title: Noninvasive diagnosis of cardiac rejection through echocardiographic tissue characterization.
abstract: Ultrasonic tissue characterization is based on the assumption that microscopic tissue structures are identifiable by their acoustic properties. Our study group consisted of 23 cardiac recipients. Two-dimensional images were obtained within 2 hours of endomyocardial biopsy. The end-diastolic echo frames were digitized into the matrix of an image-processing system. A region of interest was placed into the anteroseptal segment of the left ventricle. The texture within the region of interest was analyzed using four major groups of texture analysis (first-order histogram, co-occurrence matrix, run-length statistic, and power spectrum). A total of 408 echocardiographic examinations were compared with histologic findings. The 117 initially calculated texture parameters were reduced incrementally using a series of discriminant analyses. A set of three texture parameters (inverse difference moment undirected, run-length nonuniformity vertical, and sector sum) was able to describe changed echocardiographic texture when rejection occurred. Using these three parameters, echocardiographic sensitivity was 89.0% and specificity was 83.6% for moderate rejection. We conclude that cardiac rejection is associated with echocardiographic texture alterations and that serial echocardiographic texture analysis can reliably identify rejection.
authors.affiliation: German Heart Institute, Berlin.
authors.forename: E
authors.initials: E
authors.lastname: Lieback
authors.forename: R
authors.initials: R
authors.lastname: Meyer
authors.forename: M
authors.initials: M
authors.lastname: Nawrocki
authors.forename: J
authors.initials: J
authors.lastname: Bellach
authors.forename: R
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000328:Adult; D001706:Biopsy; D004452:Echocardiography; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000000981:diagnostic imaging*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012680:Sensitivity and Specificity