Ultrasonic Tissue Characterization: Review of a Noninvasive Technique for Assessing Myocardial Viability

The determination of myocardial perfusion and myocardial viability has prognostic and therapeutic implications, particularly in the current era of percutaneous transluminal coronary angioplasty and thrombolytic therapy. Several modes of investigation, including positron emission tomography, thallium-201 scintigraphy, and nuclear magnetic resonance imaging are used to differentiate viable from nonviable myocardium. Though these noninvasive tests are useful diagnostic modalities, they are expensive, time consuming, and too cumbersome to be used in the acute setting. Expeditious distinction between viable and nonviable myocardium, during acute coronary syndromes, is of great importance since reperfusion can minimize the extent of ischemic injury and infarction. An expanding body of evidence confirms that ultrasonic tissue characterization has great potential to become a practical bedside diagnostic tool in the search for salvageable myocardium. Further clinical investigative studies would help accomplish a better understanding of the complex interaction between ultrasound and myocardium. (ECHOCARDIOGRAPHY, Volume 13, July 1996)