(MCE) Myocardial contrast echocardiography is a contrast enhanced ultrasound method that utilizes intravenous injected microbubbles as red blood cell tracers. MCE can assess myocardial perfusion both at rest and stress to evaluate viable myocardium after acute infarction.
MCE perfusion imaging improves the blood echoes during the microbubble passage and the imaging system suppresses the clutter represented by non-contrast-bearing tissue.

See also Injection Rate, Stress Echocardiogram, and Myomap.

Cardiac ultrasound, also known as echocardiography or echocardiogram, is used to provide several different levels and types of heart testing. Cardiac ultrasound utilizes the same ultrasound principles as used for obstetric and gynecologic evaluations of pregnant women, gallbladder ultrasound and other abdominal structures.
The ultrasound is directed out of a hand held probe which can be moved to image the heart from different positions. Additionally, so that heart events can be timed, ECG leads are placed on the chest. The reflected wave is converted into an actual image of the heart and displayed in a real-time mode or M-mode ultrasound format. M-mode recordings permit measurement of cardiac dimensions and detailed analysis of complex motion patterns depending on transducer angulations. Also the time relationships with other physiological variables such as ECG, heart sounds, and pulse tracings, can be recorded simultaneously. A stress echocardiogram provides information about the cardiac performance.
Two-dimensional tomographic images of selected cardiac sections give more information than M-mode about the shape of the heart and also show the spatial relationships of its structures during the cardiac cycle (diastole to systole).

See also M-Mode Echocardiography, and Myocardial Contrast Echocardiography.

(PD) Power Doppler imaging (PDI) is a Doppler technique, sensitive to low blood flow, allowing a complete visualization of detailed vascular blood structure. This medical imaging method is useable for detecting microbubbles during myocardial contrast echocardiography.

See also Resistive Index.

Selective detection of the microbubble contrast medium can be enhanced by Doppler processing that removes signals with zero Doppler frequency shifts. This will remove tissue harmonics. By detecting overlong bursts of inverted pulses and using Doppler detection methods, very high sensitivity to microbubbles can be achieved. The bubbles can be detected at sufficiently low incident power levels to avoid destroying them. Pulse inversion Doppler has demonstrated the first real-time images of myocardial perfusion using perfluorocarbon gas agents.

See also Pulse Inversion Imaging, Myocardial Contrast Echocardiography, and Perfluorochemicals.

(TEE) Transesophageal echocardiography provides a superior view of cardiac anatomy compared with transthoracic echocardiography. TEE is performed by the introduction of a probe attached to a fiberoptic endoscope into the esophagus. Caused by the position close to the heart e.g., clot finding and the view of the mitral valve are improved.

Indications:
The piezoelectric crystal creating the acoustic power is mounted on the gastroscope that must be swallowed by the patient. This endoscopic transducer is miniaturized to approximately the size of a fingernail. Usually the probe is in place for an average of 15 minutes, to numb the surface a topical anesthetic is sprayed into the throat, in addition a conscious sedation is recommended.

See also Myocardial Contrast Echocardiography, Stress Echocardiogram, M-Mode Echocardiography, Contrast Enhanced Ultrasound and Vascular Ultrasound Contrast Agents.