Harmonic imaging: echocardiographic enhanced contrast intensity and duration

The intensity and duration of contrast effect within the left ventricular cavity after an intravenous bolus of Levovist Injection were observed with both harmonic and fundamental imaging in nine patients with known or suspected coronary artery disease. Contrast intensity was assessed by a qualitative grading system (0, none; 1, weak; 2, moderate; 3, good) and by videodensitometric analysis of pixel intensity. Duration of left ventricular contrast effect was determined by measuring time from the initial visual appearance of contrast agent to its disappearance. The mean increase in pixel intensity within the left ventricular cavity from precontrast to peak contrast was significantly greater for second harmonic than for fundamental imaging (25.5 vs 7.1; P < 0.012). The mean contrast intensity qualitative score with harmonic imaging was higher (2.6 +/- 0.73 vs 1.2 +/- 0.44; P < 0.01) and the duration of contrast effect was longer (242 +/- 131 s vs 53 +/- 33 s; P < 0.004). Second harmonic imaging significantly enhanced contrast intensity and prolonged visible duration of contrast effect after a peripheral venous injection of Levovist.