Diagnostic and therapeutic utilization of microbubbles

Myocardial contrast echocardiography (MCE) is rapidly becoming a technique that can be utilized with intravenous microbubbles to detect myocardial perfusion abnormalities during stress echocardiography. Real-time techniques with low mechanical index pulse sequence schemes have been developed that allow for the simultaneous detection of wall motion and perfusion during pharmacologic stress echocardiography. MCE is also very helpful in determining the viability of the dysfunctional myocardium in the setting of acute myocardial infarction, and in the setting of chronic coronary artery disease. Microbubbles normally pass freely through the large and small vessels, but do adhere to the endothelium in the setting of endothelial dysfunction. This may be one method of concentrating the delivery of drugs or genes bound to microbubbles to selective areas of endothelial dysfunction. Ultrasound-mediated destruction of microbubbles may also be useful for targeted drug delivery and enhancing intravascular thrombolysis.