Detection of intracardiac shunt flow in atrial septal defect using a real-time two-dimensional color-coded Doppler flow imaging system and comparison with contrast two-dimensional echocardiography.
To evaluate the noninvasive detection of shunt flow using a newly developed real-time 2-dimensional color-coded Doppler flow imaging system (D-2DE), 20 patients were examined, including 10 with secundum atrial septal defect (ASD) and 10 control subjects. These results were compared with contrast 2-dimensional echocardiography (C-2DE). Doppler 2DE displayed the blood flow toward the transducer as red and the blood flow away from the transducer as blue in 8 shades, each shade adding green according to the degree of variance in Doppler frequency. In the patients with ASD, D-2DE clearly visualized left-to-right shunt flow in 7 of 10 patients. In 5 of these 7 patients, C-2DE showed a negative contrast effect in the same area of the right atrium. Thus, D-2DE increased the sensitivity over C-2DE for detecting left-to-right shunt flow (from 50% to 70%). However, the specificity was slightly less in D-2DE (90%) than C-2DE (100%). Doppler 2DE could not visualize right-to-left shunt flow in all patients with ASD, though C-2DE showed a positive contrast effect in the left-sided heart in 9 of 10 patients with ASD. Thus, D-2DE is clinically useful for detecting left-to-right shunt flow in patients with ASD.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002648:Child; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014743:Videotape Recording