Echographic diagnosis of left intraventricular thrombi: contribution of high frequency probes

Two-dimensional echocardiography is the reference technique for the diagnos is of left ventricular thrombi. However, ii has some limitations due to poo r imaging of the apex; location of many thrombi. Apical resolution improvem ent is possible using a 5 MHz ultrasonic transducer, which may identify 3.5 MHz ultrasonic transducer false positive results. In a series of 53 patient s with left ventricular dysfunction, we detected 11 thrombi. Using the 5MHz ultrasonic transducer as a reference the sensitivity of the 3.5MHz ultraso nic transducer was 100%, and much greater than that of the 2.5MHz ultrasoni c transducer (55%), which was associated with 4 false positive results. The increased sensitivity associated with transducers of higher frequency was however limited by the echogenicity of patients, all the more since we used a medium instead of a short focalisation. Due to its therapeutic consequences, the detection of left ventricular thro mbi must be enhanced using 5 MHz ultrasonic transducer, all the more in ech ogenic patients.