Mele Donato, Soukhomovskaia Olga, Pacchioni Emanuele, Merli Elisa, Avigni Nicola, Federici Luca, Levine Robert A, Ferrari Roberto
Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, and Centro di Fisiopatologia Cardiovascolare Salvatore Maugeri, Foundation IRCCS, Ferrara, Italy.
J Am Soc Echocardiogr. 2006 Nov;19(11):1373-81. doi: 10.1016/j.echo.2006.05.011.
Tissue harmonic imaging (THI) reduces near-field and side-lobe artifacts. This could improve recognition of cardiac masses, including thrombi and spontaneous echocontrast (SEC), a known thromboembolic risk factor.
We tested the hypothesis that THI improves detection of left ventricular (LV) thrombi and SEC compared with transthoracic fundamental imaging in patients with recent myocardial infarction.
In all, 118 consecutive patients with recent myocardial infarction were studied at predischarge. The echocardiographic examination was performed in both fundamental imaging and THI modality and evaluated by 3 skilled and 3 nonexperienced observers for recognition of LV thrombosis and SEC.
THI increased LV thrombi diagnosis by 25% by skilled observers and by 50% by nonexperienced readers, reducing the number of false-positive diagnoses by 67%. Also, compared with fundamental imaging, THI improved recognition of LV SEC by both experienced and nonexperienced observers by 56% and 62%, respectively.
The improved recognition of LV thrombosis and SEC by THI in patients with myocardial infarction is clinically relevant allowing appropriate treatment and prognostic stratification. Therefore, routine use of THI should be recommended when studying such patients in clinical practice.
组织谐波成像（THI）可减少近场和旁瓣伪像。这可能会提高对心脏肿块的识别能力，包括血栓和自发显影（SEC），后者是一种已知的血栓栓塞危险因素。
我们检验了这样一个假设，即在近期心肌梗死患者中，与经胸基本成像相比，THI能提高左心室（LV）血栓和SEC的检测率。
总共对118例近期心肌梗死患者在出院前进行了研究。采用基本成像和THI两种模式进行超声心动图检查，并由3名技术熟练的观察者和3名经验不足的观察者评估LV血栓形成和SEC情况。
技术熟练的观察者通过THI使LV血栓诊断率提高了25%，经验不足的观察者提高了50%，假阳性诊断数量减少了67%。此外，与基本成像相比，THI使经验丰富和经验不足的观察者对LV SEC的识别率分别提高了56%和62%。
THI提高了心肌梗死患者对LV血栓形成和SEC的识别率，具有临床意义，有助于进行适当的治疗和预后分层。因此，在临床实践中研究此类患者时，建议常规使用THI。
