Usefulness of real-time three-dimensional echocardiography for diagnosis of infective endocarditis.
OBJECTIVE
To compare transthoracic 2-dimentional echocardiography (2DE) and real-time three-dimensional echocardiography (RT-3DE) evaluation of clinically suspected infective endocarditis (IE) and to determine the feasibility of RT-3DE in vegetation detection.


METHODS
There were 46 patients (mean age 61+/-17 years, 54% male) enrolled. We acquired 2DE and RT-3DE with full volume images. RT-3DE images were analyzed by 3D QLAB software. Parameters suggestive of vegetation for RT-3DE assessment included mobile nodules, focal thickness, and uneven surface. The diagnosis of IE was made according to the Duke criteria.


RESULTS
The sensitivity and specificity were 91.6% and 88.2% for 2DE, and 91.6% and 100% for RT-3DE. Among three parameters of RT-3DE, presence of mobile nodule (83.3% vs. 0%, p < 0.001) were significantly higher in IE patients but not focal thickness (75% vs. 65%, p = 0.723), or uneven surface (33% vs. 10%, p = 0.064).


CONCLUSIONS
The sensitivity of RT-3DE and 2DE was similar for endocarditis diagnosis, but the specificity of RT-3DE was higher. Mobile nodules viewed by RT-3DE might be a useful finding for vegetation detection.
Liu
Yen-Wen
YW
Department of Internal Medicine, National Cheng Kung University Medical Center, Tainan, Taiwan.
Tsai
Wei-Chuan
WC
Lin
Chih-Chan
CC
Hsu
Chih-Hsing
CH
Li
Wei-Ting
WT
Lin
Li-Jen
LJ
Chen
Jyh-Hong
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019560:Echocardiography, Three-Dimensional; D004696:Endocarditis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013624:Taiwan; D055815:Young Adult