title: Improved visualization of aortic intima-media thickening with the use of perflutren lipid microspheres.
abstract: BACKGROUND
  Transesophageal echocardiography (TEE) has been used to diagnose atherosclerotic disease for patients who present with systemic embolic events. The primary aim of this study was to assess the supplemental value of echocardiographic contrast to standard TEE in identifying the aortic intima-medial thickness.
  
  
  METHODS
  An aorta phantom was used to validate the accuracy of border delineation with and without contrast during TEE imaging. In all, 44 patients underwent TEE imaging of the thoracic aorta with a subsequent administration of a 0.3-mL bolus of perflutren lipid microspheres (Definity). Precontrast and postcontrast images were analyzed semiquantitatively for border delineation and quantitatively for intima-medial thickness and cross-sectional area.
  
  
  RESULTS
  Wall thickness in the aortic phantom model with contrast was smaller, more accurate, and more reproducible to the true measurement. The clinical studies reflected similar results with average contrast intima-medial thickness measured at 0.15 +/- 0.08 cm and noncontrast at 0.18 +/- 0.08 cm (P < .01). The lateral wall showed the greatest improvement with a score of 1.23 increasing to an average of 1.82 (P < .001) with contrast. The medial, anterior, and posterior walls improved to an average 1.98, 1.39, and 2.0, respectively (P = .01).
  
  
  CONCLUSIONS
  Contrast agents provide better aortic intima-media enhancement during TEE.
authors.affiliation: St Louis University School of Medicine, St Louis, Missouri 63110-2539, USA. smbierig@yahoo.com
authors.forename: S Michelle
authors.initials: SM
authors.lastname: Bierig
authors.forename: Alan
authors.initials: A
authors.lastname: Maniet
authors.forename: Steven C
authors.initials: SC
authors.lastname: Herrmann
authors.forename: Jacob G
authors.initials: JG
authors.lastname: Hoover
authors.forename: Denise
authors.initials: D
authors.lastname: Sherriff
authors.forename: Sarah
authors.initials: S
authors.lastname: Kutter
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Labovitz
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren