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Three-dimensional echocardiography in various types of heart disease: a comparison study of magnetic resonance imaging and 64-slice computed tomography in a real-world population. J Echocardiogr 2016; 15:18-26. [PMID: 27589871 DOI: 10.1007/s12574-016-0315-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 08/04/2016] [Accepted: 08/14/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-systolic volume (ESV)] and ejection fraction (EF) is of critical importance. The development of real-time three-dimensional echocardiography (RT3DE) has shown better correlation than two-dimensional (2D) echocardiography with magnetic resonance imaging (MRI) measurements. The aim of our study was to assess the accuracy of RT3DE and 64-slice computed tomography (CT) in the evaluation of LV volumes and function using MRI as the reference standard in a real-world population with various types of heart disease with different chamber geometry. METHODS The study population consisted of 66 patients referred for cardiac MRI for various pathologies. All patients underwent cardiac MRI, and RT3DE and 64 slices CT were then performed on a subsequent day. The study population was then divided into 5 clinical groups depending on the underlying heart disease. RESULTS RT3DE volumes correlated well with MRI values (R 2 values: 0.90 for EDV and 0.94 for ESV). RT3DE measurements of EF correlated well with MRI values (R 2 = 0.86). RT3DE measurements resulted in slightly underestimated values of both EDV and ESV, as reflected by biases of -9.18 and -4.50 mL, respectively. Comparison of RT3DE and MRI in various types of cardiomyopathies showed no statistical difference between different LV geometrical patterns. CONCLUSION These results confirm that RT3DE has good accuracy in everyday clinical practice and can be of clinical utility in all types of cardiomyopathy independently of LV geometric pattern, LV diameter or wall thickness, taking into account a slight underestimation of LV volumes and EF compared to MRI.
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Reant P, Barbot L, Montaudon M, Landelle M, Arsac F, Dijos M, Pillois X, Touche C, Corneloup O, Roudaut R, Laurent F, Lafitte S. Robustness of a new three-dimensional echocardiographic algorithm for left ventricular volume and ejection fraction quantification: experts vs. novices. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2011; 12:895-903. [DOI: 10.1093/ejechocard/jer179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mor-Avi V, Jenkins C, Kühl HP, Nesser HJ, Marwick T, Franke A, Ebner C, Freed BH, Steringer-Mascherbauer R, Pollard H, Weinert L, Niel J, Sugeng L, Lang RM. Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error. JACC Cardiovasc Imaging 2009; 1:413-23. [PMID: 19356461 DOI: 10.1016/j.jcmg.2008.02.009] [Citation(s) in RCA: 254] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 01/25/2008] [Accepted: 02/06/2008] [Indexed: 12/17/2022]
Abstract
OBJECTIVES We sought to study: 1) the accuracy and reproducibility of real-time 3-dimensional echocardiographic (RT3DE) analysis of left ventricular (LV) volumes in a multicenter setting, 2) interinstitutional differences in relationship with the investigators' specific experience, and 3) potential sources of volume underestimation. BACKGROUND Reproducibility and accuracy of RT3DE evaluation of LV volumes has not been validated in multicenter studies, and LV volumes have been reported to be underestimated compared to cardiac magnetic resonance (CMR) standard. METHODS A total of 92 patients with a wide range of ejection fractions underwent CMR and RT3DE imaging at 4 different institutions. Images were analyzed to obtain LV end-systolic volume (ESV) and end-diastolic volume (EDV). Reproducibility was assessed using repeated analyses. The investigation of potential sources of error included: phantom imaging, intermodality analysis-related differences, and differences in LV boundary identification, such as inclusion of endocardial trabeculae and mitral valve plane in the LV volume. RESULTS The RT3DE-derived LV volumes correlated highly with CMR values (EDV: r = 0.91; ESV: r = 0.93), but were 26% and 29% lower consistently across institutions, with the magnitude of the bias being inversely related to the level of experience. The RT3DE measurements were less reproducible (4% to 13%) than CMR measurements (4% to 7%). Minimal changes in endocardial surface position (1 mm) resulted in significant differences in measured volumes (11%). Exclusion of trabeculae and mitral valve plane from the CMR reference eliminated the intermodality bias. CONCLUSIONS The RT3DE-derived LV volumes are underestimated in most patients because RT3DE imaging cannot differentiate between the myocardium and trabeculae. To minimize this difference, tracing the endocardium to include trabeculae in the LV cavity is recommended. With the understanding of these intermodality differences, RT3DE quantification of LV volume is a reliable tool that provides clinically useful information.
