One of the most important and most common indications for ultrasound contrast agents is improvement of endocardial border delineation. The following example shows a left ventricle with an apical aneurysm.

Using a mechanical index of 0,06 with the M5S probe and the Vivid E 9 platform there is no apical swirling but a very good contrast in the entire sector field. By applying the 2.0 MHz – frequency there are no artifacts in the area of the mitral valve and no papillary muscle artifact.

Patients with aortic valve stenosis have often a calcification of the aortic ring, making the measurement of the ring diameter challenging, when the size of the new valve has to be choosen for a TAVI procedure. If the orifice of a stenotic aortic valve has to be calculated even a few millimeters of mismeasurement in diameter produce a significant error in calculated grade of stenosis. The following examples show contrast use for a better delineation of LVOT and aortic ring diameter.

Good border delineation of left ventricular outflow tract in a patient with aortic valve stenosis, Vivid E 9, 2 MHz frequency.
Simultaneous biplane imaging of the aortic ring with the 4V probe and 1.6 MHz frequency (Vivid E9 platform) in a patient with an aortic valve stenosis.