[Analysis of myocardial texture in two-dimensional echocardiographic images]

To evaluate tissue changes, we studied myocardial texture using two-dimensional echocardiographic images. We investigated 19 normal subjects, 28 patients with left ventricular hypertrophy, and 12 patients with old anteroseptal myocardial infarction of longer than one year duration. Using 2.5, 3.5, and 5.0 MHz transducers, two-dimensional echocardiograms in the parasternal long-axis view were obtained, and the textures of the interventricular septal images were classified in three types; type I, with a nearly uniformly speckled or echolucent appearances; type II, with multiple, discrete, small (2 to 4 mm) highly refractile echoes; type III, with larger highly refractile echoes (greater than 4 mm) appearing as a cluster of broad patches or band-like echoes. Normal subjects belonged to the type I texture, while many with left ventricular hypertrophy belonged to the type II category. Type III was often observed in patients with old anteroseptal infarction. Using a transducer of higher frequency, there tended to be a shift from type II to I or type III to II. In phantom experiments using carbolandam granules instead of the myocardium, the echocardiographic texture became rough when the phantom was farther from the transducer or the transducer was of low frequency. We suggest that the texture in two-dimensional images may reflect myocardial tissue changes, when other factors including the apparatus and technique remain stable.