By J. Roelandt, R. S. Meltzer (auth.), Peter Hanrath M.D., Walter Bleifeld M.D., Jacques Souquet Ph.D. (eds.)
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Extra info for Cardiovascular Diagnosis by Ultrasound: Transesophageal, Computerized, Contrast, Doppler Echocardiography
In addition, the 2DE computer should offer important advantages of objectivity and speed. COMMENT It must be emphasized that computerized quantitative analysis of global and regional cardiac function requires satisfactory 2DE definition of the endocardial (and epicardial) interface . The superior 2DE images obtained in the dog demonstrated reproducibility and validity of the 2DE computer system. While clinical 2DE studies have presented a much lower yield of images suitable for quantitative measurement by either computerized or hand drawn methods of analysis, a recent examination of a patient subset from the catheterization laboratory with satisfactory 2DE images indicates similar suitability of the automatic edge detection technique and good condition with cineangiography (21).
Nevertheless, the multiple cineioop display of digitized images provided by the computer system have been employed by us and found advantageous in several clinical 2DE studies which did not permit automated edge detection. Thus, a two-view display allows an investigator to set up one dynamic view of a control and next to it an intervention facilitating comparison study (18). Conventional 2DE methods would entail repeated rewinding and successive playback of required portions of the study, and the evaluation would not be as comprehensive a s when images are viewed side by side.
The sensitivity of contrast echocardiography in detecting this small accompanying R-L shunt is high. Patients with a hemodynamic situation that favours such a shunt (Eisenmenger-reaction, ASD with pulmonic stenosis or Ebstein's disease), virtually always have positive contrast studies (8-12). Even in uncomplicated ASD the sensitivity has been reported as high as 73-100 % 23 «(average 82 %) (7-12). l). Surprisingly the intensity of contrast shunting is not helpful in predicting either right ventricular systolic pressure or the magnitude of the L-R shunt (7-11).
Cardiovascular Diagnosis by Ultrasound: Transesophageal, Computerized, Contrast, Doppler Echocardiography by J. Roelandt, R. S. Meltzer (auth.), Peter Hanrath M.D., Walter Bleifeld M.D., Jacques Souquet Ph.D. (eds.)