Determination of Infarct Size and Transmurality by Contrast-Enhanced 3D-Echocardiography

Dans le Circulation imaging, un article belge (enfin Wallon…) qui me fait rêver, de l’échographie de contraste en 3D! Le pied… Un peu comme d’aller au resto et au cinéma (sans les enfants). A suivre des exemples (en 2D) d’échographie de contraste ou l’on note une stagnation des bulles dans une partie, ou dans la totalité de la zone infarcie. Des images assez superposable au rehaussement tardif constaté en IRM…

Determination of Infarct Size and Transmurality by Contrast-Enhanced 3D-Echocardiography

Patrick Montant; Fabien Chenot; Céline Goffinet; Alain Poncelet; David Vancraeynest; Agnès Pasquet; Bernhard L. Gerber and Jean-Louis J. Vanoverschelde1

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

Methods and 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 using different settings, in the presence or absence of contrast. The highest contrast-to-noise ratio was obtained using second harmonic imaging (1.6/3.2 MHz), at an MI of 0.5, in the presence of contrast. Using this modality, the sensitivity and specificity for the 3D-Echo detection of cMR scars on a segmental basis were 78% and 99%, respectively. On a per patient basis, they were of 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,> 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 the quantification of scars.

Conclusions—Contrast-enhanced 3D-Echo is a promising new tool for the detection and the quantification of myocardial infarct scars.

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