Postprocessing Method for Enhanced Left Ventricular Thrombus Detection in Echocardiography

Background and Objectives: The incidence of left ventricular thrombus has decreased in recent years due to advancements in reperfusion strategies for acute myocardial infarction and the use of medications to reduce ventricular remodeling. However, the accurate detection of thrombus remains crucial. Echocardiography is a primary diagnostic tool for thrombus detection, but in cases where the apex of the left ventricle is not clearly visualized, contrast injection is often required for diagnosis. We developed a postprocessing Left Ventricular Thrombus Detection Method (LVTDM) to enhance image details in the region of interest, enabling diagnosis without additional contrast injection. A purpose of our study is the evaluation of Left Ventricular Thrombus Detection Method. Materials and Methods: We analyzed echocardiography video files from 29 patients with apical wall motion abnormalities using LVTDM to identify the presence or absence of thrombus in the left ventricular apex. The results were verified with diagnoses obtained from the same echocardiography examinations following contrast injection. Our method demonstrated a sensitivity of 100% and a specificity of 83%, with a negative predictive value of 100% for ruling out thrombus. There was a strong correlation in thrombus detection/ruling out between LVTDM and contrast echocardiography. The Left Ventricular Thrombus Detection Method can be integrated into routine echocardiography examinations to effectively rule out thrombus when the apex is not clearly visualized. The implementation of this method has the potential to reduce the need for contrast injection by approximately half for detecting left ventricular thrombus.