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Improved detection of intra-cardiac thrombus & structural abnormalities

The evidence for use of contrast in clinical echocardiography: Left Ventricular Opacification – LVO


Artefacts or excessive ultrasound ‘noise’ can prevent accurate assessment of the left ventricular apex and also of overall cardiac geometry in patients with sub-optimal image quality. Contrast is a quick, cheap and highly effective way of diagnosing ventricular thrombus [17], apical hypertrophic cardiomyopathy [18], left ventricular non-compaction [19], myocardial abscess [20] and pseudo-aneurysms [21]. Other imaging modalities are also available, such as cardiac MRI, but the widespread availability of echocardiography and the considerably lower cost make contrast echocardiography the first-line imaging modality in such patients.

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17. Thanigaraj S, Schechtman KB, Perez JE. Improved echocardiographic delineation of left ventricular thrombus with the use of intravenous second-generation contrast image enhancement. J Am Soc Echocardiogr 1999;12(12):1022-6
18. Soman P, Swinburn J, Callister M, Stephens NG, Senior R. Apical hypertrophic cardiomyopathy: bedside diagnosis by intravenous contrast echocardiography. J Am Soc Echocardiogr 2001;14(4):311-3
19.Koo BK, Choi D, Ha JW, Kang SM, Chung N, Cho SY. Isolated noncompaction of the ventricular myocardium: contrast echocardiographic findings and review of the literature. Echocardiography 2002;19(2):153-6
20. Walker N, Bhan A, Desai J, Monaghan MJ. Myocardial abscess: a rare complication of valvular endocarditis demonstrated by 3D contrast echocardiography. Eur J Echocardiogr 2010;11(10):E37
21. Moreno R, Zamorano JL, Almeria C, Rodrigo JL, Villate A, Serra V, et al. Usefulness of contrast agents in the diagnosis of left ventricular pseudoaneurysm after acute myocardial infarction. Eur J Echocardiogr 2002;3(2):111-6