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Affiliation(s)
- Victor Mor-Avi
- University of Chicago Medical Center, Chicago, Illinois 60637, USA.
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Tamborini G, Brusoni D, Torres Molina JE, Galli CA, Maltagliati A, Muratori M, Susini F, Colombo C, Maffessanti F, Pepi M. Feasibility of a new generation three-dimensional echocardiography for right ventricular volumetric and functional measurements. Am J Cardiol 2008; 102:499-505. [PMID: 18678314 DOI: 10.1016/j.amjcard.2008.03.084] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 03/24/2008] [Accepted: 03/24/2008] [Indexed: 11/26/2022]
Abstract
Right ventricular (RV) dimensions and function are of diagnostic and prognostic importance in cardiac disease. Because of the peculiar morphology of the right ventricle, 2-dimensional echocardiography has several limitations in RV evaluation. Recently, new 3-dimensional transthoracic echocardiographic software adapted for RV morphology was introduced. The aims of this study were to evaluate the feasibility of 3-dimensional RV analysis in a large population and to compare and correlate 3-dimensional RV data with classic 2-dimensional and Doppler parameters, including tricuspid annular plane systolic excursion and peak systolic velocity on Doppler tissue imaging, RV fractional shortening area, RV stroke volume (by the Doppler method), and pulmonary arterial systolic pressure. Two hundred subjects were studied: 48 normal controls and 152 patients with valvular heart disease (104 patients), idiopathic dilated cardiomyopathy (20 patients), or pulmonary hypertension (28 patients). The mean times for 3-dimensional acquisition and 3-dimensional reconstruction were 3 +/- 1 and 4 +/- 2 minutes, respectively. Imaging quality was good in most cases (85%). The mean RV diastolic and systolic volumes were 103 +/- 38 and 46 +/- 28 ml, respectively. The RV ejection fraction (RVEF) was correlated negatively with pulmonary arterial systolic pressure and positively with tricuspid annular plane systolic excursion, peak systolic velocity, and fractional shortening area. The pathologic group was characterized by larger RV volumes and lower RVEFs. Three-dimensional echocardiography clearly showed that in the pathologic group, patients with pulmonary hypertension had the largest RV volumes and the lowest RVEFs and that those with idiopathic dilated cardiomyopathy were characterized by RVEFs lower than those of patients with valvular disease. In conclusion, this new quantitative 3-dimensional method to assess RV volumes and function is feasible, relatively simple, and not time consuming. Data obtained with 3-dimensional analysis are well correlated with those obtained by 2-dimensional and Doppler methods and can differentiate normal and pathologic subjects.
