Real-time 3-dimensional echocardiographic imaging of congenital heart disease using matrix-array technology: freehand real-time scanning adds instant morphologic details not well delineated by conventional 2-dimensional imaging.
OBJECTIVE
We sought to investigate whether real-time (RT) 3-dimensional echocardiography (RT3D) using matrix-array technology could resolve a specific morphologic detail that could not be well resolved during conventional 2-dimensional (2D)/Doppler echocardiographic imaging of congenital heart disease.


BACKGROUND
Although 2D echocardiography is currently the primary imaging modality of congenital heart disease, there are still some anatomic details that cannot be well delineated by that modality.


METHODS
In all, 70 patients underwent RT3D examination using matrix-array transducer. Applying the standard sweeping technique as for 2D imaging, freehand RT imaging was used for immediate feedback. The 2D examinations of the last 23 consecutive patients were used to validate the additional value of RT3D by 3 examiners blinded to the findings of RT3D.


RESULTS
The adequacy of 2D imaging to resolve the morphologic detail in question ranged from 30% to 70%, whereas RT3D imaging was considered successful in delineating the morphologic detail in 80% to 100% of patients instantly. The image resolution was superior or equivalent to that obtained by 2D imaging. Heart valves, septal defects, and volumetric valvular and vascular color flow morphologies were well delineated by RT3D.


CONCLUSIONS
Matrix-array RT3D is a significant breakthrough technology that allowed instant visualization of cardiac anatomic details that could not be well delineated by 2D imaging. Further improvements of some technical limitations should make RT3D matrix-array cardiac imaging a significant modality in the field of echocardiographic imaging of congenital cardiac anomalies.
Seliem
Mohamed A
MA
Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. Seliem@email.chop.edu
Fedec
Anysia
A
Cohen
Meryl S
MS
Ewing
Stanford
S
Farrell
Paul E
PE
Rychik
Jack
J
Schultz
Amy H
AH
Gaynor
J William
JW
Spray
Thomas L
TL
D000293:Adolescent; D000328:Adult; D001709:Biotechnology / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003199:Computer Systems; D015150:Echocardiography, Doppler / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013673:Technology Assessment, Biomedical