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Murine Echocardiography and Ultrasound Imaging
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Improved Visualization in Difficult-to-Image Stress Echocardiography Patients Using Real-Time Harmonic Spatial

Dongwoon Hyun, Anna Lisa C Crowley, Melissa LeFevre

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    Summary
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    Harmonic spatial coherence imaging (HSCI) significantly improves visualization of the left ventricle (LV) during stress echocardiography, especially in obese patients. This advanced technique reduces image clutter, enhancing diagnostic accuracy for myocardial ischemia detection.

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    Area of Science:

    • Medical Imaging
    • Cardiovascular Ultrasound
    • Diagnostic Echocardiography

    Background:

    • Stress echocardiography assesses cardiac function but is challenged by image clutter in obese patients.
    • Left ventricular (LV) endocardial border visualization is crucial for detecting myocardial ischemia.
    • Obesity rates have increased globally, exacerbating imaging difficulties in echocardiography.

    Purpose of the Study:

    • To evaluate the efficacy of harmonic spatial coherence imaging (HSCI) in improving LV visualization during stress echocardiography.
    • To compare HSCI with conventional tissue harmonic imaging (THI) in difficult-to-image patients.

    Main Methods:

    • Implemented a real-time, efficient short-lag spatial coherence (SLSC) imaging formulation on a GPU-based beamformer.
    • Conducted a comparative study using HSCI and THI on 15 patients undergoing stress echocardiography.
    • Experienced readers assessed the visualization of 17 LV segments on a three-point scale.

    Main Results:

    • HSCI demonstrated clear superiority over THI in unadjusted symmetry tests.
    • Per-patient median total scores significantly favored HSCI.
    • When simplified to a two-level scale, HSCI showed overall superiority over THI, with statistical significance after adjustment for clustering.

    Conclusions:

    • HSCI significantly enhances LV visualization in stress echocardiography compared to THI.
    • This improved imaging may reduce the need for contrast agents in challenging patient populations.
    • HSCI represents a promising advancement for diagnosing myocardial ischemia, particularly in obese individuals.