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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Cardiac thrombotic stability determined by contrast-enhanced echocardiography: investigative protocol and preliminary

Ying Li1, Xin Wang2, Weidong Ren1

  • 1Department of Ultrasound, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang City, 110004, China.

BMC Cardiovascular Disorders
|June 1, 2021
PubMed

Insights

A new contrast-enhanced ultrasound (CEUS) scoring system effectively assesses cardiac thrombus stability. This system correlates thrombus substrate and hardness with embolism risk and thrombolytic time.

Area of Science:

  • Cardiovascular Imaging
  • Biomedical Engineering
  • Thrombosis Research

Background:

  • Cardiac thrombi pose significant risks, including embolism.
  • Accurate assessment of thrombus stability is crucial for patient management.
  • Current methods for evaluating thrombus characteristics have limitations.

Purpose of the Study:

  • To develop and validate a novel scoring system for cardiac thrombotic stability.
  • To utilize contrast-enhanced ultrasound (CEUS) for quantitative thrombus assessment.
  • To correlate CEUS findings with thrombus hardness and substrate composition.

Main Methods:

  • An in vitro model using human whole blood was established to simulate thrombus formation over time.
  • Thrombi were analyzed using CEUS, histology, and shear wave elastography.
  • A cohort of 28 patients with cardiac thrombi underwent transthoracic echocardiography and CEUS.
  • A scoring system based on contrast penetration (substrate, Ts) and hardness (Th) was applied.

Main Results:

  • In vitro thrombi showed increased solidification and hardness over time.
  • CEUS contrast agents penetrated only fresh, non-stable thrombi.
  • Higher scores for substrate (Ts) and hardness (Th) correlated with longer thrombolytic times.
  • Increased Ts and Th were associated with a greater risk of embolism.

Conclusions:

  • The novel CEUS scoring system accurately reflects cardiac thrombus hardness and substrate quality.
  • This CEUS-based scoring system provides a quantitative measure of thrombotic stability.
  • The findings suggest potential for improved clinical risk stratification of cardiac thrombi.
Abstract

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