Elastography in detection cardiovascular diseases

Abstract

A very active research area in the medical imaging field is early detection of cardiovascular diseases. Assessment of the local and global mechanical functions is one of the major goals of accurate diagnosis. Clinical assessment of myocardial ischemia based on visually-assessed wall motion scoring from echocardiography is semiquantitative, operator dependent, and heavily weighted by operator experience and expertise. Cardiac motion estimation methods such as tissue Doppler imaging, used to assess myocardial muscle velocity, provides quantitative parameters such as the strain-rate and strain derived from Doppler velocity. However, tissue Doppler imaging does not differentiate between active contraction and simple rotation or translation of the heart wall, nor does it differentiate tethering (passively following) tissue from active contraction. The possibility of of elastography for estimation and imaging of the local cardiac muscle displacement and strain in a human heart in vivo. In its noninvasive applications, elastography has been typically used to determine local tissue strain through the use of externally applied compression. We present a strain imaging modality called cardiac elastography that provides two-dimensional strain information. Not only do these preliminary results show that elastography is feasible in cardiac applications in vivo, but also that it can provide new information regarding cardiac motion and mechanical function. Future prospects include assessment of the role of elastography in detection of ischemia and infarction. Though observational, the differences suggest that cardiac elastography may be a useful tool for assessment of myocardial function. The method is two-dimensional, real time and avoids the disadvantage of observer-dependent judgment of myocardial contraction and relaxation estimated from conventional echocardiography