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Lu X, Xie M, Tomberlin D, Klas B, Nadvoretskiy V, Ayres N, Towbin J, Ge S. How accurately, reproducibly, and efficiently can we measure left ventricular indices using M-mode, 2-dimensional, and 3-dimensional echocardiography in children? Am Heart J 2008; 155:946-53. [PMID: 18440346 DOI: 10.1016/j.ahj.2007.11.034] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Accepted: 11/12/2007] [Indexed: 01/21/2023]
Abstract
BACKGROUND Measurements of left ventricular (LV) size, mass, and function are the most common and important tasks for echocardiography in clinical practice and research in children with congenital and acquired heart diseases. There are little data to compare the utility of M-mode (MM), 2-dimensional (2D), and 3-dimensional (3D) echocardiographic techniques for quantification of LV indices. The objective of the study was to assess the accuracy, reproducibility, and efficiency of these echocardiographic methods for measurement of LV indices in children. METHODS A prospective study was conducted in 20 consecutive children (mean 10.6 +/- 2.8 years, 11 male and 9 female subjects) using conventional MM, 2D, and real-time 3D echocardiography (RT3DE). A Sonos 7500 system (Philips Medical Systems, Andover, MA) was used. M-mode and 2DE measurements were made according to the American Society of echocardiography recommendations. To include the entire LV for volumetric measurement, full-volume 3D data sets were acquired from 4 electrocardiogram gated subvolumes. The 3DE measurements were made off-line manually using 4-plane and 8-plane algorithms by 4D Echo-View (TomTec Imaging Systems, Munich, Germany) and a semiautomated algorithm by QLAB (Philips Medical Systems). Magnetic resonance imaging studies were also performed to determine the LV indices by a disk summation method based on the Simpson principle. RESULTS The correlation and agreement between MM, 2D, and RT3D echocardiography and magnetic resonance imaging measurements are good (r = 0.81-0.97) for the 3 methods. The correlation was superior for RT3DE compared with 2DE and MM. The correlation and agreement were similar for the three 3DE methods. The intra- and interobserver variabilities ranged from MM (4.3%-4.8% and 7.0%-8.7%), 2DE (3.3%-4.5% and 5.5%-7.3%), and 3DE (0.4%-2.3%, and 0.2%-4.8%). The total time (acquisition and analysis) used for MM measurements was the least compared with 2DE and 3DE. The total time for 3DE using the semiautomated algorithms was not significantly different compared with that for 2DE. CONCLUSIONS Our study showed that MM provides the most efficient assessment of LV indices but is the least accurate and reproducible technique compared with 2DE and 3DE. Three-dimensional echocardiography using both automated and manual analysis algorithm is superior to MM and 2DE for measurements of LV indices, and the automated 3DE algorithm is as efficient as 2DE. Therefore, 3DE using the automated algorithm is the method of choice for quantification of LV indices.
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Gopal AS, Chukwu EO, Mihalatos DG, Katz AS, Mathew ST, Lachmann JS, Toole RS, Schapiro W, Reichek N. Left Ventricular Structure and Function for Postmyocardial Infarction and Heart Failure Risk Stratification by Three-dimensional Echocardiography. J Am Soc Echocardiogr 2007; 20:949-58. [DOI: 10.1016/j.echo.2007.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Indexed: 11/25/2022]
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Houck RC, Cooke JE, Gill EA. Live 3D Echocardiography: A Replacement for Traditional 2D Echocardiography? AJR Am J Roentgenol 2006; 187:1092-106. [PMID: 16985162 DOI: 10.2214/ajr.04.0857] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We describe the development of real-time 3D imaging and review the previously used versions of 3D echocardiography so that the reader will appreciate why current developments truly do represent a quantum leap in the technology. CONCLUSION Three-dimensional echocardiography has now been shown to have several advantages over 2D echocardiography, particularly for volume measurements, visualization of septal defects, and whole-valve evaluation. Given these data, it is clear that 3D echocardiography is here to stay and soon will become part of routine echocardiographic examinations.
