Automated quantitative assessment of wall motion in patients with poor acoustic windows

Abstract

Background No technique exists for objective evaluation of left ventricular wall motion in contrast-enhanced images. We tested a new technique for quantification of regional fractional area change using contrast-enhanced power modulation imaging with color kinesis. Methods The feasibility of this technique for detecting acute ischemia was first tested in 11 pigs. Next, the accuracy for detecting resting wall-motion abnormalities was determined in 52 patients requiring contrast and compared with conventional interpretation of 2-dimensional images by inexperienced readers. Expert interpretation of 2-dimensional images served as the gold standard. Results In pigs, coronary occlusion resulted in reversible hypokinesis and reduced regional fractional area change. In patients with poor acoustic windows, this technique's accuracy for quantitative detection of resting wall-motion abnormalities was 86% compared with 81% for conventional interpretation by inexperienced readers ( P < .01). Conclusions Regional wall motion can be accurately assessed using color-encoded power modulation imaging for patients requiring contrast. This technique may prove a useful diagnostic aid to echocardiographers of varying levels of experience.