Detection of resting myocardial perfusion defects by SonoVue® myocardial contrast echocardiography

Background: SonoVue((R)) is a new microbubble contrast agent containing sulfur hexafluoride. We assessed the efficacy of SonoVue((R)) myocardial contrast echocardiography (MCE) to detect resting perfusion abnormalities. Methods: Nineteen adult patients with a wall motion abnormality in a screening echocardiogram were studied. Each patient received up to four bolus injections of 2.0 mL SonoVue((R)) (Bracco Diagnostics, Inc.) during echocardiographic examination using either B-mode (n = 12) or power Doppler (n = 7) imaging. Each patient also had SPECT nuclear perfusion imaging performed. Segmental assessment of myocardial perfusion from SonoVue((R)) MCE images were compared with corresponding SPECT nuclear images. Results: Using B-mode imaging, the mean number of views obtained with a single SonoVue((R)) injection ranged from 1.4 to 1.9, with 2 or 3 injections required for a complete examination. Ninety-four percent of segments were scored as diagnostic. Agreement between B-mode and SPECT images was 72% for segments with a perfusion defect, 86% for normal perfusion, and 80% for segments with either perfusion defect or normal perfusion (all views combined). Using power Doppler imaging, the mean number of views obtained with a single SonoVue((R)) injection ranged from 1.0 to 1.3, with 2 to 4 injections required for a complete examination. Sixty-eight percent of segments were scored as diagnostic. Agreement between power Doppler and SPECT images was 67% for perfusion defects, 53% for segments with normal perfusion, and 59% for segments with either perfusion defect or normal perfusion (all views combined). Conclusions: SonoVue((R)) MCE has the potential to assess myocardial perfusion at rest. B-mode imaging was more accurate than power Doppler imaging when compared with SPECT nuclear imaging.