Three‐Dimensional Echocardiography

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Abstract
We developed a new, rapid (6 seconds) acquisition technique allowing collection of approximately six through nine apical rotational tomograms for three‐dimensional (3‐D) echocardiography. To justify an appropriate sampling density for precise and accurate measurement of chamber volumes in left ventricles with complicated shape, we designed a validation study in vitro using six canine heart specimens with irregular, asymmetric left ventricles with known volumes (28.5 to 104.3 ml; mean, 71.2 ml). The number of equally spaced slices were incrementally deleted from the original high resolution scans (48 slices) to 2 slices in 3‐D reconstruction. We created subgroups of 48‐ and 36‐, 24‐ and 16‐, 12‐ and 8‐, 6‐ and 4‐, and 3‐ and 2‐component slices to compare left ventricular (LV) volumes measured in 3‐D images with different slice resolution with the reference standard measured in the specimen. The accuracy and precision of LV volume were relatively constant in the subgroup of 4‐ and 6‐ through 36‐ and 48‐component slices. When the subgroup with 6‐ and 4‐component slices was used, the correlation was r = 0.991, P < 0.0001, root mean‐square percent error of 5.0%, bias of 0.5 ± 3.7 ml, and interobserver variability of 5.0%. With the reduction in component slices equal or less than three, the accuracy decreased significantly (root‐mean‐square percent error = 8.1% and bias = ‐2.0 ± 5.7 ml) compared with higher slice resolutions. This study demonstrated that 3‐D echocardiography using apical rotational techniques can accurately quantify LV volume in the canine heart specimens with irregular shapes with as few as 4–6 axial slices. The rapid 3‐D acquisition technique is therefore anticipated to yield precise and accurate LV volumetry.

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