[Contrast-color Doppler echocardiography. Improved right heart diagnosis following intravenous injection of Echovist].
Flow patterns in the right heart are often difficult to visualize by color-coded Doppler flow imaging. The echogenicity of blood was increased in 48 patients by intravenous injection of 10 ml echovist (200 mg/ml), a saccharide solution with defined size and concentration of microbubbles. Its effect on improving color-coding was compared with the effect of agitated gelifundol (10 ml) in 21 patients with tricuspid valve regurgitation. The non-controlled size and concentration of microbubbles resulted in weaker or uncontrollably exaggerated color-coding in half of the patients. In eight normals biphasic atrial flow was visible only after injection of echovist. In 25 patients with tricuspid regurgitation the blue coded area of reflux was 25 +/- 21% of the atrial area from the parasternal approach and 10 +/- 9% from the apical approach without correlation of these results. After echovist the area of reflux was 57 +/- 31% (p less than 0.001) in the parasternal and 53 +/- 26% (p less than 0.001) in the apical approach (r = 0.83). This was paralleled by an increase of the severity of tricuspid regurgitation as defined by the length or area of reflux (p less than 0.01-0.001). The qualitative diagnosis was safely established in the five patients with VSD in the control color Doppler flow imaging, but only in three out of 10 patients with ASD, and in nine of 10 after injection of echovist. The intravenous injection of echovist, when using color-coded Doppler flow imaging for evaluation of right heart disease, facilitates the qualitative diagnosis of ASD and also of tricuspid regurgitation, particularly in the apical approach.(ABSTRACT TRUNCATED AT 250 WORDS)
von Bibra
H
H
I. Med. Klinik rechts der Isar der Technischen Universität, München.
Hartmann
F
F
Petrik
M
M
Schlief
R
R
Renner
U
U
Blömer
H
H
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003116:Color; D003287:Contrast Media; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005780:Gelatin / Q000031:analogs & derivatives*; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis*; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis*
D003287:Contrast Media; D011134:Polysaccharides; D005780:Gelatin; C002803:oxypolygelatine; C040642:SHU 454
Kontrast-Farbdoppler-Echokardiographie. Verbeserte Rechtsherzdiagnostik nach intravenöser Injektion von Echovist.