Basis for detection of stenosis using venous administration of microbubbles during myocardial contrast echocardiography: bolus or continuous infusion?

Wei, Kevin; Jayaweera, Ananda R.; Firoozan, Soroosh; Linka, André; Skyba, Danny M.; Kaul, Sanjiv

doi:10.1016/s0735-1097(98)00212-5

Cited by 191 publications

(93 citation statements)

References 9 publications

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“…These include the diagnosis of liver lesions [2], the assessment of microvascular damage after a myocardial infarction [3] and the detection of coronary disease [4]. Microbubbles are a pure blood pool contrast agent, because their size is of the same order as red blood cells and thus cannot leave the vascular bed and escape in the interstitium [5], [6]. Their size along with their unique acoustic properties allow for the imaging of perfusion in real time using diagnostic ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Accuracy of Liver Lesion DCEUS Quantification With Respiratory Gating

Christofides¹,

Leen²,

Averkiou³

2016

IEEE Trans. Med. Imaging

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Section: Introductionmentioning

confidence: 99%

Evaluation of the Accuracy of Liver Lesion DCEUS Quantification With Respiratory Gating

Christofides¹,

Leen²,

Averkiou³

2016

IEEE Trans. Med. Imaging

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“…Following the administration of low-dose dipyridamole, images are acquired at one transmission per cardiac cycle, and a decrease in myocardial enhancement is observed on the endocardial surface in areas supplied by a stenotic coronary artery [37][38][39]. VoluMap analysis clearly demonstrates the reduced RMCI on the endocardial surface, providing images that are easily interpreted even by inexperienced users (Figure 9).…”

Section: Volumetric Imagingmentioning

confidence: 99%

Quantitative Myocardial Contrast Echocardiography in Coronary Artery Disease

Ito

2006

J Echocardiogr

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SummaryIt is now possible to perform myocardial contrast echocardiography (MCE) at the bedside with intravenous injection of commercially available contrast media. Detecting coronary stenosis and myocardial viability in patients is the major aim of anMCE study, but its diagnosis has relied largely on subjective interpretation of regional perfusion by experienced readers. Thus, quantifying MCE data and displaying comprehensive images have been be necessary for its routine application. In this review, two methods for quantifying and displaying MCE parameters will be introduced: 1) parametric imaging that separately displays the parameters of myocardial blood volume, blood flow velocity, and myocardial blood flow; and 2) volumetric imaging that displays a color-coded map of myocardial blood volume fraction. Both methods of analysis provide quantitative and easy-to-understand images even to unexperienced observers. (J Echocardiogr 2006; 4: 99-109)

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“…MCE is based on the microvascular rheology of microbubbles that is similar to that of red blood cells. Wei et al [25] and Jayaweera et al [26] have shown that the magnitude of a myocardial perfusion defect in a clinical study following the administration of adenosine is related to the severity of coronary stenoses. A recent study has demonstrated that the sensitivity of myocardial contrast perfusion abnormalities is greater than that of wall motion abnormalities for the detection of coronary stenosis > 50% diameter, even at a low dose of dobutamine infusion [13].…”

Section: Mce During Dsementioning

confidence: 99%

Utility of Combined Assessment of Coronary Flow Velocity and Myocardial Perfusion During Low-dose Dobutamine Stress Echocardiography in the Detection of Left Anterior Coronary Artery Disease

Ohno¹,

Honma²,

Takayama³

et al. 2006

J Echocardiogr

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Background. Ischemia produces a sequence of events beginning with a decline in coronary flow reserve, myocardial perfusion abnormalities, and wall motion abnormalities. We hypothesized that low-dose dobutamine stress, combined with myocardial contrast echocardiography (MCE) and transthoracic Doppler echocardiography (TTDE), could detect myocardial ischemia preceding wall motion abnormalities according to this ischemic cascade.Methods. Ninety-six patients suspected of having stable angina pectoris underwent TTDE, MCE, and semi-quantitative dobutamine stress echocardiography (Semi-DSE). Wall motion was assessed using a scoring system. The contrast agent, Levovist, was injected intravenously to assess the coronary flow velocity (CFV) ratio in the left anterior descending coronary artery (LAD) and myocardial perfusion abnormalities in the LAD territory. The CFV ratio was calculated as the CFV during low-dose dobutamine stress divided by the baseline CFV. Time-intensity data for MCE were fitted for y = A (1 e t ) from which the rate of the intensity rise ( ) was calculated and the ratio was derived at baseline and during stress.Results. Semi-DSE and low-dose dobutamine stress combined with TTDE and MCE were obtained successfully in 85patients. The sensitivity and specificity of Semi-DSE for detecting 75% LAD stenosis were 79% and 93%, respectively. In the LAD territory, Semi-DSE showed 6 false negative and 4 false positive findings. However, failures of the CFV ratio and ratio to increase >1.81 and >1.23 times that at baseline, respectively, indicated the presence of critical LAD stenosis, especially in 3 out of 6 false negative cases.Conclusions. Low-dose dobutamine stress combined with TTDE and MCE is a useful method for detecting critical LAD stenosis during Semi-DSE. This method overcomes the limitations of Semi-DSE. (J Echocardiogr 2006; 4: 69-77)

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Basis for detection of stenosis using venous administration of microbubbles during myocardial contrast echocardiography: bolus or continuous infusion?

Abstract: Both bolus injection and continuous infusion provide quantitative assessment of relative stenosis severity. Compared with bolus injection, continuous infusion also allows quantification of MBF and data acquisition without attenuation of any myocardial bed.

Cited by 191 publications

References 9 publications

Evaluation of the Accuracy of Liver Lesion DCEUS Quantification With Respiratory Gating

Evaluation of the Accuracy of Liver Lesion DCEUS Quantification With Respiratory Gating

Quantitative Myocardial Contrast Echocardiography in Coronary Artery Disease

Utility of Combined Assessment of Coronary Flow Velocity and Myocardial Perfusion During Low-dose Dobutamine Stress Echocardiography in the Detection of Left Anterior Coronary Artery Disease

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