An established setting for a MCE stress test with the Philips IE 33 platform (german software version)

With the default setting “adult echo” the X5-1 probe is activated with a mechanical index of 1.1

 

With the button “Perfusion” in the fourth row MCE settings are activated.	Mechanical index MI is depicted on the top at the right side of the screen, as default here 1,1

Choosing the menue “contrast MI low” in the bottom line the setting for MCE can be modified on the right sreen:
With “flash-images” 8 to 15 frames with high mechanical index (MI 0.97 – 1.28) can be selected to destroy the bubbles. The recording of the MCE images follows with an MI of 0.09 – 0.1 . Setup for this platform has been stored under the menue “Perfusion” and is displayed on the start screen as menue point 4 in the second line from the bottom.

fokus mitral valve, flash images 8 – (15), flash MI 0.97 – 1.28, following MI of 0.1.	Top right in the second row shows mechanical index during “flash” (in this example 0.97) and in the first row MI during “low MI” imaging (here 0.1)

Using the button “weiter ->” a sceen with further menues is opened:

 

	We use “chromascale 2” and grey scale “1”. With “Mittelung hoch” the images become “smooth”, less “pixelated” and a perfusion defect may be easier to recognize.

 

The following image shows 4 endsystolic frames form a MCE stress test with a vasodilatator, recorded with the Philips IE33 platform:

	..
	Top left first endsystolic fram after flash, on the right delayed replenishment of contrast in the apex. Bottom right complet replenishment seventh endsystoly after flash. In the absence of a wall motion abnormality this finding suggests an intermediate 50-70% LAD stenosis. (with courtesy of H.Becher, Alberta, Canada)