MethodComparison of Contrast Agent–Enhanced Versus Non-Contrast Agent–Enhanced Real-Time Three-Dimensional Echocardiography for Analysis of Left Ventricular Systolic Function
Section snippets
Methods
Thirty-nine consecutive patients (mean age 58 ± 15 years, range 24 to 79; 34 men) in sinus rhythm were prospectively studied with RT3DE and MRI on the same day. These patients were referred for routine evaluation of cardiac function after myocardial infarction (n = 28), cardiomyopathy (n = 10), and myocarditis (n = 1). No patient was excluded from the study because of echocardiographic image quality. The institutional review board approved the study, and all patients gave informed consent.
RT3DE
Results
The mean time for data analysis ranged from 5 to 20 minutes, depending on image quality. From the total number of 624 segments, 173 segments (28%) had an image quality score <2 without contrast agent enhancement. This number decreased to 69 segments (11%) with contrast agent enhancement. After enhancement, the mean image quality index improved from 2.4 ± 1.0 to 3.0 ± 0.9 (p <0.001). The most profound improvement was seen in the anterior segments (from 1.9 ± 1.4 to 2.6 ± 1.3). A similar
Discussion
Two-dimensional echocardiography remains the most often used imaging modality to assess LV function, but it is limited in accuracy because of geometric assumptions of LV shape and high intra- and interobserver variabilities.8 Improvement in accuracy was shown by 3-dimensional echocardiography because of the absence of these geometric assumptions.5 Despite technologic improvements, image quality remains worse than 2-dimensional echocardiographic imaging. Reliable LV contour detection is possible
References (19)
- et al.
Electrocardiogram-gated single-photon emission computed tomography versus cardiac magnetic resonance imaging for the assessment of left ventricular volumes and ejection fraction: a meta-analysis
J Am Coll Cardiol
(2002) - et al.
Comparison of native and contrast-enhanced harmonic echocardiography for visualization of left ventricular endocardial border
Am J Cardiol
(1999) - et al.
Reliability of reporting left ventricular systolic function by echocardiography: a systematic review of 3 methods
Am Heart J
(2003) - et al.
Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging
J Am Coll Cardiol
(2004) - et al.
Contrast echocardiography improves the accuracy and reproducibility of left ventricular remodeling measurements: a prospective, randomly assigned, blinded study
J Am Coll Cardiol
(2001) - et al.
Comparison of contrast-enhanced real-time live 3-dimensional dobutamine stress echocardiography with contrast 2-dimensional echocardiography for detecting stress-induced wall-motion abnormalities
J Am Soc Echocardiogr
(2006) - et al.
Usefulness of ultrasound contrast agent to improve image quality during real-time three-dimensional stress echocardiography
Am J Cardiol
(2007) - et al.
Improved semiautomated quantification of left ventricular volumes and ejection fraction using 3-dimensional echocardiography with a full matrix-array transducer: comparison with magnetic resonance imaging
J Am Soc Echocardiogr
(2005) - et al.
Dual triggering improves the accuracy of left ventricular volume measurements by contrast-enhanced real-time 3-dimensional echocardiography
J Am Soc Echocardiogr
(2005)
Cited by (45)
Diagnostic value of three-dimensional contrast-enhanced echocardiography for left ventricular volume and ejection fraction measurement in patients with poor acoustic windows: A comparison of echocardiography and magnetic resonance imaging
2014, Journal of the American Society of EchocardiographyCitation Excerpt :Jenkins et al.5 found a bias of 14% for EDV and ESV. Krenning et al.17 found biases, respectively, of 9%, 7%, and −4% for EDV, ESV, and EF. Jacobs et al.1 showed a bias reduction relative to MRI of 34% for EDV and 49% for ESV.
Value of Three-Dimensional Contrast-Enhanced Ultrasound in the Diagnosis of Small Adnexal Masses
2013, Ultrasound in Medicine and BiologyQuantitation of cardiac chamber geometry and function using transthoracic three-dimensional echocardiography
2012, Journal of Cardiovascular EchographyEAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography
2012, Journal of the American Society of EchocardiographyCitation Excerpt :The full-volume acquisition should be made during a breath hold to minimize the risk for breathing (stitch) artifacts. As discussed above, contrast LV opacification is often of value.26-29 There is no general agreement on how the imaging planes should be displayed.