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The present chapter highlights the most important information about microcirculation and its evaluation using contrast-enhanced ultrasonography (CEUS). In the beginning it outlines some general considerations about microcirculation, together with its morphological and physiological particularities under normal and pathological circumstances. The ultrasonographic (US) evaluation of vascularity is based on the Doppler technique and the harmonic technique using contrast agents. Then it presents briefly the Doppler ultrasound (DUS) and discusses its most important current and emerging indications. CEUS is presented extensively, covering the fundamentals of sonographic contrast agents, harmonic imaging and quantification techniques. A special focus is placed not only on the current and emerging indications of CEUS but also on the advantages and limitations of the method. This chapter also incorporates information about experimental CEUS applications and future perspectives. CEUS is the recommended US method for the characterization of microcirculation. The results of the examination are displayed in real-time, under the eyes of the examiner, while the quantitative assessment of the contrast agent kinetics parameters is easy to perform. This method allows a precise definition of the healthy or pathologic state of an organ and the follow-up of treatment response.

Noninvasive Evaluation of Microcirculation under Normal and Pathological Conditions Using Contrast-Enhanced Ultrasonography (CEUS)