Digital storage of echocardiograms offers superior image quality to analog storage, even with 20:1 digital compression: results of the Digital Echo Record Access Study.

A large interobserver and intraobserver variability study was performed comparing both digitally compressed and uncompressed echocardiographic images with the same images recorded onto super-VHS video-cassette tape (the current standard). In a blinded, randomized fashion, 179 observers scored the diagnostic and image quality of 20 pairs of echocardiographic loops representing various pathologic conditions. Overall, the digital images were preferred to the S-VHS images both for image quality and diagnostic content (p < 0.0001) regardless of the background or experience level of the observer. Furthermore, uncompressed digital images and those compressed by the Joint Photographic Experts Group (JPEG) algorithm at ratios of 20:1 were judged equivalent. These findings show that digital compression may be used routinely in echocardiography, resulting in improved image and diagnostic quality over present standards.