CLINICAL RESEARCH: ECHOCARDIOGRAPHY
High-resolution transthoracic real-time three-dimensional echocardiography
Quantitation of cardiac volumes and function using semi-automatic border detection and comparison with cardiac magnetic resonance imaging
Harald P. Kühl, MD*,*,
Marcus Schreckenberg, PhD ,
Dierk Rulands, MD*,
Markus Katoh, MD ,
Wolfgang Schäfer, MD, PhD ,
Georg Schummers, PhD,
Arno Bücker, MD,
Peter Hanrath, MD* and
Andreas Franke, MD*
* Medizinische Klinik I, Aachen, Germany
Department of Diagnostic Radiology, Aachen, Germany
Department of Nuclear Medicine, University Hospital, Aachen, Germany
TomTec Imaging Systems GmbH, Unterschleissheim, Germany
Manuscript received October 23, 2003;
revised manuscript received December 5, 2003,
accepted January 12, 2004.
* Reprint requests and correspondence: Dr. Harald P. Kühl, Medizinische Klinik I, Universitätsklinikum, Pauwelstrasse 30, 52057 Aachen, Germany.
hkuehl{at}ukaachen.de
OBJECTIVES: We sought to validate high-resolution transthoracic real-time (RT) three-dimensional echocardiography (3DE), in combination with a novel semi-automatic contour detection algorithm, for the assessment of left ventricular (LV) volumes and function in patients.
BACKGROUND: Quantitative RT-3DE has been limited by impaired image quality and time-consuming manual data analysis.
METHODS: Twenty-four subjects with abnormal (n = 14) or normal (n = 10) LVs were investigated. The results for end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) obtained by manual tracing were compared with the results determined by the semi-automatic border detection algorithm. Moreover, the results of the semi-automatic method were compared with volumes and EF obtained by cardiac magnetic resonance imaging (CMRI).
RESULTS: Excellent correlation coefficients (r = 0.98 to 0.99) and low variability (EDV –1.3 ± 8.6 ml; ESV –0.2 ± 5.4 ml; EF –0.1 ± 2.7%; p = NS) were observed between the semi-automatically and manually assessed data. The RT-3DE data correlated highly with CMRI (r = 0.98). However, LV volumes were underestimated by RT-3DE compared with CMRI (EDV –13.6 ± 18.9 ml, p = 0.002; ESV –12.8 ± 20.5 ml, p = 0.005). The difference for EF was not significant between the two methods (EF 0.9 ± 4.4%, p = NS). Observer variability was acceptable, and repeatability of the method was excellent.
CONCLUSIONS: The RT-3DE, in combination with a semi-automatic contour tracing algorithm, allows accurate determination of cardiac volumes and function compared with both manual tracing and CMRI. High repeatability suggests applicability of the method for the serial follow-up of patients with cardiac disease.
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Abbreviations and Acronyms
| | CMRI | = cardiac magnetic resonance imaging | | 3DE | = three-dimensional echocardiography | | EDV | = end-diastolic volume | | EF | = ejection fraction | | ESV | = end-systolic volume | | LV | = left ventricular/ventricle | | RT | = real-time |
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