From a Toy with Lots of Potential to a Useful Clinical Tool—The Oxford Way of Doing Contrast Echocardiography

There have been a large number of experimental and clinical studies demonstrating a variety of applications of ultrasound contrast agents. Although there has been a con- vergence of opinions over the last few years, there is still some debate on the practical clinical issues including indications, choice of contrast agent, best imaging modality etc. Many papers and presentations conclude that the use of contrast has huge potential (Table 14.1) [1], but concrete guidelines on how to integrate the technology into a busy clinical echocardiography laboratory are lacking. There are only a few well-controlled multicentre studies which are based on good blind reads, but the protocols of these stud- ies performed in academic (tertiary) centres are not suitable for echocardiography laboratories in district general hospitals.