title: Quantification of mitral valve stenosis by three-dimensional transesophageal echocardiography.
abstract: The aim of this study was the evaluation of the diagnostic potentials of transesophageal 3D- echocardiography in the determination of mitral valve stenosis. 54 patients were investigated by transthoracic and multiplane transesophageal echocardiography. In 41 patients cardiac catheterization was performed. 3D- echocardiographic data acquisition was performed by automatic transducer rotation at 2 degree increments over a span of 180 degrees. The transesophageal probe was linked to an ultrasound unit and to a 3D- workstation capable of ECG- and respiration gated data acquisition, postprocessing and 2D/3D image reconstruction. The mitral valve was visualized in sequential cross-sectional planes out of the 3D data set. The spatial position of the planes was indicated in a reference image. In the cross-sectional plane with the narrowest part of the leaflets the orifice area was measured by planimetry. For topographic information a 3D view down from the top of the left atrium was reconstructed. Measurements were compared to conventional transthoracic planimetry, to Doppler-echocardiographic pressure half time and to invasive data. The mean difference to transthoracic planimetry, pressure half time and to invasive measurements were 0.3 +/- 0.1 cm2, 0.2 +/- 0.1 cm2 and 0.1 +/- 0.1 cm2, respectively. Remarkable differences between the 3D- echocardiographic and the 2D- or Doppler- echocardiographic methods were observed in patients with severe calcification or aortic regurgitation. In 22% of the patients the 3D data set was not of diagnostic quality. New diagnostic information from a 3D view of the mitral valve could be obtained in 69% of the patients. Thus, although image quality is limited, 3D- echocardiography provides new topographic information in mitral valve stenosis. It allows the use of a new quantitative method, by which image plane positioning errors and flow-dependent calculation is avoided.
authors.affiliation: II Medical Clinic, University of Mainz, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Kupferwasser
authors.forename: S
authors.initials: S
authors.lastname: Mohr-Kahaly
authors.forename: T
authors.initials: T
authors.lastname: Menzel
authors.forename: M
authors.initials: M
authors.lastname: Spiecker
authors.forename: G
authors.initials: G
authors.lastname: Dohmen
authors.forename: E
authors.initials: E
authors.lastname: Mayer
authors.forename: H
authors.initials: H
authors.lastname: Oelert
authors.forename: R
authors.initials: R
authors.lastname: Erbel
authors.forename: J
authors.initials: J
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging*; D015588:Observer Variation