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Affiliation(s)
- Robin C Houck
- Department of Medicine, Division of Cardiology, University of Washington School of Medicine, Harborview Medical Center, Box 359748, 329 Ninth Ave., Seattle, WA 98104-2599, USA
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Jaochim Nesser H, Sugeng L, Corsi C, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, Schmidt F, Schummers G, Lang RM, Mor-Avi V. Volumetric analysis of regional left ventricular function with real-time three-dimensional echocardiography: validation by magnetic resonance and clinical utility testing. Heart 2006; 93:572-8. [PMID: 16980520 PMCID: PMC1955565 DOI: 10.1136/hrt.2006.096040] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Quantitative information on regional left ventricular volumes from real-time three-dimensional echocardiographic (RT3DE) images has significant clinical potential but needs validation. AIM To validate these measurements against cardiac magnetic resonance (CMR) and test the feasibility of automated detection of regional wall motion (RWM) abnormalities from RT3DE data. METHODS RT3DE (Philips) and CMR (Siemens) images were obtained from 31 patients and analysed by using prototype software to semiautomatically calculate indices of regional left ventricular function, which were compared between RT3DE and CMR (linear regression, Bland-Altman). Additionally, CMR images were reviewed by an expert, whose RWM grades were used as a reference for automated classification of segments as normal or abnormal from RT3DE and from CMR images. For each modality, normal regional ejection fraction (REF) values were obtained from 15 patients with normal wall motion. In the remaining 16 patients, REFs were compared with thresholds that were derived from patients with normal wall motion and optimised using receiver operating characteristic analysis. RESULTS RT3DE measurements resulted in good agreement with CMR. Regional indices calculated in patients with normal wall motion varied between segments, but overall were similar between modalities. In patients with abnormal wall motion, RWM was graded as abnormal in 74% segments. CMR and RT3DE thresholds were similar (16-segment average 55 (10)% and 56 (7)%, respectively). Automated interpretation resulted in good agreement with expert interpretation, similar for CMR and RT3DE (sensitivity 0.85, 0.84; specificity 0.81, 0.78; accuracy 0.84, 0.84, respectively). CONCLUSION Analysis of RT3DE data provides accurate quantification of regional left ventricular function and allows semiautomated detection of RWM abnormalities, which is as accurate as the same algorithm applied to CMR images.
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Sugeng L, Mor-Avi V, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, Schmidt F, Galuschky C, Schummers G, Lang RM, Nesser HJ. Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference. Circulation 2006; 114:654-61. [PMID: 16894035 DOI: 10.1161/circulationaha.106.626143] [Citation(s) in RCA: 374] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cardiac CT (CCT) and real-time 3D echocardiography (RT3DE) are being used increasingly in clinical cardiology. CCT offers superb spatial and contrast resolution, resulting in excellent endocardial definition. RT3DE has the advantages of low cost, portability, and live 3D imaging without offline reconstruction. We sought to compare both CCT and RT3DE measurements of left ventricular size and function with the standard reference technique, cardiac MR (CMR). METHODS AND RESULTS In 31 patients, RT3DE data sets (Philips 7500) and long-axis CMR (Siemens, 1.5 T) and CCT (Toshiba, 16-slice MDCT) images were obtained on the same day without beta-blockers. All images were analyzed to obtain end-systolic and end-diastolic volumes and ejection fractions using the same rotational analysis to eliminate possible analysis-related differences. Intertechnique agreement was tested through linear regression and Bland-Altman analyses. Repeated measurements were performed to determine intraobserver and interobserver variability. Both CCT and RT3DE measurements resulted in high correlation (r2 > 0.85) compared with CMR. However, CCT significantly overestimated end-diastolic and end-systolic volumes (26 and 19 mL; P < 0.05), resulting in a small but significant bias in ejection fraction (-2.8%). RT3DE underestimated end-diastolic and end-systolic volumes only slightly (5 and 6 mL), with no significant bias in EF (0.3%; P = 0.68). The limits of agreement with CMR were comparable for the 2 techniques. The variability in the CCT measurements was roughly half of that in either RT3DE or CMR values. CONCLUSIONS CCT provides highly reproducible measurements of left ventricular volumes, which are significantly larger than CMR values. RT3DE measurements compared more favorably with the CMR reference, albeit with higher variability.
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Affiliation(s)
- Lissa Sugeng
- University of Chicago, MC5084, 5841 S Maryland Ave, Chicago, IL 60637, USA.
