Enhanced visualisation of the right ventricle by contrast echocardiography in congenital heart disease

Contrast echocardiography improves endocardial border detection of the left ventricle. Whether this is also true for the right ventricle (RV) is unknown. The aim of this study is to assess whether the use of contrast (Sonovue) echocardiography has additional value in RV endocardial border visualisation (EBV), and whether it has impact on the echocardiographic judgement of RV function.

Twenty adult patients with congenital heart disease were imaged using second harmonic two-dimensional echocardiography with and without contrast. Two independent observers analysed EBV of 13 RV wall segments in each patient. EBV was graded for each wall segment from 0 to 3 ( 0 = not visible, 3 = optimal visible).

EBV improved in all patients with contrast echocardiography compared to second harmonic imaging (mean EBV 1.00 +/- 0.77 with second harmonics, 2.13 +/- 0.75 with contrast, P < 0.0001). The benefit was most evident in the near-field images. In 55% of the patients visual estimation of RV function changed with contrast echocardiography.

The use of contrast echocardiography is superior to second harmonic imaging for RV EBV. Improved EBV may allow more accurate assessment of RV dimensions and function.