SonoVue


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