Affiliations

Aurora St. Luke’s Medical Center

Abstract

Introduction/Background:

Contrast perfusion echocardiography is emerging as a useful tool in scenarios often dominated by magnetic resonance imaging (MRI) with delayed gadolinium enhancement (DGE), such as diagnosing myocardial metastases. While cardiac MRI is the gold standard for soft tissue characterization, echocardiography’s wide availability and quick execution make it a more accessible option.

Description:

A 60-year-old male with lung cancer presented with chest pain and elevated troponin. Echocardiography showed a small pericardial effusion. Contrast-enhanced echocardiography revealed multiple areas lacking contrast uptake, suggestive of metastatic lesions. MRI with DGE confirmed the presence of multiple metastases.

Discussion:

Contrast echocardiography detects tumors by revealing areas of absent contrast uptake, indicating perfusion deficits due to disrupted microvascular integrity or myocardial replacement by tumor tissue providing fast, accessible results. In contrast, MRI with DGE offers detailed tissue characterization, showing delayed contrast washout and bright enhancement in tumor tissue, allowing precise differentiation from other pathologies (Figure 1B). Echocardiography, due to its accessibility, speed, and cost-effectiveness, holds great potential for expanded use in tumor perfusion imaging. This case demonstrates its effectiveness in diagnosing cardiac metastases, making it a valuable tool in settings where MRI is less available.

Presentation Notes

Presented at Scientific Day; May 20, 2026; Milwaukee, WI.

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May 20th, 12:00 AM

Contrast Perfusion Echocardiography Rises to Meet the Challenge of Magnetic Resonance Imaging

Introduction/Background:

Contrast perfusion echocardiography is emerging as a useful tool in scenarios often dominated by magnetic resonance imaging (MRI) with delayed gadolinium enhancement (DGE), such as diagnosing myocardial metastases. While cardiac MRI is the gold standard for soft tissue characterization, echocardiography’s wide availability and quick execution make it a more accessible option.

Description:

A 60-year-old male with lung cancer presented with chest pain and elevated troponin. Echocardiography showed a small pericardial effusion. Contrast-enhanced echocardiography revealed multiple areas lacking contrast uptake, suggestive of metastatic lesions. MRI with DGE confirmed the presence of multiple metastases.

Discussion:

Contrast echocardiography detects tumors by revealing areas of absent contrast uptake, indicating perfusion deficits due to disrupted microvascular integrity or myocardial replacement by tumor tissue providing fast, accessible results. In contrast, MRI with DGE offers detailed tissue characterization, showing delayed contrast washout and bright enhancement in tumor tissue, allowing precise differentiation from other pathologies (Figure 1B). Echocardiography, due to its accessibility, speed, and cost-effectiveness, holds great potential for expanded use in tumor perfusion imaging. This case demonstrates its effectiveness in diagnosing cardiac metastases, making it a valuable tool in settings where MRI is less available.

 

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