title: Role of parasternal data acquisition during contrast enhanced real-time three-dimensional echocardiography.
abstract: BACKGROUND
  Recent technical developments have resulted in high-resolution real time three-dimensional echocardiography (RT3DE). The purpose of this study was to investigate the beneficial role of parasternal-acquired images in addition to apical-acquired images during contrast stress RT3DE.
  
  
  METHODS
  The study comprised 30 consecutive patients (52 +/- 11 years, 18 males) with chest pain referred for routine stress testing. The contrast RT3DE images were acquired from the apical and parasternal window with a Sonos 7500 echo system attached to a X4 matrix array transducer.
  
  
  RESULTS
  From the apical and parasternal acquisition, 464 segments (91%) and 267 segments (52%) could be analyzed, respectively (P < 0.001). From the apical window, more basal segments were not analyzable (22 of 180, 12% vs. 24 of 330, 7%; P = 0.06). From the parasternal window, more apical segments were not analyzable (117 of 150, 78% vs. 126 of 360, 35%; P < 0.01). The mean image quality index of the 464 analyzable segments from the apical-acquired images was 2.43. Fourteen of 180 basal segments (8%), 12 of 180 midventricular segments (7%) and 2 of 150 apical segment (1%) were only available with parasternal data acquisition. In addition to these 28 segments, 79 segments (15%) already visualized from the apical window improved in quality. The overall mean image quality index, now assessed from 492 (96%) of all segments, using both the apical and parasternal acquired data, improved to 2.74 (P < 0.05).
  
  
  CONCLUSIONS
  Addition of parasternal to apical acquisition of contrast RT3DE data can decrease the number of nonvisualized segments and improve mean image quality.
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Attila
authors.initials: A
authors.lastname: Nemes
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Geleijnse
authors.forename: Wim B
authors.initials: WB
authors.lastname: Vletter
authors.forename: Boudewijn J
authors.initials: BJ
authors.lastname: Krenning
authors.forename: Osama I I
authors.initials: OI
authors.lastname: Soliman
authors.forename: Folkert J
authors.initials: FJ
authors.lastname: ten Cate
mesh_terms: D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride
chemical_list: D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride