Ward R Parker, Collins Keith A, Balasia Beth, Spencer Kirk T, Decara Jeanne M, Mor-Avi Victor, Sugeng Lissa, Lang Roberto M
University of Chicago Medical Center, 5841 S Maryland Ave, MC5084, Chicago, IL 60637, USA.
J Am Soc Echocardiogr. 2004 Jan;17(1):10-4. doi: 10.1016/j.echo.2003.09.007.
Although harmonic imaging (HI) improves endocardial visualization and is necessary for myocardial perfusion imaging, it has yet to be implemented in transesophageal echocardiography. Our goal was to determine whether HI implemented in a prototype transesophageal echocardiography probe improved endocardial visualization and allowed perfusion imaging.
In 23 patients, fundamental and harmonic images were obtained in the transgastric short-axis (TSAX) and midesophageal 4-chamber views, and reviewed for endocardial visualization by 3 readers blinded to imaging mode. In 14 additional patients, perfusion imaging was performed in the TSAX view during contrast infusion.
HI improved overall endocardial visualization, most noticeably in the anterior and lateral segments (P <.004) in the TSAX view, and in the lateral segments (P <.01) in the midesophageal 4-chamber view. The salvage rate was 8.3% in the TSAX view and 12.6% in the midesophageal 4-chamber view. Myocardial perfusion was consistently confirmed in the inferior (86%), posterior (100%), and lateral (79%) segments, but rarely in the septal (21%), anteroseptal (0%), and anterior (14%) segments.
Use of HI with transesophageal echocardiography improves endorcardial visualization and allows partial assessment of myocardial perfusion.
尽管谐波成像（HI）可改善心内膜的可视化，且是心肌灌注成像所必需的，但尚未应用于经食管超声心动图检查。我们的目标是确定在原型经食管超声心动图探头中实施的HI是否能改善心内膜的可视化并实现灌注成像。
对23例患者在经胃短轴（TSAX）和食管中段四腔心切面获取基波图像和谐波图像，由3名对成像模式不知情的阅片者评估心内膜的可视化情况。另外对14例患者在TSAX切面注射造影剂时进行灌注成像。
HI改善了整体心内膜的可视化，在TSAX切面最明显的是前壁和侧壁节段（P <.004），在食管中段四腔心切面是侧壁节段（P <.01）。TSAX切面的挽救率为8.3%，食管中段四腔心切面为12.6%。在下壁（86%）、后壁（100%）和侧壁（79%）节段可始终确认心肌灌注，但在间隔（21%）、前间隔（0%）和前壁（14%）节段很少见。
经食管超声心动图检查中使用HI可改善心内膜的可视化，并可对心肌灌注进行部分评估。
