Abstract: Fibrin-targeted microbubbles and their use in ultrasound-based diagnostic and therapeutic applications are disclosed. In particular, the invention relates to the use of fibrin-targeted polymerized shell lipid microbubbles and methods of fabricating and using such fibrin-targeted microbubbles for ultrasound imaging of fibrin deposition in tissue, including adhesions and atherosclerotic plaques. The invention further relates to the use of such fibrin-targeted microbubbles as carriers for drug delivery and in ultrasound-based methods of treatment.