Future directions in echocardiography.

Future developments in echocardiography will likely focus on the continued evolution of existing techniques, such as real-time 3-dimensional (RT3D) imaging and contrast-enhanced imaging; higher resolution imaging; and greater flexibility in imaging systems due to miniaturization, enhanced connectivity, and integration with other techniques. Improvements in RT3D image quality may include expanded parallel processing and use of transesophageal matrix arrays. Two areas of future clinical potential for contrast-enhanced echocardiography/ultrasound are the use of targeted microbubbles for diagnostic and therapeutic applications and expanded vascular imaging. Although molecular imaging holds great promise for the future, in the short-term, it is likely that contrast will be used more extensively for vascular imaging to assess both the effects of interventions on local perfusion and the activity of atherosclerotic plaque based on the size/density of the vasa vasorum. The widespread use of ultrasound will be facilitated by the development of a convenient portable or readily available ultrasonic equivalent of the stethoscope.