title: Quantification of the aortic valve area in three-dimensional echocardiographic data sets: analysis of orifice overestimation resulting from suboptimal cut-plane selection.
abstract: BACKGROUND
  Our study was designed to determine the feasibility of three-dimensional echocardiographic (3DE) aortic valve area planimetry and to evaluate potential errors resulting from suboptimal imaging plane position.
  
  
  RESULTS
  Transesophageal echocardiography with acquisition of images for 3DE was performed in 27 patients. Aortic valve orifice was planimetered in two-dimensional echocardiograms (2DE) and in two-dimensional views reconstructed from 3DE data sets optimized for the level of the cusp tips. To evaluate the errors caused by suboptimal cut-plane selection, orifice was also measured in cut-planes angulated by 10, 20, and 30 degrees or shifted by 1.5 to 7.5 mm. Planimetered orifice areas was similar in 2DE and 3DE studies: 2.09 +/- 0.97 cm2 versus 2.07 +/- 0.92 cm2. Significant overestimation was observed with cut-plane angulation (0.09, 0.19, and 0.34 cm2 at 10 degree increments) or parallel shift (0.11, 0.22, 0.33, 0.43, and 0.63 cm2 at 1.5 mm increments). Three-dimensional echocardiographic measurement reproducibility was very low and superior to that of 2DE.
  
  
  CONCLUSIONS
  Three-dimensional echocardiography allows accurate aortic valve area quantification with excellent reproducibility. Relatively small inaccuracy in cut-plane adjustment is a major source of errors in aortic valve area planimetry.
authors.affiliation: Thoraxcenter, Division of Cardiology, Erasmus University and University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands.
authors.forename: J D
authors.initials: JD
authors.lastname: Kasprzak
authors.forename: Y F
authors.initials: YF
authors.lastname: Nosir
authors.forename: A
authors.initials: A
authors.lastname: Dall'Agata
authors.forename: A
authors.initials: A
authors.lastname: Elhendy
authors.forename: M
authors.initials: M
authors.lastname: Taams
authors.forename: F J
authors.initials: FJ
authors.lastname: Ten Cate
authors.forename: J R
authors.initials: JR
authors.lastname: Roelandt
mesh_terms: D001021:Aortic Valve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results