Potential Applications of 3D-Echocardiography

Potential Applications of 3D-Echocardiography

The potential applications of 3D-echo can be categorized

into 3 major areas: (1) Interpretation of morphology and

pathology, (2) Quantification of volumes and function,

(3) 3D-echocardiography as a teaching tool.

Interpretation of Morphology and Pathology

The clinical potential of 3D-echocardiography has been thoroughly

explored. Our own experience and that of others have

clearly demonstrated that the anatomy (Figure 1) and pathology

of the heart and the great vessels can often be displayed

[8, 9] in a more comprehensive format. Even fairly small

structures such as coronary arteries, a paravalvular leak or

small masses and vegetations can be visualized [7, 10].

Our findings also show that this technique can be applied

in numerous settings. For example, in valvular heart disease

(Figure 2), to determine the size of infectious vegetations, to

determine the mitral valve area in mitral stenosis (Figure 3),

for complex congenital malformations, or aortic dissection

(Figure 4). Furthermore, it has also been shown that jets can

be reconstructed from color Doppler information to assist in

the quantification of valvular lesions [11].

Quantification of Ventricular Volumes and Function

3D-echo has been applied to derive quantitative measurements

of volume, mass and dimensions of the left and right

ventricles and also other cardiac lesions, such as atrial and

ventricular septal defects [12]. While quantification of

ventricular volumes with two-dimensional imaging requires

geometric assumptions, measurement obtained with

3D-echo represents true volumes. Several studies have

shown 3D-echo to be superior to 2D-echocardiography for

both left and right ventricular volumes [13]. The processrequires acquisition of a 3-dimensional data set and manual

endocardial contour tracing. Several calculations including

volumes (throughout the cardiac cycle), global and regional

ejection fractions can be computed (Figure 5). The endocardial

surface of the ventricular cavity can be displayed from

multiple angles in a dynamic mode. Since the process of

manual endocardial border tracing is still time-consuming,

semi-automated contour detection algorithms are now being

developed. In addition, there is experimental evidence that

contrast opacification of the left ventricle could further

enhance the applicability of 3D-volume computation [14].

The advent of real time volumetric scanning will certainly

enhance the applicability of 3D-volume computation [15].