Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Am Soc Echocardiogr. 2011 Aug;24(8):853-9. doi: 10.1016/j.echo.2011.04.015. Epub 2011 Jun 8.
With recent developments in echocardiographic technology, a new system using real-time three-dimensional echocardiography (RT3DE) that allows single-beat acquisition of the entire volume of the left ventricle and incorporates algorithms for automated border detection has been introduced. Provided that these techniques are acceptably reliable, three-dimensional echocardiography may be much more useful for clinical practice. The aim of this study was to evaluate the feasibility and accuracy of left ventricular (LV) volume measurements by RT3DE using the single-beat full-volume capture technique.
One hundred nine consecutive patients scheduled for cardiac magnetic resonance imaging and RT3DE using the single-beat full-volume capture technique on the same day were recruited. LV end-systolic volume, end-diastolic volume, and ejection fraction were measured using an auto-contouring algorithm from data acquired on RT3DE. The data were compared with the same measurements obtained using cardiac magnetic resonance imaging.
Volume measurements on RT3DE with single-beat full-volume capture were feasible in 84% of patients. Both interobserver and intraobserver variability of three-dimensional measurements of end-systolic and end-diastolic volumes showed excellent agreement. Pearson's correlation analysis showed a close correlation of end-systolic and end-diastolic volumes between RT3DE and cardiac magnetic resonance imaging (r = 0.94 and r = 0.91, respectively, P < .0001 for both). Bland-Altman analysis showed reasonable limits of agreement. After application of the auto-contouring algorithm, the rate of successful auto-contouring (cases requiring minimal manual corrections) was <50%.
RT3DE using single-beat full-volume capture is an easy and reliable technique to assess LV volume and systolic function in clinical practice. However, the image quality and low frame rate still limit its application for dilated left ventricles, and the automated volume analysis program needs more development to make it clinically efficacious.
随着超声心动图技术的最新发展，一种新的系统使用实时三维超声心动图（RT3DE），允许单次获取整个左心室的容积，并结合自动边界检测算法。如果这些技术具有可接受的可靠性，那么三维超声心动图可能对临床实践更有用。本研究的目的是评估使用单次全容积采集技术的 RT3DE 进行左心室（LV）容积测量的可行性和准确性。
招募了 109 名连续患者，这些患者在同一天接受心脏磁共振成像和使用单次全容积采集技术的 RT3DE。使用 RT3DE 上的自动轮廓算法测量 LV 收缩末期容积、舒张末期容积和射血分数。将这些数据与使用心脏磁共振成像获得的相同测量值进行比较。
在 84%的患者中，单次全容积采集的 RT3DE 容积测量是可行的。三维测量收缩末期和舒张末期容积的观察者间和观察者内变异性均显示出极好的一致性。Pearson 相关分析显示 RT3DE 与心脏磁共振成像之间的收缩末期和舒张末期容积密切相关（r 分别为 0.94 和 0.91，均 P <.0001）。Bland-Altman 分析显示有合理的一致性界限。在应用自动轮廓算法后，成功自动轮廓的比例（需要最小手动校正的病例）<50%。
使用单次全容积采集的 RT3DE 是一种在临床实践中评估 LV 容积和收缩功能的简单而可靠的技术。然而，图像质量和低帧率仍然限制了其在扩张性左心室中的应用，并且自动容积分析程序需要进一步开发才能在临床上发挥功效。
