Comparative diagnostic accuracy of multiplane and multislice three-dimensional dobutamine stress echocardiography in the diagnosis of coronary artery disease.
BACKGROUND
Although real-time three-dimensional echocardiography (RT3DE) is useful for delineating the extent and severity of stress-induced wall motion abnormalities during dobutamine stress echocardiography (DSE), it also provides simultaneous multiple two-dimensional cut planes, which may potentially improve the detection of stress-induced wall motion abnormalities. The aim of this study was to determine the comparative diagnostic accuracy of RT3DE in multiplane and multislice modes for the diagnosis of coronary artery disease (CAD) during DSE against coronary angiography reference.


METHODS
Multiplane and multislice cut planes (3 V, GE Healthcare, Milwaukee, WI) at rest and peak dose of dobutamine were acquired in 71 patients with known or suspected CAD. In multiplane mode, matrix array transducer allowed the simultaneous visualization of parasternal long and short-axis views or apical 4-, 2-, and 3-chamber views. From full-volume datasets, 9 equidistant 2-dimensional short-axis images from LV base to apex were extracted and simultaneously displayed (multislice mode). Visual assessment of regional wall motion was performed. Coronary angiography was performed within 48 hours and used as a reference.


RESULTS
Abnormal findings (new or worsened wall motion abnormalities or fixed wall motion abnormalities) were noted in 36 patients by multiplane mode and 28 patients by multislice mode. Coronary angiography showed significant stenosis in 32 of 71 patients in 49 of 213 coronary arteries. On a patient basis, sensitivity was not different, but specificity was significantly higher in multislice mode (95%) compared with multiplane mode (77%, P < .05). Diagnostic accuracy for detecting right CAD was also significantly higher in multislice mode (93% vs 80%, P < .05).


CONCLUSIONS
Assessment of LV wall motion from multiple short-axis slices extracted from full-volume RT3DE datasets improves the diagnosis of CAD and is thus a useful addition to DSE tools.
Yoshitani
Hidetoshi
H
Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
Takeuchi
Masaaki
M
Mor-Avi
Victor
V
Otsuji
Yutaka
Y
Hozumi
Takeshi
T
Yoshiyama
Minoru
M
D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004280:Dobutamine; D025401:Echocardiography, Stress; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D004280:Dobutamine