title: Real-time three-dimensional myocardial contrast echocardiography: is it clinically feasible?
abstract: OBJECTIVE
  Real-time 3D echocardiography (RT3DE) and 2D low mechanical index (LMI), contrast specific, myocardial perfusion imaging are now both accepted techniques. We evaluated the feasibility of an RT3DE LMI implementation in unselected patients.
  
  
  RESULTS
  Forty-six patients undergoing contrast enhanced dobutamine stress echo were imaged with novel 3D LMI power modulation software. All patients underwent contrast enhanced 2D and RT3DE acquisitions, in left ventricular opacification (LVO), and LMI perfusion modes. The data sets were evaluated segmentally for wall motion (WM) and myocardial contrast enhancement. Of the 736 evaluated segments, WM could be assessed in 726 (98.6%) of the 2D and 708 (96.2%) 3D segments (P = 0.007). Perfusion could be assessed in 721 (98%) of 2D and 701 (95.2%) of 3D segments (P = 0.006). Six hundred and sixty-one segments had normal WM and thickening in 2D and of these RT3DE demonstrated normal myocardial opacification in 77.2% of basal, 85% of mid, and 91.8% of apical segments. Thirty-four segments were akinetic, with no evidence of perfusion in 2D, and of these RT3DE revealed a perfusion defect in 31 (91%, P = NS).
  
  
  CONCLUSIONS
  LMI RT3DE evaluation of myocardial perfusion is feasible in most segments. It has the potential to accurately locate and possibly quantify perfusion defects.
authors.affiliation: Department of Non-Invasive Cardiology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bhan
authors.forename: S
authors.initials: S
authors.lastname: Kapetanakis
authors.forename: B S
authors.initials: BS
authors.lastname: Rana
authors.forename: E
authors.initials: E
authors.lastname: Ho
authors.forename: K
authors.initials: K
authors.lastname: Wilson
authors.forename: P
authors.initials: P
authors.lastname: Pearson
authors.forename: S
authors.initials: S
authors.lastname: Mushemi
authors.forename: J
authors.initials: J
authors.lastname: Deguzman
authors.forename: J
authors.initials: J
authors.lastname: Reiken
authors.forename: M D
authors.initials: MD
authors.lastname: Harden
authors.forename: N
authors.initials: N
authors.lastname: Walker
authors.forename: P G
authors.initials: PG
authors.lastname: Rafter
authors.forename: M J
authors.initials: MJ
authors.lastname: Monaghan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D025401:Echocardiography, Stress; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity