Three-dimensional echoventriculography

doi:10.1016/0002-8703(83)90683-X

American Heart Journal

Volume 106, Issue 3, September 1983, Pages 435-443

https://doi.org/10.1016/0002-8703(83)90683-X Get rights and content

Abstract

A method of generating a three-dimensional image of the human left ventricle by computer techniques is described. The volume of each image was estimated by a modifications of Simpson's rule. The method was applied to nine suitable patients and estimations of end-diastolic and end-systolic volumes were compared to volumes determined by cineangiography. Significant linear correlation coefficients of 0.95 and 0.94 were obtained for end-diastolic and end-systolic volumes, respectively. The standard errors of estimate were 9 ml for end-diastolic volumes and 7 ml for end-systolic volumes. The value of this methodology lies in the ability to estimate left ventricular volumes with accuracy, using ar imaging technique of little inconvenience and no risk to the patient and computer hardware that is readily available at most clinical institutions.

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Cited by (69)

Clinical Application of Three-Dimensional Echocardiography
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Citation Excerpt :
In the early 1990s, 3DE was initially created as a series of two-dimensional (2D) images sequentially acquired from one window or non-sequentially obtained from multiple acoustic windows gated to ECG and respiration to reconstruct one 3D (three-dimensional) volume.1–6
Echocardiography is one of the most valuable diagnostic tools in cardiology. Technological advances in ultrasound, computer and electronics enables three-dimensional (3-D) imaging to be a clinically viable modality which has significant impact on diagnosis, management and interventional procedures.
Since the inception of 3D fully-sampled matrix transthoracic and transesophageal technology it has enabled easier acquisition, immediate on-line display, and availability of on-line analysis for the left ventricle, right ventricle and mitral valve. The use of 3D TTE has mainly focused on mitral valve disease, left and right ventricular volume and functional analysis. As structural heart disease procedures become more prevalent, 3D TEE has become a requirement for preparation of the procedure, intra-procedural guidance as well as monitoring for complications and device function. We anticipate that there will be further software development, improvement in image quality and workflow.
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Effect of three-dimensional valve shape on the hemodynamics of aortic stenosis: Three-dimensional echocardiographic stereolithography and patient studies
2002, Journal of the American College of Cardiology
This study tested the hypothesis that the impact of a stenotic aortic valve depends not only on the cross-sectional area of its limiting orifice but also on three-dimensional (3D) valve geometry.
Valve shape can potentially affect the hemodynamic impact of aortic stenosis by altering the ratio of effective to anatomic orifice area (the coefficient of orifice contraction [Cc]). For a given flow rate and anatomic area, a lower Cc increases velocity and pressure gradient. This effect has been recognized in mitral stenosis but assumed to be absent in aortic stenosis (constant Cc of 1 in the Gorlin equation).
In order to study this effect with actual valve shapes in patients, 3D echocardiography was used to reconstruct a typical spectrum of stenotic aortic valve geometrics from doming to flat. Three different shapes were reproduced as actual models by stereolithography (computerized laser polymerization) with orifice areas of 0.5, 0.75, and 1.0 cm² (total of nine valves) and studied with physiologic flows. To determine whether valve shape actually influences hemodynamics in the clinical setting, we also related Cc (= continuity/planimeter areas) to stenotic aortic valve shape in 35 patients with high-quality echocardiograms.
In the patient-derived 3D models, Cc varied prominently with valve shape, and was largest for long, tapered domes that allow more gradual flow convergence compared with more steeply converging flat valves (0.85 to 0.90 vs. 0.71 to 0.76). These variations translated into differences of up to 40% in pressure drop for the same anatomic area and flow rate, with corresponding variations in Gorlin (effective) area relative to anatomic values. In patients, Cc was significantly lower for flat versus doming bicuspid valves (0.73 ± 0.14 vs. 0.94 ± 0.14, p < 0.0001) with 40 ± 5% higher gradients (p < 0.0001).
Three-dimensional valve shape is an important determinant of pressure loss in patients with aortic stenosis, with smaller effective areas and higher pressure gradients for flatter valves. This effect can translate into clinically important differences between planimeter and effective valve areas (continuity or Gorlin). Therefore, valve shape provides additional information beyond the planimeter orifice area in determining the impact of valvular aortic stenosis on patient hemodynamics.
Three-dimensional echocardiography: The future today!
