Diagnostic value of parametric imaging of left ventricular wall motion from contrast-enhanced echocardiograms in patients with poor acoustic windows

Echocardiographic analysis of regional left ventricular wall motion (RWM) is challenging in patients with suboptimal images even with contrast. We hypothesized that parametric images obtained from contrast-enhanced (CE) images can accurately describe RWM and thus improve the diagnostic accuracy of inexperienced readers. CE images were acquired in 45 patients with poor acoustic windows. Expert interpretation of RWM was used as a reference for comparisons against: (1) visual reading of parametric images, (2) interpretation of dynamic images by two inexperienced readers with and without parametric images, (3) quantitative analysis of RWM. Visual reading of parametric images showed good agreement with the expert (84%). Inexperienced readers increased their accuracy from 74 to 84%. Automated classification was feasible and accurate (80%). Parametric images derived from CE images of patients with poor acoustic windows accurately depicted RWM, improved the diagnostic accuracy of inexperienced readers, and allowed objective detection of RWM abnormalities.