BACKGROUND Echocardiography with an ultrasound-enhancing contrast agent (CON) is a powerful tool for identifying the endocardial border. However, the precise relationship of measurements obtained from CON to the reference values of two-dimensional unenhanced echocardiography (BASL) remains undefined, especially regarding wall thickness. The aim of this study was to systematically determine the differences between unenhanced and enhanced images for a broad range of left ventricular (LV) measurements and to define reference values for the relationship between the two methods. METHODS We examined the echocardiograms of 624 consecutive patients in whom CON was performed for clinical indications. We excluded 192 patients in whom studies were technically difficult for measurement by either or both methods. Echocardiograms were from standard parasternal and apical views according to American Society of Echocardiography guidelines. Recordings were measured for wall thickness and chamber dimension in 343 patients and for LV volumes and ejection fraction in 212 patients. RESULTS LV wall thickness measurements were systematically reduced with a bias of 0.2 cm with limits of agreement (LOA) from -0.5 to 0.16 cm in interventricular septal thickness, and from -0.46 to 0.13 cm in posterior wall thickness in CON. LV dimensions and volumes systematically increased with a bias of 0.2 cm (LOA, -0.19 to 0.58 cm) and 14 to 16 mL (LOA, -11.9 to 42.8 mL), respectively. LV ejection fraction systematically decreased with a bias of 3.4% (LOA, -13.5% to 6.8%) in CON compared to BASL. All differences showed normal distribution in the Kolmogorov-Smirnov test. CONCLUSION CON yields significantly different measurements of cardiac size and function compared to unenhanced imaging. These data define the systematic differences in measurements between CON and BASL images; the range of differences is narrow. These differences may influence management when the measurement value is a borderline.

中文翻译：

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通过超声心动图对超声增强剂对心脏大小和功能测量的影响进行系统评估。

背景技术使用超声增强造影剂 (CON) 的超声心动图是用于识别心内膜边界的有力工具。然而，从 CON 获得的测量值与二维非增强超声心动图 (BASL) 参考值的精确关系仍未确定，尤其是在壁厚方面。本研究的目的是系统地确定各种左心室 (LV) 测量的未增强图像和增强图像之间的差异，并确定两种方法之间关系的参考值。方法 我们检查了 624 名因临床指征而进行 CON 的连续患者的超声心动图。我们排除了 192 名研究在技术上难以通过其中一种或两种方法进行测量的患者。根据美国超声心动图学会指南，超声心动图来自标准胸骨旁和心尖切面。记录测量了 343 名患者的壁厚和腔室尺寸以及 212 名患者的 LV 容积和射血分数。结果 LV 壁厚测量值系统性降低，偏差为 0.2 厘米，一致性限 (LOA) 从室间隔厚度的 -0.5 到 0.16 厘米，CON 中后壁厚度从 -0.46 到 0.13 厘米。LV 尺寸和容积系统地增加，偏差分别为 0.2 厘米（LOA，-0.19 至 0.58 厘米）和 14 至 16 毫升（LOA，-11.9 至 42.8 毫升）。与 BASL 相比，CON 的 LV 射血分数系统性降低，偏差为 3.4%（LOA，-13.5% 至 6.8%）。所有差异在 Kolmogorov-Smirnov 检验中均呈正态分布。结论 与未增强成像相比，CON 产生了显着不同的心脏大小和功能测量值。这些数据定义了 CON 和 BASL 图像之间测量的系统差异；差异范围很窄。当测量值处于临界值时，这些差异可能会影响管理。