University of Oslo, Oslo, Norway, Norway; Department of Cardiology, Vestfold Hospital Trust, Tønsberg, Norway.
Int J Cardiol. 2013 Sep 30;168(2):1306-15. doi: 10.1016/j.ijcard.2012.12.002. Epub 2013 Jan 5.
Recent developments in 3-dimensional echocardiography (3DE) have resulted in smaller probes, faster data acquisition and wider applicability. In spite of this, there is still an ongoing debate as to its ability to provide additional information to 2DE in general hospital clinical practice.
A systematic literature search in EMBASE and MEDLINE was performed in order to identify original articles comparing the two techniques. Studies with a blinded comparison between 2DE and 3DE against a "gold standard" were included; these studies comprised patients with well defined inclusion and exclusion criteria. The number of patients, selection criteria, echo manufacturer, cardiac disorder, and types of comparisons, along with "gold standard" and principal results were compared.
A total of 836 original articles were identified, of which 35 were screened for eligibility. 20 studies from 18 publications were included for analysis. The results for LV assessment and reproducibility were clearly in favour of 3DE. In valvular heart disease the superiority of 3DE was also apparent, but was less convincing due to patient selection, methodological problems and the application of questionable "gold standards".
In patients with a regular heart rhythm and for whom it was possible to obtain good quality images the introduction of 3DE has improved the accuracy and reproducibility of LV volume and EF measurements. The results for valvular heart disease are still controversial. It does not seem justifiable to introduce 3DE into common cardiac practice. Further studies are needed in order to support such an implementation.
三维超声心动图（3DE）的最新进展导致探头更小、数据采集更快、适用范围更广。尽管如此，在综合医院临床实践中，它是否能提供二维超声心动图（2DE）之外的附加信息，仍存在持续的争论。
我们在 EMBASE 和 MEDLINE 中进行了系统的文献检索，以确定比较两种技术的原始文章。纳入了将 2DE 与 3DE 与“金标准”进行盲法比较的研究；这些研究包括符合明确纳入和排除标准的患者。比较了患者数量、选择标准、超声制造商、心脏疾病以及比较类型，以及“金标准”和主要结果。
共确定了 836 篇原始文章，其中有 35 篇被筛选出符合条件。最终有 20 项研究来自 18 篇出版物被纳入分析。左心室评估和可重复性的结果显然有利于 3DE。在瓣膜性心脏病中，3DE 的优势也很明显，但由于患者选择、方法学问题以及应用可疑的“金标准”，结果并不那么令人信服。
在有规律的心律且能够获得高质量图像的患者中，引入 3DE 提高了左心室容积和射血分数测量的准确性和可重复性。瓣膜性心脏病的结果仍存在争议。将 3DE 引入常规心脏实践似乎是不合理的。需要进一步的研究来支持这种应用。
