Assessment of Myocardial Perfusion during Adenosine Stress Using Real Time Three-Dimensional and Two-Dimensional Myocardial Contrast Echocardiography: Comparison with Single-Photon Emission Computed Tomography

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 27; no. 4; pp. 421 - 429
• Main Authors: Abdelmoneim, Sahar S., Bernier, Mathieu, Dhoble, Abhijeet, Moir, Stuart, Hagen, Mary E., Ness, Sue Ann C., Abdel-Kader, Samir S., Pellikka, Patricia A., Mulvagh, Sharon L.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-04-2010
• Subjects: 3-dimensional echocardiography; Adenosine - administration & dosage; Aged; Computer Systems; contrast echocardiography; Contrast Media; coronary artery disease; Coronary Artery Disease - diagnostic imaging; Echocardiography, Stress - methods; Echocardiography, Three-Dimensional - methods; Exercise Test - methods; Female; Fluorocarbons; Humans; Image Enhancement - methods; Image Processing, Computer-Assisted - methods; Male; Myocardial Perfusion Imaging; Observer Variation; Reproducibility of Results; single-photon emission computed tomography; Tomography, Emission-Computed, Single-Photon - methods
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/j.1540-8175.2009.01026.x

Objectives: To evaluate diagnostic accuracy of adenosine two‐dimensional and three‐dimensional myocardial contrast echocardiography (2D‐ and 3D‐MCE) compared with single‐photon emission computed tomography (SPECT) for assessing myocardial perfusion. Methods: From January through August 2007, patients with known or suspected CAD who were referred for SPECT underwent simultaneous adenosine 2D‐MCE and 3D‐MCE (live and full volume [FV]). Perfusion and wall motion in 17 segments in the left anterior descending, left circumflex, and right coronary artery territories were analyzed. Results: We studied 30 patients: mean (SD) age, 72.6 (8.2) years; 19 (63%) men. Perfusion by SPECT was abnormal in 13 patients (43%). When comparing MCE with SPECT, sensitivity was comparable for 2D‐MCE, 92%; live 3D‐MCE, 91%; and FV 3D‐MCE, 90%. Specificity was comparable for 2D‐MCE, 75%; live 3D‐MCE, 69%; and FV 3D‐MCE, 79%. Agreement between live 3D‐MCE and 2D‐MCE was 92% (κ[SE], 0.83 [0.17]) and between FV 3D‐MCE and 2D‐MCE, 88% (κ[SE], 0.76 [0.13]). For eight patients in whom SPECT showed reversible defects, live 3D‐MCE correctly identified defects in seven (88%), whereas FV 3D‐MCE correctly identified them in five (63%) (P = 0.57). Conclusion: Myocardial perfusion assessment is feasible by 3D‐MCE with the advantage of rapid, facile acquisition and offline image manipulation. (Echocardiography 2010;27:421‐429)