University of Chicago Medical Center, Chicago, Illinois 60637, USA.
JACC Cardiovasc Imaging. 2010 Jan;3(1):10-8. doi: 10.1016/j.jcmg.2009.09.017.
We undertook volumetric analysis of the right ventricle (RV) by real-time 3-dimensional echocardiography (RT3DE), cardiac magnetic resonance (CMR), and cardiac computed tomography (CCT) on images obtained in RV-shaped phantoms and in patients with a wide range of RV geometry.
Assessment of the RV by 2-dimensional (2D) echocardiography remains challenging due to its unique geometry and limitations of the current analysis techniques. RT3DE, CMR, and CCT, which can quantify RV volumes, promise to overcome the limitations of 2D echocardiography.
Images were analyzed using RV Analysis software. Volumes measured in vitro were compared with the true volumes. The human protocol included 28 patients who underwent RT3DE, CMR, and CT on the same day. Volumetric analysis of CMR images was used as a reference, against which RT3DE and CCT measurements were compared using linear regression and Bland-Altman analyses. To determine the reproducibility of the volumetric analysis, repeated measurements were performed for all 3 imaging modalities in 11 patients.
The in vitro measurements showed that: 1) volumetric analysis of CMR images yielded the most accurate measurements; 2) CCT measurements showed slight (4%) but consistent overestimation; and 3) RT3DE measurements showed small underestimation, but considerably wider margins of error. In humans, both RT3DE and CCT measurements correlated highly with the CMR reference (r=0.79 to 0.89) and showed the same trends of underestimation and overestimation noted in vitro. All interobserver and intraobserver variability values were <14%, with those of CMR being the highest.
Volumetric quantification of RV volume was performed on CMR, CCT, and RT3DE images. Eliminating analysis-related intermodality differences allowed fair comparisons and highlighted the unique limitations of each modality. Understanding these differences promises to aid in the functional assessment of the RV.
通过在 RV 形状的体模和具有广泛 RV 几何形状的患者中获得的图像，使用实时 3 维超声心动图（RT3DE）、心脏磁共振（CMR）和心脏计算机断层扫描（CCT）对右心室（RV）进行容积分析。
由于 RV 的独特几何形状和当前分析技术的限制，二维（2D）超声心动图对 RV 的评估仍然具有挑战性。RT3DE、CMR 和 CCT 可以定量 RV 容积，有望克服 2D 超声心动图的局限性。
使用 RV 分析软件分析图像。体外测量的容积与真实容积进行比较。人体方案包括 28 名患者，他们在同一天接受 RT3DE、CMR 和 CT。使用 CMR 图像的容积分析作为参考，使用线性回归和 Bland-Altman 分析比较 RT3DE 和 CCT 测量值。为了确定容积分析的可重复性，对 11 名患者的所有 3 种成像方式进行了重复测量。
体外测量结果表明：1）CMR 图像的容积分析得出的测量值最准确；2）CCT 测量值略有（4%）但一致的高估；3）RT3DE 测量值显示出较小的低估，但误差幅度要大得多。在人体中，RT3DE 和 CCT 测量值与 CMR 参考值高度相关（r=0.79 至 0.89），并显示出与体外相同的低估和高估趋势。所有观察者间和观察者内变异性值均<14%，其中 CMR 的值最高。
在 CMR、CCT 和 RT3DE 图像上进行 RV 容积的容积定量。消除与分析相关的模态间差异允许进行公平比较，并突出了每种模态的独特局限性。了解这些差异有望有助于 RV 的功能评估。
