ABSTRACT
Non-invasive medical imaging has become an essential part of the practice of cardiovascular medicine and traditionally relies on the ability to characterize disease-related anatomic and/or physiologic changes. This chapter focuses on some advances that have allowed the imaging of molecular and cellular alterations of disease with targeted contrast enhanced ultrasound (CEU). Conventionally, CEU is performed by ultrasound detection of gas-containing microbubbles that have shells composed of protein, lipids, or biocompatible polymers. The properties of the imaging detectors must also be considered when developing a method for molecular assessment of disease. The inflammatory response is a key feature in many cardiovascular diseases. A key part of this response is the recruitment of circulating leukocytes to the vascular endothelium through leukocyte capture, rolling, adhesion, and transmigration. Thrombus-targeted microbubbles have been developed to improve the diagnostic accuracy of ultrasound for detecting vascular or intracardiac thrombi. Fibrin targeting of nanoparticle emulsion agents has been used to enhance vascular thrombi on ultrasound imaging.
