Rapid three-dimensional myocardial contrast echocardiography: Volumetric quantitation of nonperfused myocardium after intravenous contrast administration

Current acquisition, methods for quantitative three-dimensional myocardial contrast echocardiography require long acquisition times and therefore requ ire the invasive administration of deposit contrast agents administered int ra-arterially or into the Left atrium. This study addressed the feasibility of obtaining accurate and precise quantitative volumetric measurements of nonperfused myocardium after an intravenous bolus of echocardiographic cont rast agent using a rapid three-dimensional myocardial contrast echocardiogr aphic acquisition technique. An open-chest pig model of acute left anterior descending coronary artery (LAD) occlusion was used. After LAD ligature, a n intravenous bolus of contrast agent was given and images were obtained ov er a 12-second period using a continuously rotating transducer placed at th e apical position. There was no significant microbubble destruction during the rotational acquisition period as measured by differences in mean. gray scale values of apical, mid, and basal myocardial regions between the first and Last image frames of acquisition. Calculated volumes of nonperfused my ocardium demonstrated significant agreement and correlation (mean differenc e +/- SD = -0.30 +/- 1.71 cm(3); r = 0.89; P < 0.01; y = 1.06x - 1.08) with anatomic specimens. When expressed as percent of total LV volume being non perfused, the mean difference +/- SD was 2.1 +/- 3.6%, r = 0.94 P < 0.01, a nd y = 1.33x - 4.08. We conclude that accurate and precise measurements of nonperfused myocardium after an acute LAD coronary artery occlusion can be obtained after the intravenous bolus administration, of a contrast material when a rapid 12-second acquisition with a continuously rotating transducer is used.