Influence of transducer frequency and imaging modality on the intraoperative assessment of myocardial perfusion with transesophageal echocardiography.

Journal Article (Journal Article)

OBJECTIVE: To determine factors that improve intraoperative myocardial perfusion assessment with conventional ultrasound imaging and intravenous ultrasound agents. DESIGN: Prospective cohort study with repeated interventions on each patient. SETTING: Single university hospital. PARTICIPANTS: Fourteen patients scheduled for elective coronary artery bypass graft surgery. INTERVENTIONS: Myocardial perfusion was evaluated with contrast transesophageal echocardiography during conventional imaging after central venous injections of the contrast agent Optison (0.3 mL) before cardiopulmonary bypass. Eight patients received the injection during continuous sampling at each of 4 transducer frequency settings (3.5, 5.0, 6.0, 7.0 MHz). In another 6 patients, injections were administered during continuous and intermittent sampling (electrocardiogram-gated) at 3.5 and 5.0 MHz. Generalized estimating equations were used to compare mean responses, with p < or = 0.05 considered significant. MEASUREMENTS AND MAIN RESULTS: All recorded images were analyzed with off-line videodensitometry. Background-corrected peak pixel intensity (PPI(corr)) and rate of change in pixel intensity (PPI(corr)/T(PPI)) were determined for each injection. PPI(corr) was greater at 3.5 MHz than at 5.0, 6.0, and 7.0 MHz (p < 0.001). PPI(corr)/T(PPI) was greater at 3.5 MHz than at 5.0 (p < 0.001), 6.0 (p = 0.003), and 7.0 MHz (p < 0.001). PPI(corr) was greater for gated than for nongated sampling conditions at 3.5 (p < 0.05) and 5.0 MHz (p < 0.05). CONCLUSION: To optimize myocardial contrast opacification, intraoperative transesophageal echocardiography should be performed with intermittent sampling at a transducer frequency close to the intrinsic frequency of the contrast agent.

Full Text

Duke Authors

Cited Authors

  • Dupont, FW; Fisher, AM; Toledano, A; Aronson, S

Published Date

  • December 2001

Published In

Volume / Issue

  • 15 / 6

Start / End Page

  • 728 - 730

PubMed ID

  • 11748521

International Standard Serial Number (ISSN)

  • 1053-0770

Digital Object Identifier (DOI)

  • 10.1053/jcan.2001.28317


  • eng

Conference Location

  • United States