Quantitative Three-Dimensional Echocardiography by Rapid Imaging from Multiple Transthoracic Windows: In Vitro Validation and Initial In Vivo Studies

Daniel F. Leotta, MS, Brad Munt, MD, Edward L. Bolson, MS, Carol Kraft, RDCS, Roy W. Martin, PhD, Catherine M. Otto MD, Florence H. Sheehan, MD, Seattle, Washington

Abstract

Three-dimensional (3D) echocardiography has demonstrated superiority over two-dimensional techniques in the determination of left ventricular mass and volumes. We describe a technique based on a magnetic tracking system which provides rapid 3D image acquisition from multiple acoustic windows. Interactive 3D border tracing and reconstruction with a piecewise smooth subdivision model accurately reproduced phantom volume (calculated volume = 1.00 true volume - 0.6 ml, r = 1.000, SEE = 1.3 ml), in vitro heart volume (calculated volume = 1.02 true volume - 1.3 ml, r = 1.000, SEE = 0.4 ml), in vitro heart mass (calculated mass = 0.98 true mass + 1.4 g, r = 0.998, SEE = 2.5 g), and in vivo stroke volume (calculated stroke volume = 1.18 Doppler stroke volume - 17.9 ml, r = 0.990, SEE = 2.8 ml). The 3D in vivo data sets, which include views from three acoustic windows, were acquired in less than 90 seconds. We conclude that this method of 3D echocardiographic data acquisition and analysis overcomes limitations inherent in currently available systems.