Detection and quantification of myocardial scars by contrast-enhanced 3D echocardiography.
BACKGROUND
Myocardial infarct scars are usually imaged by delayed-enhanced cardiac magnetic resonance (DE-cMR). In this study, we tested the hypothesis that the detection and quantification of myocardial scars can be evaluated by 3D echocardiography (3D-echo).


RESULTS
Fifty patients with a healed myocardial infarction (>3 months) and 10 controls underwent 3D echo and DE-cMR within 2 weeks. 3D-echo images were acquired with different settings, with or without contrast. The highest contrast-to-noise ratio was obtained with second-harmonic imaging (1.6/3.2 MHz), at a mechanical index of 0.5, in the presence of contrast. Using this modality, we calculated the sensitivity and specificity of the 3D-echo detection of cMR scars on a segmental basis to be 78% and 99%, respectively. On a per-patient basis, they were 96% and 90%, respectively. Good correlation and limits of agreement were found between the assessment of scar mass by 3D echo and DE-cMR (r=0.93, P<0.001; bias, 1.4+/-3.6 g), and the concordance between both techniques for the assessment of scar transmurality was good. Intraobserver, interobserver, and day-to-day reproducibility was comparable between 3D echo and DE-cMR for both the detection and quantification of scars.


CONCLUSIONS
Contrast-enhanced 3D echo is a promising new tool for the detection and quantification of myocardial infarct scars.
Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Louvain, Belgium.
Patrick
P
Montant
Fabien
F
Chenot
Céline
C
Goffinet
Alain
A
Poncelet
David
D
Vancraeynest
Agnès
A
Pasquet
Bernhard L
BL
Gerber
Jean-Louis J
JL
Vanoverschelde
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D009942:Organometallic Compounds; D010743:Phospholipids; D011446:Prospective Studies; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride; D015899:Tomography, Emission-Computed, Single-Photon
D003287:Contrast Media; D009942:Organometallic Compounds; D010743:Phospholipids; C420843:contrast agent BR1; C064572:gadobenic acid; D008536:Meglumine; D013459:Sulfur Hexafluoride