Visualization and quantification of myocardial mass at risk using three-dimensional contrast echocardiography.
OBJECTIVE
Three-dimensional echocardiographic assessment of myocardial ischemia using contrast echocardiography has been hampered by limitations of available contrast agents and analytic software. In the study presented, a three-dimensional perfusion imaging method was evaluated in the porcine model of myocardial ischemia using a novel contrast agent.


METHODS
Three-dimensional echocardiography was performed in eight open-chested pigs before, during and after left anterior descending (six animals) or circumflex (two animals) coronary artery occlusion. The intramyocardial contrast effect was obtained by left atrial injection of Myomap, a deposit contrast agent.


RESULTS
Myocardial opacification was visible in all studies and retained in all three-dimensional datasets. Three-dimensional intensity analysis demonstrated a significant difference, exceeding 20 intensity units in every animal (in 127-level scale), between perfused and non-perfused myocardium. Reperfusion followed by contrast reinjection resulted in homogenous myocardial enhancement. Myocardial mass at risk was clearly delineated in all studies and measured with a mean error of -0.1 +/- 2.0 g against real mass (p = non-significant). Spatial extent of ischemia could be displayed in volume-rendered reconstruction of separate perfusion territories.


CONCLUSIONS
Quantitative analysis of myocardial contrast enhancement from three-dimensional datasets is feasible and allows accurate measurement of myocardial mass at risk.
Kasprzak
J D
JD
Medical University of Lódź, Poland.
Vletter
W B
WB
Roelandt
J R
JR
van Meegen
J R
JR
Johnson
R
R
Ten Cate
F J
FJ
D000818:Animals; D003287:Contrast Media; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D007091:Image Processing, Computer-Assisted; D008863:Microspheres; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D009929:Organ Size; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D013552:Swine
D003287:Contrast Media