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Current role of contrast echocardiography in the diagnosis of cardiovascular diseases

机译：对比超声心动图在心血管疾病诊断中的当前作用

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The use of contrast echocardiography (CE) in cardiovascular medicine has grown significantly over the last 15 years. Depending on the site of injection, contrast enhancement of the right‐ or left‐sided cardiac chambers or myocardium now can be achieved. Contrast echocardiography can improve the evaluation of patients with valvular heart disease by enhancing the Doppler signal; CE also improves detection of intracardiac or intrapulmonary shunts. In patients with coronary artery disease, enhancement of the endocardial blood‐tissue boundary allows for improved visualization of endocardial wall motion, assessment of wall thickening, and calculation of ejection fraction. Contrast echocardiography promises to delineate myocardial perfusion and has the potential for quantitating coronary flow and assessing myocardial viability. These applications may add important physiologic information to the anatomic information readily available from noncontrast echocardiography. Because it can be rapidly performed at the bedside, CE may be a valuable tool for use with inpatients with acute myocardial ischemia. When CE has been used after recanalization of occluded coronary arteries, the assessment of myocardial salvage conveys information concerning reflow, stunning, and prognosis, and in the case of an angioplasty it provides immediate information regarding the success of the procedure. Contrast echocardiography can also assess myocardial areas at risk of irreversible damage and the presence or absence of collateral flow. When performed with transesophageal or epicardial echocardiography in the operating room, CE is emerging as a valuable tool in the assessment of cardioplegia distribution and graft patency as well as in the delineation of the regional supply of each graft. With the continued development of newer contrast agents and refinement of ultrasound imaging equipment, the applications of CE will continue to grow.
机译：在过去的15年中，对比超声心动图（CE）在心血管医学中的使用已显着增长。根据注射部位的不同，现在可以实现右侧或左侧心脏腔或心肌的对比度增强。超声心动图检查可以通过增强多普勒信号来改善瓣膜性心脏病的评估。 CE还可以改善心内或肺内分流的检测。对于冠心病患者，心内膜组织边界的增强可改善心内膜壁运动的可视化，评估壁增厚以及计算射血分数。对比超声心动图有望描绘出心肌灌注，并具有定量冠状动脉血流和评估心肌生存能力的潜力。这些应用可以将重要的生理信息添加到易于从非造影超声心动图获得的解剖学信息中。由于CE可以在床旁快速进行，因此CE可能是用于急性心肌缺血住院患者的有价值的工具。在闭塞的冠状动脉再通后使用CE时，对心肌抢救的评估可传达有关回流，电击和预后的信息，如果是血管成形术，则可立即提供有关手术成功与否的信息。对比超声心动图还可以评估有不可逆损害风险和是否存在侧支血流的心肌区域。当在手术室中进行经食道或心外膜超声心动图检查时，CE逐渐成为评估心脏麻痹分布和移植物通畅性以及确定每个移植物区域供应的重要工具。随着新型造影剂的不断开发和超声成像设备的不断完善，CE的应用将继续增长。

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