Determination of Infarct Size and Transmurality by Contrast-Enhanced 3D-Echocardiography
OBJECTIVES: Myocardial infarct scars are usually imagedusing delayed-enhanced cardiac magnetic resonance (DE-cMR).In this study, we tested the hypothesis that the detection andthe quantification of myocardial scars can be evaluated by 3D-Echo.
METHODS: Fifty patients with a healed myocardialinfarction (>3 months) and 10 controls underwent 3D-Echoand DE-cMR within 2 weeks. 3D-Echo images were acquired usingdifferent settings, in the presence or absence of contrast.
RESULTS: The highest contrast-to-noise ratio was obtained using secondharmonic imaging (1.6/3.2 MHz), at an MI of 0.5, in the presenceof contrast. Using this modality, the sensitivity and specificityfor the 3D-Echo detection of cMR scars on a segmental basiswere 78% and 99%, respectively. On a per patient basis, theywere of 96% and 90%, respectively. Good correlation and limitsof agreement were found between the assessment of scar massby 3D-Echo and DE-cMR (r=0.93, p<0.001, bias: 1.4±3.6g),and the concordance between both techniques for the assessmentof scar transmurality was good. Intraobserver, interobserverand day-to-day reproducibility was comparable between 3D-Echoand DE-cMR for both the detection and the quantification ofscars.
CONCLUSIONS: Contrast-enhanced 3D-Echo is a promising newtool for the detection and the quantification of myocardialinfarct scars.
