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Quantitative Assessment of Aortic Stenosis by Three‐Dimensional Anyplane and Three‐Dimensional Volume‐Rendered Echocardiography
Author(s) -
Handke Michael,
Schäfer Dietrich Markus,
Heinrichs Gudrun,
Magosaki Etsuko,
Geibel Annette
Publication year - 2002
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1046/j.1540-8175.2002.00045.x
Subject(s) - stenosis , medicine , body orifice , volume (thermodynamics) , doppler echocardiography , cardiology , aortic valve , limits of agreement , high resolution , aortic valve stenosis , nuclear medicine , radiology , physics , anatomy , geology , remote sensing , quantum mechanics , blood pressure , diastole
Aortic stenosis is a challenge for three‐dimensional (3‐D) echocardiographic image resolution. This is the first study evaluating both 3‐D anyplane and 3‐D volume‐rendered echocardiography in the quantification of aortic stenosis. In 31 patients, 3‐D echocardiography was performed using a multiplane transesophageal probe. Within the acquired volume dataset, five parallel cross sections were generated through the aortic valve. Subsequently, volume‐rendered images of the five cross sections were reconstructed. The smallest orifice areas of both series were compared with the results obtained by two‐dimensional (2‐D) transesophageal planimetry and those calculated by Doppler continuity equation. No significant differences were found between Doppler ( 0.76 ± 0.18 cm 2 ), 2‐D echocardiography ( 0.78 ± 0.24 cm 2 ), and 3‐D anyplane echocardiography ( 0.72 ± 0.29 cm 2 ). The orifice area measured smaller ( 0.54 ± 0.31 cm 2 , P < 0.001 ) by 3‐D volume‐rendered echocardiography. Bland‐Altmann analysis indicated that for 3‐D anyplane echocardiography, the mean difference from Doppler and 2‐D echocardiography was − 0.04 ± 0.24 cm 2 and − 0.06 ± 0.23 cm 2 , respectively. For 3‐D volume‐rendered echocardiography, the mean difference was −0.23 ± 0.24 cm 2 and − 0.25 ± 0.26 cm 2 , respectively. In the subgroup with good resolution in the 3‐D dataset, close limits of agreement were obtained between 3‐D echocardiography and each of the reference methods, while the subgroup with poor resolution showed wide limits of agreement. In conclusion, planimetry of the stenotic aortic orifice by 3‐D volume‐rendered echocardiography is feasible but tends to underestimate the orifice area. Three‐dimensional anyplane echocardiography shows better agreement with the reference methods. Accuracy is influenced strongly by the structural resolution of the stenotic orifice in the 3‐D dataset.