Kasprzak J D, Drozdz J, Zwierzak M, Borkowski M, Plewka M, Elhendy A, Ten Cate F J, Roelandt J R, Krzemińska-Pakuła M
Klinika Kardiologii Instytutu Medycyny Wewnetrznej AM w Łodzi.
Pol Arch Med Wewn. 2000 Jan-Feb;103(1-2):35-40.
Harmonic imaging is a new imaging modality using nonlinear acoustic response, which is particularly sensitive for the particles of contrast agents. Our study was designed to compare the potential of harmonic echocardiographic imaging of the left ventricle using a contrast agent, Levovist to improve the detection of endocardium in patients with suboptimal image quality. 40 patients were studied using standard transthoracic apical views of the left ventricle patients using fundamental frequency and second harmonic frequency after and intravenous injection of 2.5 g Levovist. The quality of endocardial delineation in 16 standard segments was scored from 0 to 2. Endocardial visualization index was calculated as a mean of the scores to express overall diagnostic quality. Harmonic imaging with contrast significantly improved left ventricular endocardial border detection (endocardial visualization index at baseline 1.24 +/- 0.41, with contrast 1.63 +/- 0.38; p < 0.001). The improvement was qualitatively observed in all parts of the left ventricle: in apex (2.4 +/- 0.8), in the middle part (2.5 +/- 0.9) and slightly less in the basal part (2.1 +/- 1.1) as scored on a 0-3 scale. The number of invisible segments decreased from 124 (fundamental) to 50 in contrast harmonic mode. The persistence of the contrast enhancement, prolonged in harmonic as compared to fundamental imaging (284 +/- 136s vs 117 +/- 87s; p < 0.001) enabled convenient recording of all necessary views. Harmonic imaging after an intravenous injection of Levovist significantly improves the visualization of left ventricular endocardial border. Prolonged contrast effect after a single bolus enhances the pertinence of the method in clinical practice.
谐波成像技术是一种利用非线性声学响应的新型成像方式，对造影剂颗粒尤为敏感。我们的研究旨在比较使用造影剂声诺维进行左心室谐波超声心动图成像，以改善图像质量欠佳患者心内膜检测的潜力。对40例患者采用标准经胸左心室心尖视图，在静脉注射2.5克声诺维后，分别使用基波频率和二次谐波频率进行研究。对16个标准节段的心内膜描绘质量从0到2进行评分。计算心内膜可视化指数作为评分均值以表达整体诊断质量。使用造影剂的谐波成像显著改善了左心室心内膜边界检测（基线时心内膜可视化指数为1.24±0.41，使用造影剂时为1.63±0.38；p<0.001）。在左心室所有部位均定性观察到了改善：在心尖部（评分为2.4±0.8）、中部（2.5±0.9），基底部改善稍小（2.1±1.1），评分范围为0 - 3分。不可见节段的数量从基波成像时的124个减少到谐波造影模式下的50个。与基波成像相比，谐波成像中造影剂增强的持续时间延长（284±136秒对117±87秒；p<0.001），便于记录所有必要视图。静脉注射声诺维后的谐波成像显著改善了左心室心内膜边界的可视化。单次推注后造影剂效果的延长增强了该方法在临床实践中的针对性。
