Real-time three-dimensional echocardiography: technological gadget or clinical tool?
The complex anatomy of cardiac structures requires three-dimensional spatial orientation of images for a better understanding of structure and function, thereby improving image interpretation. Real-time three-dimensional echocardiography is a recently developed technique based on the design of an ultrasound transducer with a matrix array that rapidly acquires image data in a pyramidal volume. The simultaneous display of multiple tomographic images allows three-dimensional perspective and the anatomically correct examination of any structure within the volumetric image. As a consequence, it is less operator-dependent and hence more reproducible. Dedicated software systems and technologies are based on high-performance computers designed for graphic handling of three-dimensional images by providing possibilities beyond those obtainable with echocardiography. This methodology allows simultaneous display of multiple superimposed planes in an interactive manner as well as a quantitative assessment of cardiac volumes and ventricular mass in a three-dimensional format without a pre-established assumption of cardiac chamber geometry. In addition, myocardial contraction and/or perfusion abnormalities are clearly identified. Finally, real-time three-dimensional colour Doppler flow mapping enables complete visualisation of the regurgitant jet and new ways of assessing regurgitant lesion severity. Thus, this technique expands the abilities of non-invasive cardiology and may open new doors for the evaluation of cardiac diseases. In this article, current and future clinical applications of real-time three-dimensional echocardiography are reviewed.
Badano
Luigi P
LP
Department of Cardiopulmonary Sciences, University Hospital of Udine, Udine, Italy. badano.luigi@aoud.sanita.fvg.it
Dall'Armellina
Erica
E
Monaghan
Mark J
MJ
Pepi
Mauro
M
Baldassi
Mara
M
Cinello
Margherita
M
Fioretti
Paolo M
PM
D002306:Cardiac Volume; D002986:Clinical Trials as Topic; D003199:Computer Systems; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D016276:Ventricular Function