Pepi Mauro, Tamborini Gloria, Pontone GianLuca, Andreini Daniele, Berna Giovanni, De Vita Stefano, Maltagliati Anna
Centro Cardiologico Monzino, IRCCS, Milan, Italy.
Ital Heart J. 2003 Aug;4(8):544-50.
Despite its wide diagnostic potential, three-dimensional (3D) echocardiography is a quite rarely employed technique. The ideal method to obtain transthoracic 3D imaging is on-line 3D echocardiography, but first-generation real-time instruments had technical limitations. A new on-line 3D technology which allows true real-time volume rendering of the cardiac anatomy has been recently introduced and its feasibility and diagnostic advantages have been evaluated in the clinical setting.
The system utilizes a "matrix" transducer with a dedicated software. It allows instantaneous acquisition and rendering on-line 3D images and interactive manipulation of 3D data. Eighty-three adult patients with various cardiac pathologies underwent on-line 3D echocardiography. Long- and short-axis views of the aorta, mitral valve and left ventricle and surgical views of these structures were attempted. The duration of acquisition and reconstruction, and the quality and incremental clinical value of 3D images in comparison with two-dimensional imaging were annotated.
The mean time of 3D examination was 10 +/- 5 min; the mean number of acquisitions was 10.8 per patient. The quality of the 3D images was optimal in 39%, good in 37%, sufficient in 19%, and insufficient in 5% of the patients. In all cases at least one optimal or good live 3D image was obtained from the parasternal and apical views. The reconstruction of surgical or en face views was easily and rapidly (1-2 min) achieved by two experts in 3D echocardiography. The additional clinical values of 3D vs two-dimensional imaging was demonstrated in 7 patients with mitral valve disease, 3 with aortic valve pathology, and 3 with congenital heart disease. Several on-line 3D images that have not correspondence with two-dimensional echocardiography were reconstructed, creating projections dedicated to the diagnostic goal.
On-line 3D echocardiography can be easily performed in adult patients and allows for unique planes and projections. The instant rendering of 3D images facilitates the recognition of cardiac structures and increases the diagnostic potential of transthoracic echocardiography.
尽管三维（3D）超声心动图具有广泛的诊断潜力，但它是一种很少使用的技术。获取经胸3D成像的理想方法是在线3D超声心动图，但第一代实时仪器存在技术局限性。最近引入了一种新的在线3D技术，该技术可实现心脏解剖结构的真正实时容积成像，并已在临床环境中评估了其可行性和诊断优势。
该系统使用带有专用软件的“矩阵”换能器。它允许即时采集和在线渲染3D图像以及对3D数据进行交互式操作。83例患有各种心脏疾病的成年患者接受了在线3D超声心动图检查。尝试获取主动脉、二尖瓣和左心室的长轴和短轴视图以及这些结构的手术视图。记录采集和重建的持续时间，以及与二维成像相比3D图像的质量和增加的临床价值。
3D检查的平均时间为10±5分钟；每位患者的平均采集次数为10.8次。3D图像质量在39%的患者中为最佳，37%为良好，19%为足够，5%为不足。在所有病例中，至少从胸骨旁和心尖视图获得了一张最佳或良好的实时3D图像。两名3D超声心动图专家轻松快速地（1 - 2分钟）完成了手术或正面视图的重建。在7例二尖瓣疾病、3例主动脉瓣病变和3例先天性心脏病患者中证明了3D与二维成像相比的额外临床价值。重建了几张与二维超声心动图不对应的在线3D图像，创建了专门用于诊断目的的投影。
在线3D超声心动图可在成年患者中轻松进行，并可提供独特的平面和投影。3D图像的即时渲染有助于心脏结构的识别，并增加了经胸超声心动图的诊断潜力。
