title: Rapid freehand scanning three-dimensional echocardiography: accurate measurement of left ventricular volumes and ejection fraction compared with quantitative gated scintigraphy.
abstract: This study was performed to assess clinical feasibility of rapid freehand scanning 3-dimensional echocardiography (3DE) for measuring left ventricular (LV) end-diastolic and -systolic volumes and ejection fraction using quantitative gated myocardial perfusion single photon emission computed tomography as the reference standard. We performed transthoracic 2-dimensional echocardiography and magnetic freehand 3DE using a harmonic imaging system in 15 patients. Data sets (3DE) were collected by slowly tilting the probe (fan-like scanning) in the apical position. The 3DE data were recorded in 10 to 20 seconds, and the analysis was performed within 2 minutes after transferring the raw digital ultrasound data from the scanner. For LV end-diastolic and -systolic volume measurements, there was a high correlation and good agreement (LV end-diastolic volume, r = 0.94, P <.0001, standard error of the estimates = 21.6 mL, bias = 6.7 mL; LV end-systolic volume, r = 0.96, P <.0001, standard error of the estimates = 14.8 mL, bias = 3.9 mL) between gated single photon emission computed tomography and 3DE. There was an overall underestimation of volumes with greater limits of agreement by 2-dimensional echocardiography. For LV ejection fraction, regression and agreement analysis also demonstrated high precision and accuracy (y = 0.82x + 5.1, r = 0.93, P <.001, standard error of the estimates = 7.6%, bias = 4.0%) by 3DE compared with 2-dimensional echocardiography. Rapid 3DE using a magnetic-field system provides precise and accurate measurements of LV volumes and ejection fraction in human beings
authors.affiliation: Health Science, Kobe University Graduate School of Medicine, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Kawai
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Morioka
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shiotani
mesh_terms: D000328:Adult; D000368:Aged; D019560:Echocardiography, Three-Dimensional; D005240:Feasibility Studies; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left