Echocardiography, Three-Dimensional ; methods ; trends

BACKGROUNDLeft atrial (LA) maximum volume is becoming a prognostic biomarker for left ventricular (LV) diastolic dysfunction. However, we assessed LV diastolic function by measuring LA phasic volumes using real-time threedimensional echocardiography (RT3DE) in patients with stable coronary artery disease (CAD).

METHODSSixty-five stable CAD patients with normal LV ejection fraction (LVEF) were divided into three groups according to degree of coronary stenosis: control (n = 15) with <50% stenosis as control group, mildS (n = 25) with mild stenosis (50%-70%) and severeS (n = 25) with >70% stenosis. LA phasic volumes and function were evaluated and compared using RT3DE and two dimensional echocardiography (2DE). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were examined. The correlations of RT3DE-derived parameters with other conventional indices were analyzed.

RESULTSSignificant correlations between RT3DE and 2DE for LA volume measurements were: control, r = 0.93; mildS, r = 0.94; severeS, r = 0.90 (all P < 0.05). Patients with severe coronary stenosis presented higher NT-proBNP level, indices of LA minimum volume and volume before atrial contraction, but lower LA total emptying fraction (LAEF) and LAEFpassive. Significant correlations of RT3DE derived LA volume indices with E/E' (r = 0.695) and NF-proBNP (r = 0.630) level were found.

CONCLUSIONSRT3DE derived, LA indices correlate well with NT-proBNP level and may be superior to 2DE measurements for the evaluation of LV diastolic dysfunction. Enlargement of LA minimum volume in stable CAD patients without systolic dysfunction appears earlier and may be better correlated with LV diastolic function than that of LA maximum volume.

Echocardiography ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnosis

Image interpolation techniques were widely applied in medical imaging for image generation and post processing. Firstly, traditional interpolation methods were listed out in the details of shape-based interpolation and dynamic elastic registration interpolation. Secondly, the characteristics, development and problems in interpolation of rotary scanning ultrasonic cardiac images were analyzed. The relation between interpolation and registration was stated. The analysis indicated that excellent methods in rotary scanning interpolation should be registration-based methods. At last, several evaluation methods about images interpolation were discussed.
Algorithms ; Echocardiography, Three-Dimensional ; methods ; Fourier Analysis ; Image Processing, Computer-Assisted ; methods

Dynamic 3D ultrasound is a very promising technology for clinical use, but not being a Cartesian 3D dataset, 3D ultrasound data can not be visualized directly with real-time volume rendering accelerated by 3D texture hardware. In this paper, fast volume rendering using 3D texture hardware acceleration is introduced and modern PC graphics card architecture analyzed. A modified method is proposed to obtain real-time volume rendering of dynamic 3D ultrasound data by programming vertex shader in GPU. Experimental results show that 3D ultrasound data can be rendered with real-time speed in normal PC platform. The method can be widely applied in future 3D dynamic ultrasound clinical research.
Algorithms ; Computer Graphics ; Computer Simulation ; Echocardiography, Three-Dimensional ; methods ; Humans ; Image Interpretation, Computer-Assisted ; methods

BACKGROUNDThe left atrial appendage (LAA) is an important source of thrombus formation. We investigated the feasibility of the recently developed real-time three-dimensional transesophageal echocardiography (RT3D-TEE) method in assessment of the morphology and function of the LAA.

METHODSNinety-six consecutive patients (58 males with a mean age of (43.4 ± 12.5) years) who were referred for 2-dimensional (2D) transesophageal echocardiography (TEE) underwent additional RT3D-TEE. LAA morphology was visualized in multiple views. Orifice size, depth, volumes and ejection fraction (EF) of the LAA, were measured.

RESULTSAll the patients underwent RT3D-TEE examination without complications. Ninety-two patients (95.8%) had adequate images for visualization and quantitative analysis of the LAA. The LAA exhibited great variability with respect to relative dimensions and morphology. LAA orifice area was (3.8 ± 1.2) cm(2) with a diameter of (2.4 ± 0.9) cm × (1.4 ± 0.6) cm. The mean depth of the LAA was (2.9 ± 0.7) cm. End-diastolic volume (EDV-LAA), end-systolic volume (ESV-LAA) and EF of the LAA were (6.2 ± 3.7) ml, (4.1 ± 2.8) ml, and 0.35 ± 0.16, respectively. EDV-LAA, ESV-LAA and the orifice area of the LAA in patients with atrial fibrillation (AF) were larger than those without AF, whereas the EF was smaller in the AF patients.

