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Effect of color coding and subtraction on the accuracy of contrast echocardiographyBACKGROUND: Contrast echocardiography may be used to assess myocardial perfusion. However, gray scale assessment of myocardial contrast echocardiography (MCE) is difficult because of variations in regional backscatter intensity, difficulties in distinguishing varying shades of gray, and artifacts or attenuation. We sought to determine whether the assessment of rest myocardial perfusion by MCE could be improved with subtraction and color coding. METHODS AND RESULTS: MCE was performed in 31 patients with previous myocardial infarction with a 2nd generation agent (NC100100, Nycomed AS), using harmonic triggered or continuous imaging and gain settings were kept constant throughout the study. Digitized images were post processed by subtraction of baseline from contrast data and colorized to reflect the intensity of myocardial contrast. Gray scale MCE alone, MCE images combined with baseline and subtracted colorized images were scored independently using a 16 segment model. The presence and severity of myocardial contrast abnormalities were compared with perfusion defined by rest MIBI-SPECT. Segments that were not visualized by continuous (17%) or triggered imaging (14%) after color processing were excluded from further analysis. The specificity of gray scale MCE alone (56%) or MCE combined with baseline 2D (47%) was significantly enhanced by subtraction and color coding (76%, p<0.001) of triggered images. The accuracy of the gray scale approaches (respectively 52% and 47%) was increased to 70% (p<0.001). Similarly, for continuous images, the specificity of gray scale MCE with and without baseline comparison was 23% and 42% respectively, compared with 60% after post processing (p<0.001). The accuracy of colorized images (59%) was also significantly greater than gray scale MCE (43% and 29%, p<0.001). The sensitivity of MCE for both acquisitions was not altered by subtraction. CONCLUSION: Post-processing with subtraction and color coding significantly improves the accuracy and specificity of MCE for detection of perfusion defects.
Document ID
20040141816
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Pasquet, A.
(Cleveland Clinic Foundation OH, United States)
Greenberg, N.
Brunken, R.
Thomas, J. D.
Marwick, T. H.
Date Acquired
August 22, 2013
Publication Date
August 31, 1999
Publication Information
Publication: International journal of cardiology
Volume: 70
Issue: 3
ISSN: 0167-5273
Subject Category
Life Sciences (General)
Distribution Limits
Public
Copyright
Other
Keywords
Multicenter Study
Non-NASA Center
NASA Discipline Cardiopulmonary
Randomized Controlled Trial
Clinical Trial

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