Radiopraxis 2022; 15(03): 143-151
DOI: 10.1055/a-1791-7655

Apexthrombusdiagnostik in der Echokardiographie: Kontrastmitteleinsparungen

Detection of Apical Thrombus in Echocardiography: Saving Contrast Media
Thomas Reinsperger

Ein dicht gedrängter Terminplan, ein stressiger Tag im Echokardiographie-Labor. Eine verdächtige Struktur in der Herzspitze macht eine Kontrastmittelgabe unausweichlich. Diese stellt trotz ihres niedrigen Risikos einen Zeit-, Personal- und Kostenaufwand dar und darf erst nach ärztlicher Anordnung durchgeführt werden. Der autonome Untersuchungsablauf der Radiologietechnolog*innen ist gestört. Der Schrei nach Alternativmethoden ist daher groß.


After coronary artery disease, wall-motion abnormalities can occur. Because of these abnormalities, the blood flow is slower than usual. Furthermore thrombi, especially in the apex, can form. Many patients with coronary artery disease have special body conditions like obesity. Consequently, image quality is reduced and a thrombus cannot be seen clearly. In this case, contrast media is required. The application of contrast media costs time, coworkers, and money. So alternative methods are needed. Therefore, the color doppler can be applicated on the wall-motion area. The pulse repetition frequency (PRF) has to be adapted on the slow flow, so we can make the blood in form of color doppler visible. It is only possible to rule out a thrombus with color doppler. It is not possible to confirm a thrombus. The sign to rule out a thrombus is to see the color doppler on the complete endocardial border. If we cannot see this sign, we may not say that there is no thrombus. Additionally, we may not say that there is securely no thrombus. If the color doppler does not flood to the complete endocardial border it is possible that there is a thrombus. But it can also be an artifact, bad image quality or an incorrect PRF. So, we may not confirm a thrombus with this new method.

Publication History

Article published online:
27 September 2022

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