Related Experiment Video
Updated: Oct 2, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Correlation between myocardial perfusion abnormalities detected with intermittent imaging using intravenous
Ricardo E Ronderos1, Mario Boskis, Namsik Chung
1Instituto de Cardiologia La Plata, Buenos Aires, Argentina. iclp@netverk.com.ar
Background:
The clinical accuracy of myocardial contrast echocardiography (MCE) using intermittent harmonic imaging and intravenous perfluorocarbon containing microbubbles during dipyridamole stress has not been evaluated in a multicenter setting.
Hypothesis:
The accuracy of dipyridamole stress contrast echo in the detection of coronary artery disease (CAD) using myocardial perfusion images is high in comparison with technetium-99 (99Tc) sestamibi single-photon emission computed tomography (MIBI SPECT) and increases the accuracy of wall motion data.
Methods:
In 68 consecutive nonselected patients (46 men; mean age 66 years) from three different institutions in two countries. dipyridamole stress echo and SPECT with 99mTc MIBI were compared. Continuous intravenous (IV) infusion of perfluorocarbon exposed sonicated dextrose albumin (PESDA) (2-5 cc/min) was administered for baseline myocardial perfusion using triggered harmonic end systolic frames. Real-time digitized images were used for wall motion analysis. Dipyridamole was then injected in two steps: (1) 0.56 mg/kg for 3 min, (2) 0.28 mg/kg for 1 min, if the first step was negative for an inducible wall motion abnormality. After dipyridamole injection, myocardial contrast enhancement and wall motion were analyzed again by the same methodology.
Results:
There were 35 patients with perfusion defects by SPECT. Wall motion was abnormal in 22, while MCE was abnormal in 32. Wall motion and MCE each had one false positive. The proportion of correctly assigned patients was significantly better with MCE than with wall motion (p = 0.03; chi square test).
Conclusions:
Myocardial contrast echocardiography, using intermittent harmonic imaging and intravenous perfluorocarbon containing microbubbles, is a very effective method for detecting coronary artery disease during dipyridamole stress echo.
Insights
Myocardial contrast echocardiography (MCE) effectively detects coronary artery disease during dipyridamole stress. This multicenter study confirms MCE
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Myocardial contrast echocardiography (MCE) clinical accuracy using harmonic imaging and microbubbles during dipyridamole stress was unproven in multicenter settings.
- Coronary artery disease (CAD) diagnosis relies on various imaging modalities.
Purpose of the Study:
- To evaluate the multicenter clinical accuracy of dipyridamole stress MCE for detecting CAD.
- To compare MCE with wall motion analysis and 99mTc MIBI SPECT.
Main Methods:
- 68 patients underwent dipyridamole stress echocardiography and SPECT.
- Continuous intravenous infusion of perfluorocarbon microbubbles (PESDA) was used for myocardial perfusion imaging.
- Wall motion analysis and myocardial contrast enhancement were assessed post-dipyridamole injection.
Main Results:
- MCE identified 32 patients with abnormal perfusion, while wall motion analysis identified 22.
- MCE demonstrated a significantly higher proportion of correctly assigned patients compared to wall motion analysis (p=0.03).
- Both MCE and wall motion analysis had one false positive result.
Conclusions:
- Dipyridamole stress MCE using intermittent harmonic imaging and microbubbles is highly effective for CAD detection.
- MCE enhances diagnostic accuracy compared to traditional wall motion analysis during dipyridamole stress.
- This multicenter study validates MCE as a reliable tool for assessing coronary artery disease.
Related Concept Videos
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
01:28Imaging Studies for Cardiovascular System V: CT
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...