Current status of contrast echocardiography

Despite its many advantages, MCE is still on the threshold of clinical acceptance. One major reason is that no ultrasound contrast agent has yet been approved for myocardial opacification. The second reason is related to reimbursement, which varies from state to state and is not uniform. The third and perhaps the most important reason is lack of clinical expertise in this new modality. The instruments, imaging techniques and methods of microbubble administration are all undergoing rapid changes. In addition, the technique demands a level of commitment that is not universally present. Lack of knowledge of coronary physiology, image analysis techniques and ultrasound physics remain limitations to the widespread application of MCE. It is a matter of time, however, before these obstacles will be overcome and MCE will gain widespread acceptance. Given the accessibility of ultrasound to cardiologists the world over and the emergence of coronary artery disease as the major cause of mortality worldwide, MCE has great clinical potential.