Department of Pediatric Cardiology, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany.
J Ultrasound Med. 2011 Jul;30(7):899-908. doi: 10.7863/jum.2011.30.7.899.
The aim of this study was to assess the validity, accuracy, and reproducibility of real-time 3-dimensional (3D) echocardiography for small distances, areas, and volumes.
Real-time 3D echocardiography using matrix technology was performed in small calibrated tissue-mimicking phantoms and compared with 2-dimensional (2D) echocardiography. In a systematic variation of variables on data acquisition and analysis including different 3D workstations (manual disk summation versus semiautomatic border detection), the relative contributions of sources of errors were determined. The clinical relevance of the in vitro findings was assessed in 5 neonates and infants.
Distance calculation was valid (mean relative error ± SD, -0.15% ± 1.2%). Underestimation of areas and volumes was significant for both 2D and 3D echocardiography (area: 2D, -7.0% ± 2.9%; 3D, -6.0% ± 2.8%; volume: 2D, -13.1% ± 4.5%; 3D, -6.7% ± 2.5%; P < .05). Adjustment of compression and gain on data acquisition (difference of the means: 2D, 11.6%; 3D, 17.9%), gain on postprocessing (3D, 3.4%), and the border detection algorithm on analysis (2D, 4.8%; 3D, 16.6%) had a highly significant effect on volume and area calculations (P < .001). In vivo, compression and gain on acquisition (3D, 19.1%) and the 3D workstation on analysis (3D, 22.2%) had a highly significant impact on left ventricular volumetry (P < .001).
Real-time 3D echocardiography is a reliable method for calculation of small distances, areas, and volumes comparable with the size of the neonatal and infant heart. Variables influencing boundary identification during image acquisition and analysis have a significant impact on 2D and 3D area and volume calculations. Standardized protocols are mandatory to avoid these sources of error in both clinical practice and research.
本研究旨在评估实时三维（3D）超声心动图在小距离、小面积和小体积测量中的准确性、精确性和可重复性。
应用矩阵技术的实时 3D 超声心动图在小的校准组织模拟体模中进行，并与二维（2D）超声心动图进行比较。在包括不同 3D 工作站（手动磁盘求和与半自动边界检测）的数据采集和分析的变量系统变化中，确定了误差来源的相对贡献。在 5 例新生儿和婴儿中评估了体外研究结果的临床相关性。
距离测量是准确的（平均相对误差±标准差，-0.15%±1.2%）。二维和三维超声心动图均存在面积和体积的明显低估（面积：二维，-7.0%±2.9%；三维，-6.0%±2.8%；体积：二维，-13.1%±4.5%；三维，-6.7%±2.5%；均 P<0.05）。数据采集时调整压缩和增益（二维，差值为 11.6%；三维，差值为 17.9%）、后处理时增益（三维，3.4%）以及分析时边界检测算法（二维，4.8%；三维，16.6%）对体积和面积计算有显著影响（均 P<0.001）。在体内，采集时的压缩和增益（三维，19.1%）以及分析时的 3D 工作站（三维，22.2%）对左心室容积测量有显著影响（均 P<0.001）。
实时 3D 超声心动图是一种可靠的方法，可用于测量与新生儿和婴儿心脏大小相当的小距离、小面积和小体积。影响图像采集和分析过程中边界识别的变量对二维和三维面积及体积的计算有显著影响。在临床实践和研究中，需要标准化协议以避免这些误差源。
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