Three-dimensional echocardiography: where we are, where we are going.
Three-dimensional reconstruction of the heart has been an important research goal ever since the introduction of two-dimensional echocardiography. Several directions have been followed. Most approaches towards three-dimensional echocardiography are off-line and are based on the sequential rotational scanning and acquisition of multiple cross-sectional images together with their spatial position and orientation using internal coordinate reference systems. From the reconstructed volumetric data set electronic slicing can be performed which allows any-plane and paraplane echocardiography. The availability and versatility using the volumetric data set permits the retrieval of an infinite number of cardiac cross-sections which allow more accurate and reproducible measurements of valve areas, masses and cavity volumes by obviating geometric assumptions. The application of algorithms based on light reflection to the grey scale data provides tissue-depicting information allowing for dynamic volume-rendered display in projection, up till now unavailable in cardiology. This capability decreases variability both in the quality and interpretation of complex pathology among investigators. Emerging clinical experience indicates the strong potential of three-dimensional echocardiography in qualitative and quantitative diagnostic appraisal of various cardiac problems. While the technique is ready for clinical applications, its widespread use can be facilitated by a number of improvements. Advances in computer technology can be applied to three-dimensional echocardiography offering an exciting opportunity to employ virtual reality and simulation of interventional and surgical procedures, to predict results and plan appropriate therapy. In the future new physiologic parameters will provide additional information and will allow us to address new clinical questions.
Salustri
A
A
Department of Cardiology, Hospital Sandro Pertini, Rome, Italy. salustri@jnet.it
Roelandt
J R
JR
D003327:Coronary Disease / Q000000981:diagnostic imaging; D019560:Echocardiography, Three-Dimensional; D006331:Heart Diseases / Q000000981:diagnostic imaging; D006801:Humans