Transthoracic echocardiography is the most widely used diagnostic test for left ventricular (LV) thrombus, which must be distinguished from other intraventricular structures and image artifacts. To determine whether second- generation intravenous echocardiographic contrast agents provide better delineation of LV thrombus, we reviewed the results of 2-dimensional echocardiographic studies that were performed in 409 patients over a 1-year period to detect LV thrombus. Studies of 190 (46%) patients were interpreted as nondiagnostic for this purpose, of which 48 patients underwent an additional study after intravenous injection of 0.5 to 2 mL of human albumin microspheres within 1 to 4 days. In 43 (90%) of these 48 patients the contrast-enhanced study was definitive and diagnostic for either the presence or absence of an LV thrombus (P < .0001). Of the initial total of 409 patients, 81 had been studied at the bedside in intensive care units. The bedside studies were nondiagnostic for LV thrombus in 51 (63%) of these 81 patients. Of these 51 patients, 14 underwent additional imaging with contrast enhancement, and the contrast-enhanced images became diagnostic (P = .004) in 11 (79%) of them. Thus intravenous contrast image enhancement improves the diagnostic yield of echocardiography in patients in whom initial images are nondiagnostic for LV thrombus.
|Number of pages||5|
|Journal||Journal of the American Society of Echocardiography|
|State||Published - Jan 1 1999|