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Houck RC, Cooke J, Gill EA. Three-dimensional echo: transition from theory to real-time, a technology now ready for prime time. Curr Probl Diagn Radiol 2005; 34:85-105. [PMID: 15886612 DOI: 10.1016/j.cpradiol.2005.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Robin C Houck
- Department of Medicine, Division of Cardiology, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA 98104-2599, USA
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Corsi C, Lang RM, Veronesi F, Weinert L, Caiani EG, MacEneaney P, Lamberti C, Mor-Avi V. Volumetric Quantification of Global and Regional Left Ventricular Function From Real-Time Three-Dimensional Echocardiographic Images. Circulation 2005; 112:1161-70. [PMID: 16103242 DOI: 10.1161/circulationaha.104.513689] [Citation(s) in RCA: 194] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Real-time 3D echocardiographic (RT3DE) data sets contain dynamic volumetric information on cardiac function. However, quantification of left ventricular (LV) function from 3D echocardiographic data is performed on cut-planes extracted from the 3D data sets and thus does not fully exploit the volumetric information. Accordingly, we developed a volumetric analysis technique aimed at quantification of global and regional LV function.
Methods and Results—
RT3DE images obtained in 30 patients (Philips 7500) were analyzed by use of custom software based on the level-set approach for semiautomated detection of LV endocardial surface throughout the cardiac cycle, from which global and regional LV volume (LVV)–time and wall motion (WM)–time curves were obtained. The study design included 3 protocols. In protocol 1, time curves obtained in 16 patients were compared point-by-point with MRI data (linear regression and Bland-Altman analyses). Global LVV correlated highly with MRI (
r
=0.98;
y
=0.99
x
+2.3) with minimal bias (1.4 mL) and narrow limits of agreement (±20 mL). WM correlated highly only in basal and midventricular segments (
r
=0.88;
y
=0.85
x
+0.7). In protocol 2, we tested the ability of this technique to differentiate populations with known differences in LV function by studying 9 patients with dilated cardiomyopathy and 9 normal subjects. All calculated indices of global and regional systolic and diastolic LV function were significantly different between the groups. In protocol 3, we tested the feasibility of automated detection of regional WM abnormalities in 11 patients. In each segment, abnormality was detected when regional shortening fraction was below a threshold obtained in normal subjects. The automated detection agreed with expert interpretation of 2D WM in 86% of segments.
Conclusions—
Volumetric analysis of RT3DE data is clinically feasible and allows fast, semiautomated, dynamic measurement of LVV and automated detection of regional WM abnormalities.
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Affiliation(s)
- Cristiana Corsi
- University of Chicago Medical Center, Chicago, IL 60637, USA
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Kolchanova SG, Grinko AA, Zinovieva YA, Sokolov SY, Ustyusganin SS, Shur ML, Blyakhman FA. The regional elastic properties analysis of myocardium based on echocardiographic 3-D reconstruction of the left ventricle. ULTRASOUND IN MEDICINE & BIOLOGY 2004; 30:311-320. [PMID: 15063513 DOI: 10.1016/j.ultrasmedbio.2003.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2003] [Revised: 11/06/2003] [Accepted: 11/13/2003] [Indexed: 05/24/2023]
Abstract
The present study evaluates the myocardium regional elastic properties on the basis of relative thickness change (DeltaHWT) in the left ventricular (LV) wall during the diastolic filling phase. Two-dimensional (2-D) LV long-axis images were obtained with a Powervision-380 (Toshiba) transesophageal echocardiographic imager. Three-dimensional (3-D) reconstruction of the LV was carried out by rotation of the transducer in calibrated steps. Endocardial and epicardial surfaces were approximated to the shape of heart wall by means of spherical functions. At the beginning of the diastolic filling phase, LV endocardial surface was divided into equal angular segments sized about 4 x 4 mm in a spherical coordinate system. To define the displacement direction of the heart wall surface fragments at every moment (frame) of diastolic filling, a new algorithm was developed. The elastic properties of LV wall regions were represented as regional DeltaHWT maps. A qualitative test of the method was implemented according to data from clinical and instrumental inspections of the patients with ischemic heart disease (IHD). Possible error sources were considered to evaluate the method quantitatively. The method root-mean-square error was about 5.4%, including errors of initial data, approximation and rounding off.
