Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography. II. Application of digital imaging techniques

W. F. Armstrong, S. R. West, J. C. Dillon, Harvey Feigenbaum

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Abstract

Contrast echocardiography can be used to identify nonperfused regions of myocardium and localize and quantify infarcted myocardium. Analysis is usually undertaken by visual inspection of an analog two-dimensional echocardiographic image. The purpose of our study was to apply digital imaging techniques to contrast-enhanced echocardiograms for the determination of myocardial infarct size. Myocardial contrast was produced by an injection into the aortic root of a mixture of hydrogen peroxide and blood. Sixteen open chest dogs were studied 4 hours after coronary artery occlusion. Echocardiograms were evaluated by two independent observers. The results were compared with infarct location and size determined with nitro-blue tetrazolium staining of the corresponding slice of the left ventricle. Both the routine analog echocardiographic image and the digital subtraction image were analyzed. For the latter, 3 precontrast and 3 postcontrast echocardiographic end-diastolic fields were digitized in a 256 x 256 x 6 bit matrix and then averaged. Average pre- and postcontrast images were mathematically subtracted to form the digital subtraction image. There was excellent correlation between the percent of infarct determined with digital subtraction contrast echocardiography and results of nitro-blue tetrazolium staining (r = 0.97, SEE = 0.04, p < 0.001). Using linear regression, the relation between infarct size by the two studies was best described by the equation DSI = 0.92 NBT + 0.03, where DSI = digital subtraction image and NBT = infarct size by nitro-blue tetrazolium. Inter- and intraobserver variability were also excellent (r = 0.93 and 0.96, respectively). It is concluded that the digital imaging technique can be applied to contrast-enhanced echocardiography and is an accurate and reproducible method for determining infarct percent in a single slice of the left ventricle.

Original languageEnglish
Pages (from-to)141-148
Number of pages8
JournalJournal of the American College of Cardiology
Volume4
Issue number1
StatePublished - 1984

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Echocardiography
Myocardial Infarction
Heart Ventricles
Myocardium
Staining and Labeling
Observer Variation
Coronary Occlusion
Hydrogen Peroxide
Linear Models
Coronary Vessels
Thorax
Dogs
Injections
4-anisyltetrazolium blue

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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title = "Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography. II. Application of digital imaging techniques",
abstract = "Contrast echocardiography can be used to identify nonperfused regions of myocardium and localize and quantify infarcted myocardium. Analysis is usually undertaken by visual inspection of an analog two-dimensional echocardiographic image. The purpose of our study was to apply digital imaging techniques to contrast-enhanced echocardiograms for the determination of myocardial infarct size. Myocardial contrast was produced by an injection into the aortic root of a mixture of hydrogen peroxide and blood. Sixteen open chest dogs were studied 4 hours after coronary artery occlusion. Echocardiograms were evaluated by two independent observers. The results were compared with infarct location and size determined with nitro-blue tetrazolium staining of the corresponding slice of the left ventricle. Both the routine analog echocardiographic image and the digital subtraction image were analyzed. For the latter, 3 precontrast and 3 postcontrast echocardiographic end-diastolic fields were digitized in a 256 x 256 x 6 bit matrix and then averaged. Average pre- and postcontrast images were mathematically subtracted to form the digital subtraction image. There was excellent correlation between the percent of infarct determined with digital subtraction contrast echocardiography and results of nitro-blue tetrazolium staining (r = 0.97, SEE = 0.04, p < 0.001). Using linear regression, the relation between infarct size by the two studies was best described by the equation DSI = 0.92 NBT + 0.03, where DSI = digital subtraction image and NBT = infarct size by nitro-blue tetrazolium. Inter- and intraobserver variability were also excellent (r = 0.93 and 0.96, respectively). It is concluded that the digital imaging technique can be applied to contrast-enhanced echocardiography and is an accurate and reproducible method for determining infarct percent in a single slice of the left ventricle.",
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AU - West, S. R.

AU - Dillon, J. C.

AU - Feigenbaum, Harvey

PY - 1984

Y1 - 1984

N2 - Contrast echocardiography can be used to identify nonperfused regions of myocardium and localize and quantify infarcted myocardium. Analysis is usually undertaken by visual inspection of an analog two-dimensional echocardiographic image. The purpose of our study was to apply digital imaging techniques to contrast-enhanced echocardiograms for the determination of myocardial infarct size. Myocardial contrast was produced by an injection into the aortic root of a mixture of hydrogen peroxide and blood. Sixteen open chest dogs were studied 4 hours after coronary artery occlusion. Echocardiograms were evaluated by two independent observers. The results were compared with infarct location and size determined with nitro-blue tetrazolium staining of the corresponding slice of the left ventricle. Both the routine analog echocardiographic image and the digital subtraction image were analyzed. For the latter, 3 precontrast and 3 postcontrast echocardiographic end-diastolic fields were digitized in a 256 x 256 x 6 bit matrix and then averaged. Average pre- and postcontrast images were mathematically subtracted to form the digital subtraction image. There was excellent correlation between the percent of infarct determined with digital subtraction contrast echocardiography and results of nitro-blue tetrazolium staining (r = 0.97, SEE = 0.04, p < 0.001). Using linear regression, the relation between infarct size by the two studies was best described by the equation DSI = 0.92 NBT + 0.03, where DSI = digital subtraction image and NBT = infarct size by nitro-blue tetrazolium. Inter- and intraobserver variability were also excellent (r = 0.93 and 0.96, respectively). It is concluded that the digital imaging technique can be applied to contrast-enhanced echocardiography and is an accurate and reproducible method for determining infarct percent in a single slice of the left ventricle.

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