Insights from echocardiography, magnetic resonance imaging, and microcomputed tomography relative to the mid-myocardial left ventricular echogenic zone

Peter Agger, Robert S. Stephenson, Halina Dobrzynski, Andrew Atkinson, Paul A. Iaizzo, Robert H. Anderson, Jonathan C. Jarvis, Sarah L. Allan, John B. Partridge, Jichao Zhao, Henggui Zhang, David H. MacIver

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: The anatomical substrate for the mid-mural ventricular hyperechogenic zone remains uncertain, but it may represent no more than ultrasound reflected from cardiomyocytes orientated orthogonally to the ultrasonic beam. We sought to ascertain the relationship between the echogenic zone and the orientation of the cardiomyocytes. Methods: We used 3D echocardiography, diffusion tensor imaging, and microcomputed tomography to analyze the location and orientation of cardiomyocytes within the echogenic zone. Results: We demonstrated that visualization of the echogenic zone is dependent on the position of the transducer and is most clearly seen from the apical window. Diffusion tensor imaging and microcomputed tomography show that the echogenic zone seen from the apical window corresponds to the position of the circumferentially orientated cardiomyocytes. An oblique band seen in the parasternal view relates to cardiomyocytes orientated orthogonally to the ultrasonic beam. Conclusions: The mid-mural ventricular hyperechogenic zone represents reflected ultrasound from cardiomyocytes aligned orthogonal to the ultrasonic beam. The echogenic zone does not represent a space, a connective tissue sheet, a boundary between ascending and descending limbs of a hypothetical helical ventricular myocardial band, nor an abrupt change in cardiomyocyte orientation.

Original languageEnglish (US)
Pages (from-to)1546-1556
Number of pages11
JournalEchocardiography
Volume33
Issue number10
DOIs
StatePublished - Oct 1 2016

Bibliographical note

Publisher Copyright:
© 2016, Wiley Periodicals, Inc.

Keywords

  • cardiomyocyte orientation
  • computed tomography
  • diffusion tensor magnetic resonance imaging
  • echocardiography
  • helical ventricular myocardial band

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