2000, Computers and Graphics (Pergamon)
Three-dimensional echocardiography depicts the heart and its structures in their realistic forms. This capability decreases variability both in the quality and the interpretation of complex pathology, among investigators. Therefore, it is likely that the method will become the standard echocardiography examination in the future. The availability and versatility in use of the volumetric data set allows to retrieve an infinite number of cardiac cross-sections which allow more accurate and reproducible measurements of valve areas, masses and cavity volumes by obviating geometric assumptions. In the future new physiologic parameters will provide additional information and will allow to address new clinical questions.
Three-dimensional echocardiography paves the way toward virtual reality
2000, Ultrasound in Medicine and Biology
The heart is a three-dimensional (3-D) object and, with the help of 3-D echocardiography (3-DE), it can be shown in a realistic fashion. This capability decreases variability in the interpretation of complex pathology among investigators. Therefore, it is likely that the method will become the standard echocardiography examination in the future. The availability of volumetric data sets allows retrieval of an infinite number of cardiac cross-sections. This results in more accurate and reproducible measurements of valve areas, cardiac mass and cavity volumes by obviating geometric assumptions. Typical 3-DE parameters, such as ejection fraction, flow jets, myocardial perfusion and LV wall curvature, may become important diagnostic parameters based on 3-DE. However, the freedom of an infinite number of cross-sections of the heart can result in an often-encountered problem of being “lost in space” when an observer works on a 3-DE image data set. Virtual reality computing techniques in the form of a virtual heart model can be useful by providing spatial “cardiac” information. With the recent introduction of relatively low cost portable echo devices, it is envisaged that use of diagnostic ultrasound (US) will be further boosted. This, in turn, will require further teaching facilities. Coupling of a cardiac model with true 3-D echo data in a virtual reality setting may be the answer.
Influence of echocardiographic scan plane location and number on the accuracy of three-dimensional left ventricular volume and shape determination
1999, American Journal of Cardiology
Quantitative 3-dimensional (3-D) echocardiography provides accurate assessment of left ventricular (LV) volume, shape, and function, but depends on manual endocardial border tracing. This study determined the minimal number of borders that need to be traced to obtain an accurate analysis of not only the volume of the left ventricle but also its shape, using the integrated methods for quantitative 3-D echocardiography developed by our laboratory. Transthoracic 3-D echocardiographic studies were obtained in 9 normal subjects and 6 patients with heart disease by freehand scanning. The LV endocardium was manually traced in 17 ± 5 imaging planes and reconstructed in 3 dimensions. The volume and shape of each reconstruction were compared with values measured from surfaces reconstructed from 8 subsets containing 2 to 7 borders; each subset was acquired from different combinations of spatially distributed parasternal and apical views. Accurate measurements were obtained from data sets having ≥5 borders, regardless of whether the image planes were predominantly apical or parasternal views. In conclusion, the LV border should be traced in ≥5 imaging planes to obtain accurate measurements of volume and shape. The piecewise smooth reconstruction method and freehand scanning using a magnetic field tracing system allow the borders to be acquired from whatever combination of acoustic windows and views provides optimal image quality.

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^☆: This work was supported in part by the Ischemic Heart Disease Specialized Center of Research (SCOR) Grant HL-17669; and by the Veternans Administration.

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Three-dimensional echoventriculography☆

Abstract

Am Heart J

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am Heart J

Am J Cardiol

Comput Biomed Res

Am J Cardiol

Am J Cardiol

Am J Cardiol

The use of biplane angiography for measurement of left ventricular volume in man

Am Heart J

Ultrasound measurements of the left ventricle. A correlative study with angiocardiography

Arch Intern Med

Serial echocardiography in patients with acute myocardial infarction: Its value and prognostic significance

Eur J Cardiol

Study of left ventricular geometry and function by B-scan ultrasonography in patients with and without asynergy

N Engl J Med

Noninvasive left ventricular volume determination by two-dimensional echocardiography

Br Heart J

Cardiac imaging using a phased array ultrasound system. II. Clinical techniques and application

Circulation

Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography: A comparison of cineangiographic and radionuclide techniques

Circulation