Department of Cardiology 5F 003, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Neth Heart J. 2011 Oct;19(10):423-31. doi: 10.1007/s12471-011-0160-y.
One of the earliest applications of clinical echocardiography is evaluation of left ventricular (LV) function and size. Accurate, reproducible and quantitative evaluation of LV function and size is vital for diagnosis, treatment and prediction of prognosis of heart disease. Early three-dimensional (3D) echocardiographic techniques showed better reproducibility than two-dimensional (2D) echocardiography and narrower limits of agreement for assessment of LV function and size in comparison to reference methods, mostly cardiac magnetic resonance (CMR) imaging, but acquisition methods were cumbersome and a lack of user-friendly analysis software initially precluded widespread use. Through the advent of matrix transducers enabling real-time three-dimensional echocardiography (3DE) and improvements in analysis software featuring semi-automated volumetric analysis, 3D echocardiography evolved into a simple and fast imaging modality for everyday clinical use. 3DE provides the possibility to evaluate the entire LV in three spatial dimensions during the complete cardiac cycle, offering a more accurate and complete quantitative evaluation the LV. Improved efficiency in acquisition and analysis may provide clinicians with important diagnostic information within minutes. The current article reviews the methodology and application of 3DE for quantitative evaluation of the LV, provides the scientific evidence for its current clinical use, and discusses its current limitations and potential future directions.
临床超声心动图最早的应用之一是评估左心室（LV）功能和大小。准确、可重复和定量评估 LV 功能和大小对于心脏病的诊断、治疗和预后预测至关重要。早期的三维（3D）超声心动图技术显示出比二维（2D）超声心动图更好的可重复性，并且与参考方法（主要是心脏磁共振成像（CMR）成像）相比，评估 LV 功能和大小的协议限制更窄，但采集方法繁琐，缺乏用户友好的分析软件，最初限制了其广泛应用。随着能够实现实时三维超声心动图（3DE）的矩阵换能器的出现以及具有半自动容积分析功能的分析软件的改进，3D 超声心动图已发展成为一种简单快捷的日常临床成像方式。3DE 可在整个心动周期内从三个空间维度评估整个 LV，提供更准确和完整的 LV 定量评估。在采集和分析方面效率的提高可能会在数分钟内为临床医生提供重要的诊断信息。本文综述了 3DE 定量评估 LV 的方法学和应用，提供了其当前临床应用的科学证据，并讨论了其当前的局限性和潜在的未来方向。
