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(Circulation. 2003;107:2390.)
© 2003 American Heart Association, Inc.

Images in Cardiovascular Medicine

Real-Time Perfusion Echocardiography of an Intracardiac Mass

Petr Tousek, MD; Marek Orban, MD; Albert Schömig, MD; Christian Firschke, MD

From Deutsches Herzzentrum, München, Germany.

Correspondence to Priv.-Doz. Dr. med. Christian Firschke, Deutsches Herzzentrum München, Lazarettstrasse 36, D-80636 München, Germany. E-mail cfirschke@t-online.de

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 59-year-old woman was referred to our hospital for evaluation of chest pain and dyspnea. On transthoracic echocardiography, a left atrial mass suggestive of myxoma was detected (Figure 1A). To evaluate the vascularization of the left atrial mass, venous infusion (1 mL/min) of a third-generation echocardiographic contrast agent (Sono Vue, Bracco, Italy) was subsequently combined with a new contrast-specific imaging technique ("power modulation imaging," Phillips Medical Systems, Eindhoven, the Netherlands). With conventional diagnostic ultrasound, gas-filled microbubbles, the main components of echocardiographic contrast agents, are destroyed by high acoustic power (mechanical index usually >0.8) and tissue perfusion cannot be continuously imaged. Power modulation imaging, on the other hand, allows for marked reduction of transmission power (mechanical index 0.1 in the present study), resulting in tissue microbubble concentrations unequivocally above the detection threshold of the imaging system. Therefore, tissue perfusion can be continuously visualized with this technique.

View larger version (68K): [in this window] [in a new window]   Figure 1. A, Conventional 2-dimensional echocardiography demonstrating left atrial mass (asterisk) prolapsing through the mitral valve during diastole. B, Venous infusion of the echocardiographic contrast agent at 1 mL/min and visualization with power modulation imaging. The contrast agent has arrived in the left ventricular cavity (encoded in hues of yellow and red) but not yet in the myocardium or the left atrial mass (no color-coding in these tissues). C (a few frames later than B), Demonstration of perfusion not only of the myocardium but also of the left atrial mass indicated by opacification of both tissues, which, as distinct from panel B, are . . . [Full Text of this Article]