Comparison of the veracity of real-time perfusion, harmonic angio, and ultraharmonic mocardial contrast imaging modes in evaluation of acute myocardial infarction area.
BACKGROUND
Innovative advancements in ultrasound instrumentation present a number of imaging modalities for myocardial contrast echocardiography (MCE) in ischemic syndromes. How well they compare to each other in diagnostic accuracy in the detection of acute myocardial infarction is unclear. The purpose of this study was to assess the relative accuracy of 3 different imaging modes of MCE, low mechanical index (MI) real-time perfusion imaging (RTPI), triggered harmonic angio mode (HA), and ultraharmonic imaging mode (UH) in the detection of acute experimental myocardial infarction within the time frame suitable for potential reperfusion.


METHODS
MCE was performed in 10 open-chest dogs using RTPI, triggered HA and triggered UH modes at baseline and one hour after occlusion of left anterior descending coronary artery. Presence or absence of perfusion defects, and the perfusion defect size when present, were analyzed and compared with the infarct size delineated by triphenyltetrazolium chloride (TTC) staining.


RESULTS
The infarct area was (15.8 +/- 2.4)% by TTC staining; Perfusion defect area by MCE was similar to anatomic infarct area in all the three MCE approaches: (16.1 +/- 2.7)% by RTPI mode, (15.5 +/- 2.9)% by HA mode, and (15.5 +/- 3.0)% by UH mode. The sensitivity, specificity and overall diagnostic accuracy in the detection of myocardial infarction were 100%, 88%, and 94% for RTPI mode, 88%, 100%, and 94% for HA mode, and 100%, 75%, and 88% for UH mode.


CONCLUSIONS
All modes of MCE, RTPI, triggered HA mode and triggered UH mode have excellent diagnostic accuracy in the immediate hour of acute coronary occlusion within the optimal time frame suitable for reperfusion therapy.
Xing
Yan-qiu
YQ
Cardiology Unit of Senior Care Department, Qilu Hospital, Shandong University, Ji'nan 250012, China. xingyanqiu@sina.com
Zhang
Yun
Y
Li
Da-qing
DQ
Liu
Xiang-qun
XQ
Li
Xiu-qin
XQ
Zhao
Chang-qin
CQ
Chen
Mei
M
Gao
Hai-qing
HQ
D000818:Animals; D003287:Contrast Media; D004285:Dogs; D004452:Echocardiography / Q000379:methods*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D013194:Staining and Labeling; D013778:Tetrazolium Salts
D003287:Contrast Media; D013778:Tetrazolium Salts; C009591:triphenyltetrazolium