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Khankirawatana B, Khankirawatana S, Lof J, Porter TR. Left atrial volume determination by three-dimensional echocardiography reconstruction: validation and application of a simplified technique. J Am Soc Echocardiogr 2002; 15:1051-6. [PMID: 12373246 DOI: 10.1067/mje.2002.122080] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Left atrial (LA) size assessment by anteroposterior dimension is limited in accuracy. Conventional 3-dimensional (3D) reconstruction has been validated, but the process is time-consuming and the 3D system is not widely available. We developed an algorithm to simplify 3D reconstruction of LA on the basis of 3 standard apical views, tested it in 44 hemodynamic stages of 8 open-chest dogs, and compared it with LA volumes assessed by conventional 3D reconstruction. Simplified 3D reconstruction provided an accurate LA volume measurement (y = 0.93x + 0.7, r = 0.95, standard error of the estimate [SEE] = 3.6) with more than 60% of time saved. Cubic equation of anteroposterior dimension and biplane modified Simpson's method were less accurate (for biplane modified Simpson's method, y = 0.8x + 2.6, r = 0.88, SEE = 5.0; for cubic equation of anteroposterior dimension, y = 0.65x + 2.6, r = 0.76, SEE = 8.2). Without the need for a 3D-imaging acquisition tool, simplified 3D reconstruction can be applied in the clinical setting for LA size quantitation with significant time saved.
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Mor-Avi V, Lang RM. Recent advances in echocardiographic evaluation of left ventricular anatomy, perfusion, and function. Cardiol Rev 2001; 9:146-59. [PMID: 11304400 DOI: 10.1097/00045415-200105000-00008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2001] [Indexed: 11/25/2022]
Abstract
This article provides a brief overview of several recently developed, emerging technologies and discusses their potential uses on clinical grounds. These new technologies include three-dimensional imaging, objective automated evaluation of ventricular function with acoustic quantification, assessment of regional ventricular performance using color kinesis and tissue Doppler imaging, harmonic imaging, and power Doppler imaging. Our hope is that readers will gain a better understanding of the principles underlying these technological advances, which will help them to integrate these new techniques efficiently into their clinical practices.
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Affiliation(s)
- V Mor-Avi
- Section of Cardiology, Department of Medicine, University of Chicago, MC 5084, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
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Nadkarni SK, Boughner DR, Drangova M, Fenster A. In vitro simulation and quantification of temporal jitter artifacts in ECG-gated dynamic three-dimensional echocardiography. ULTRASOUND IN MEDICINE & BIOLOGY 2001; 27:211-222. [PMID: 11316530 DOI: 10.1016/s0301-5629(00)00334-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The image quality of dynamic 3-D echocardiography is limited by temporal jitter artifacts that result from the asynchronous acquisition of video frames with the cardiac cycle. This paper analyzes the source and extent of these artifacts using in vitro studies. Dynamic 3-D images of a myocardial motion phantom were reconstructed and analyzed for eight cardiac motion patterns. The extent of temporal jitter artifacts was quantified, first, from the images by computing temporal jitter maps and, second, predicted from the motion waveforms. Temporal jitter appeared as a pattern of streak artifacts converging at the axis of rotation of the imaging plane, for the rotational scanning approach used in our study. The results of the experimental analysis techniques were compared with the waveform analysis using linear regression analysis. The least squares line showed good correlation between the data (r > 0.9) and its deviation from the line of identity was calculated to be <9%.
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Affiliation(s)
- S K Nadkarni
- Imaging Research Laboratories, The John P. Robarts Research Institute, 100 Perth Drive, London, Ontario, N6A 5K8, Canada
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Mele D, Levine RA. Quantitation of ventricular size and function: principles and accuracy of transthoracic rotational scanning. Echocardiography 2000; 17:749-55. [PMID: 11153026 DOI: 10.1111/j.1540-8175.2000.tb01233.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Two-dimensional echocardiography is a readily applicable method for the quantification of ventricular volumes. However, it is limited by assumptions regarding ventricular shape. Three-dimensional echocardiography has emerged as a more accurate and reproducible approach to ventricular volume and functional assessment compared with two-dimensional echocardiography. We review the principles of transthoracic rotational scanning and its clinical application for quantitative assessment of ventricular volume and function.