CONCLUSIONSDefining LAA morphology and quantitative analysis of the size and function of the LAA with superior quality and resolution of images using RT3D-TEE is feasible. This technique may be an ideal tool for guidance of the LAA occlusion procedure. Determination of LAA volumes and volume-derived EF by RT3D-TEE provides new insights into the analysis of LAA function.

Adult ; Atrial Appendage ; diagnostic imaging ; Echocardiography, Three-Dimensional ; methods ; Echocardiography, Transesophageal ; methods ; Female ; Humans ; Male ; Middle Aged

Now real-time three-dimensional echocardiography (RT3DE) is an important tool to diagnose the complex congenital heart malformation. However, searching the cross-sections to view the cardiac anomalies in a three-dimensional ultrasound image of the heart by hand on the RT3DE system is time consuming, not repeatable, and easy to miss some places. In order to improve the existing diagnostic tool, we adopted the methods based on template matching for automatically finding the best cross-sections which are defined by Sun Kun et al. to view the cardiac anomalies in RT3DE's full-volume data. Among the methods is the entropy correlation coefficient which measured the similarity of the best cross-sections with the highest accuracy. The automatic search for these cross-sections is much quicker than the manual search. And with good repeatability it will make good preparation for the subsequent computer-aided diagnosis such as measure and registration, which is significant for the diagnosis of the complex congenital heart malformation.
Algorithms ; Echocardiography, Doppler, Color ; methods ; Echocardiography, Three-Dimensional ; Heart Defects, Congenital ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods

BACKGROUND: Evaluation of left ventricular (LV) size and function is one of the important reasons for performing echocardiography. Real time three dimensional echocardiography (RT3DE) is now available for a precise non-invasive ventricular volumetry. Aim of work was to validate RT3DE as a non-invasive cardiac imaging method for measurement of LV volumes using cardiac angiography as the reference technique. METHODS: Prospective study on 40 consecutive patients with tetralogy of Fallot (TOF) referred for cardiac catheterization for preoperative assessment. Biplane cineangiography, conventional 2 dimensional echocardiography (2DE) and RT3DE were performed for the patients. A control group of 18 age and sex matched children was included and 2DE and RT3DE were performed for them. RESULTS: The mean LV end diastolic volume (LVEDV) and LVEDV index (LVEDVI) measured by RT3DE of patients were lower than controls (p value = 0.004, 0.01, respectively). There was strong correlation between the mean value of the LVEDV and the LVEDVI measured by RT3DE and angiography (r = 0.97, p < 0.001). The mean value of LV ejection fraction measured by RT3DE was lower than that assessed by 2DE (50 ± 6.2%, 65 ± 4.6%, respectively, p value < 0.001) in the studied TOF cases. There was good intra- and inter-observer reliability for all measurements. CONCLUSION: RT3DE is a noninvasive and feasible tool for measurement of LV volumes that strongly correlates with LV volumetry done by angiography in very young infants and children, and further studies needed.
Angiocardiography* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Cineangiography ; Echocardiography ; Echocardiography, Three-Dimensional* ; Humans ; Infant ; Methods ; Prospective Studies ; Tetralogy of Fallot*

OBJECTIVETo compare the accuracy of live three-dimensional (Live-3D-TEE) and two-dimensional transesophageal echocardiography (2D-TEE) in the evaluation of functional anatomy of mitral regurgitation. METHDOS: Thirty-eight consecutive patients with severe mitral regurgitation were enrolled prospectively. The accuracy of Live-3D-TEE and 2D-TEE for functional assessment of mitral regurgitation was evaluated against surgical findings.

RESULTSThe accuracy in etiological assessment of mitral regurgitation was 94.7% with Live-3D-TEE and 89.5% with 2D-TEE (P=0.09). For assessment of lesions of the mitral valve, Live-3D-TEE showed an overall accuracy of 93.2%, significantly higher than that of 2D-TEE (88.6%, P=0.001). Live-3D-TEE also showed a significantly higher accuracy than 2D-TEE in localization of mitral valve lesions (93.3% vs 86.7%, P=0.000).

CONCLUSIONBoth Live-3D-TEE and 2D-TEE allow accurate assessment of the etiology of mitral regurgitation, but Live-3D-TEE can be more accurate in the evaluation of the lesions of the mitral valve and their localization.

