title: Three-dimensional echocardiography: assessment of inter- and intra-operator variability and accuracy in the measurement of left ventricular cavity volume and myocardial mass.
abstract: Accurate left ventricular (LV) volume and mass estimation is a strong predictor of cardiovascular morbidity and mortality. We propose that our technique of 3D echocardiography provides an accurate quantification of LV volume and mass by the reconstruction of 2D images into 3D volumes, thus avoiding the need for geometric assumptions. We compared the accuracy and variability in LV volume and mass measurement using 3D echocardiography with 2D echocardiography, using in vitro studies. Six operators measured the LV volume and mass of seven porcine hearts, using both 3D and 2D techniques. Regression analysis was used to test the accuracy of results and an ANOVA test was used to compute variability in measurement. LV volume measurement accuracy was 9.8% (3D) and 18.4% (2D); LV mass measurement accuracy was 5% (3D) and 9.2% (2D). Variability in LV volume quantification with 3D echocardiography was %SEMinter = 13.5%, %SEMintra = 11.4%, and for 2D echocardiography was %SEMinter = 21.5%, %SEMintra = 19.1%. We derived an equation to predict uncertainty in measurement of LV volume and mass using 3D echocardiography, the results of which agreed with our experimental results to within 13%. 3D echocardiography provided twice the accuracy for LV volume and mass measurement and half the variability for LV volume measurement as compared with 2D echocardiography.
authors.affiliation: Advanced Imaging Research Laboratories, John P Robarts Research Institute, and University of Western Ontario, London, Canada.
authors.forename: S K
authors.initials: SK
authors.lastname: Nadkarni
authors.forename: D R
authors.initials: DR
authors.lastname: Boughner
authors.forename: M
authors.initials: M
authors.lastname: Drangova
authors.forename: A
authors.initials: A
authors.lastname: Fenster
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D055592:Biophysical Phenomena; D001703:Biophysics; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data; D019560:Echocardiography, Three-Dimensional / Q000379:methods* / Q000706:statistics & numerical data; D006321:Heart / Q000033:anatomy & histology*; D006352:Heart Ventricles / Q000033:anatomy & histology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data; D015588:Observer Variation; D013552:Swine