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Affiliation(s)
- D Mele
- Division of Cardiology, Arcíspedale S. Anna-University of Ferrara, Italy
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Eder V, Hérault S, Hudelo C, Giraudeau B, Marchal C, Quilliet L, Pottier JM, Arbeille P. Evaluation of left ventricular systolic function by 3D echocardiography: a comparative study with X-ray angiography and radionuclide angiography. EUROPEAN JOURNAL OF ULTRASOUND : OFFICIAL JOURNAL OF THE EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY 2000; 11:105-15. [PMID: 10781658 DOI: 10.1016/s0929-8266(00)00077-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE the aim of this study was to evaluate left ventricular systolic function by 3D ultrasound as compared to with radionuclide and X-ray angiographies. METHODS one hundred and four patients were examinated by 3D ultrasound (3D-US) but only 72 examinations were successful. Thirty patients were investigated by 3D-US, M-mode US or bidimensional (2D) US, and X-ray angiography (group I) and 42 patients were investigated by 3D-US, M-mode, or 2D, and radionuclide angiography (group II). RESULTS the correlation between ejection fraction (EF) evaluated by 3D-US and reference methods was found to be good and similar for the two groups (r=0.75; P<10(-4) for group I and r=0.76; P<10(-4) for group II). The correlation between EF calculated by conventional 2D-US and by reference methods was lower (r=0.60; P=0.04 for group I and r=0.54; P=0.001 for group II). The correlation between EF evaluated by 3D- and 2D-US was modest (r=0. 55; P=0.001 for the whole group). The correlation between 3D-US left ventricle end-diastolic volume (EDV) and end-systolic volume (ESV) and those evaluated by X-ray angiography was also modest (r=0.33; NS for EDV and r=0.60; P<10(-4) for ESV). The correlations between EDV and ESV in 3D-US, and those evaluated from radionuclide angiography were fairly good and in the same range (r=0.76; P<10(-4) and r=0.87; P<10(-4)). CONCLUSION the 3D-US system using a rotating probe in an apical view is valuable for evaluation of left ventricular systolic function.
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Affiliation(s)
- V Eder
- Service Médecine Nucléaire et Ultrasons, CHU Trousseau, 37044, Tours, France.
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Rodevan O, Bjornerheim R, Ljosland M, Maehle J, Smith HJ, Ihlen H. Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates. INTERNATIONAL JOURNAL OF CARDIAC IMAGING 1999; 15:397-410. [PMID: 10595406 DOI: 10.1023/a:1006276513186] [Citation(s) in RCA: 193] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The aim of the present study was to establish the accuracy and reproducibility of left atrial volume measurements by three-dimensional (3D) echocardiography compared to 2D biplane and monoplane measurements. BACKGROUND No echocardiographic technique is generally accepted as optimal for estimation of left atrial size. METHODS Left atrial volumes of 18 unselected cardiac patients were obtained with magnetic resonance imaging (MRI) (volumes 145 +/- 58 ml). These volumes were compared with those obtained with different echocardiographic methods: a multiplane 3D method based on 90 images acquired by apical probe rotation, a simplified 3D method using only the three standard apical views, and 2D biplane and monoplane methods based on area-length, disc summation and spherical formulas. RESULTS The echocardiographic methods significantly underestimated maximum left atrial volumes as obtained by MRI by 14-37% (p < 0.001). Accuracy, expressed as 1 SD of individual estimates around this systematic underestimation, was 25 to 27% for all methods, except for the 2D 2-chamber monoplane method (37%). Interobserver coefficient of variation was between 14 and 20% for all methods (n.s.). CONCLUSION All echocardiographic methods significantly underestimated left atrial volumes as obtained by MRI. A minor non-significant improvement in individual echocardiographic estimates by the 3D methods was obtained at the cost of more time consumption. In unselected patients ultrasound image quality precludes significant improvement of left atrial volume measurements by the applied 3D methods.
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Affiliation(s)
- O Rodevan
- Department of Cardiology, The National Hospital-Rikshospitalet, University of Oslo, Norway
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