By Pravin M. Shah (auth.), Navin C. Nanda MD, Reinhard Schlief (eds.)
` Nanda and Schlief have edited and produced an authoritative and updated reference booklet for either skilled and green echocardiologists. I strongly suggest this booklet to these attracted to this box. '
International magazine of Cardiology, forty five (1994)
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Extra resources for Advances in Echo Imaging Using Contrast Enhancement
INTRODUCTION The use of a contrast agent during echocardiography was first reported in 1968 by Gramiak and Shah at the University of Rochester . The uses and applications of contrast echocardiography are still expanding, since numerous studies have shown its efficacy and safety. The committee on contrast echocardiography for the American Society of Echocardiography found only 32 cases of possible (always transient) toxicity out of 13,946 examinations surveyed . Meltzer et al.  and Armstrong et al.
Acting essentially as harmonic oscillators, gaseous bubbles pulsate strongly in the liquid medium at the resonant frequency, and greatly potentiate ultrasonic scattering and absorption cross sections, as compared to expectations based strictly on the actual bubble size. Small bubbles, on the order of 5 micron or less, resonate in the medical imaging band of 110 MHz, and such bubbles are also capable of unhindered microcirculatory passage. Unfortunately, as already reviewed, such bubbles (unless encapsulated) tend to rapidly (:E:1 s) dissolve.
Most recently, both Ophir and Parker  and deJong et al.  presented, for a liquid with gas bubbles, somewhat similar relations for a mean mixture speed of sound, which can be quite different from the sound velocity in the bubble-free (incompressible) medium. 1 % are found to significantly reduce the velocity of sound transmission in the liquid-gas mixture. It is pointed out that the bubble gas concentration could, in principle, be computed from measurements of the speed of sound. In interpreting the velocity of sound in bubbly mixtures, one should bear in mind the influence of both component densities and compressibilities.