Adult ; Aged ; Echocardiography ; methods ; Echocardiography, Three-Dimensional ; methods ; Echocardiography, Transesophageal ; methods ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency ; diagnostic imaging ; pathology ; physiopathology ; Young Adult

The design and development of multi-dimensional ultrasonic reconstruction and visualization system (MURVS) have been described in the present paper. This system is basically composed of four modules: the data input/output module, image segmentation and arrangement module, multi-dimensional reconstruction module, and the dynamic visualization module. At first, some algorithms used in the system are introduced by the authors, including the AVI segmentation algorithm, three-dimensional interpolation algorithm, and volume rendering algorithms. Then the key questions of techniques to be discussed are: how to design the main modules, how to solve the dynamic visualization problem, and how to implement the system. The experiments indicate that MURVS is able to reconstruct all three-dimensional data fields in one cardiac cycle of a patient within 4 seconds, and dynamically display the motion of the heart. It allows the medical professionals to select different parameters when observing the reconstructed results. This is very helpful for medical professionals to reach more accurate diagnoses of their patients' diseases.
Adult ; Algorithms ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Mitral Valve Stenosis ; diagnostic imaging

OBJECTIVERecently, it has been demonstrated in several studies that three-dimensional echocardiography (3DE) with any cut view interpretation of the cardiac morphological structures and its dynamic three-dimensional display can conform to the need of accurate anatomical diagnosis of complex congenital heart diseases including conotruncal defects (CTD). 3DE can not only provide functional and morphological information of CTD to decide on surgical repair but also simulate the intra operative visualization of complex anatomical cardiac structures to improve the understanding of the anatomy of CTD, but there have been scarce studies to assess systematically the potential noninvasive diagnostic value of transthoracic 3DE for CTD in children. Thus, this study attempted to evaluate the diagnostic value of transthoracic 3DE for the pathological diagnosis of CTD in children.

METHODSHP Sonos 5500 echocardiographic system interfaced with Tomtec 3DE imaging system (echo-view 4.2 software) was used to diagnose 210 patients (132 male, 78 female, aged 0-15 years, mean 3.2 +/- 3.2 years) with CTD in Shanghai Children's Medical Center from May 2000 to November 2003, including 62 patients with double outlet right ventricle, 48 patients with transposition of great arteries, 48 patients with tetralogy of Fallot, 38 patients with pulmonary atresia with interventricular septal defect and 14 patients with persistent truncus arteriosus. Diagnostic method consisting of ten designed 3DE sectional views and Van Praagh's sequential segmental approach in congenital heart diseases was used in this study. And the results were compared with those diagnosed by two-dimensional echocardiography (2DE) and angiocardiography. Surgical findings were considered as the "gold standard".

RESULTSThere were 526 image acquisitions of transthoracic 3DE in the 210 patients with CTD including 200 through subcostal window, 254 through parasternal window and 72 through apical window, among which 477 image acquisitions (93.2%) could demonstrate good spatial cardiovascular structures. Meanwhile, six 3DE sectional views of the diagnostic method of the ten designed 3DE sectional views were identified for the diagnosis of CTD as follows: en-face view of atrial and ventricular septa from left ventricle (L1a); en-face view of atrial and ventricular septa from right ventricle (L2a); four-chamber view of whole-heart oblique frontal plane (Ha and Hb); en-face view of atrial-ventricular valve from atria (S1a) and en-face view of atrial-ventricular valve from ventricles (S2a). The 3DE sectional diagnosis showed that 3DE could provide more information of inner cardiac structure than 2DE, such as ventricular configuration identification, atrial-ventricular and ventricular-arterial continuity, location and shape of ventricular septal defect (VSD), and appreciation of the defects related with aorta and pulmonary arteries, etc. In 147 cases of surgical repair, both 3DE and 2DE were in accordance with the surgical findings, but 3DE had new findings in 18 (12.2%) cases and corrected the diagnoses in 10 (6.8%) cases as compared with 2DE.

CONCLUSIONThe 3DE sectional diagnostic method could make a successfully sectional diagnosis of pathological morphology in CTD by demonstrating more spatial information of inner cardiac structure than 2DE and angiocardiography.

Adolescent ; Child ; Child, Preschool ; Echocardiography, Three-Dimensional ; methods ; Female ; Heart Defects, Congenital ; diagnostic imaging ; Humans ; Infant ; Male