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STATE-OF-THE-ART PAPER

Three-Dimensional Echocardiography

The Benefits of the Additional Dimension

Roberto M. Lang, MD^_*,_*,1, Victor Mor-Avi, PhD^_*,2, Lissa Sugeng, MD^_*,3, Petra S. Nieman, MD and David J. Sahn, MD^,4

^_* Cardiac Imaging Center, Departments of Medicine and Radiology, University of Chicago, Chicago, Illinois
Cardiac Fluid Dynamics and Imaging Laboratory, Oregon Health and Science University, Portland, Oregon

Manuscript received May 10, 2006; revised manuscript received July 6, 2006, accepted July 10, 2006.

^_* Reprint requests and correspondence: Dr. Roberto M. Lang, University of Chicago MC5084, 5841 South Maryland Avenue, Chicago, Illinois 60637. (Email: rlang{at}medicine.bsd.uchicago.edu).

Over the past 3 decades, echocardiography has become a major diagnostic tool in the arsenal of clinical cardiology for real-time imaging of cardiac dynamics. More and more, cardiologists’ decisions are based on images created from ultrasound wave reflections. From the time ultrasound imaging technology provided the first insight into the human heart, our diagnostic capabilities have increased exponentially as a result of our growing knowledge and developing technology. One of the most significant developments of the last decades was the introduction of 3-dimensional (3D) imaging and its evolution from slow and labor-intense off-line reconstruction to real-time volumetric imaging. While continuing its meteoric rise instigated by constant technological refinements and continuing increase in computing power, this tool is guaranteed to be integrated in routine clinical practice. The major proven advantage of this technique is the improvement in the accuracy of the echocardiographic evaluation of cardiac chamber volumes, which is achieved by eliminating the need for geometric modeling and the errors caused by foreshortened views. Another benefit of 3D imaging is the realistic and unique comprehensive views of cardiac valves and congenital abnormalities. In addition, 3D imaging is extremely useful in the intraoperative and postoperative settings because it allows immediate feedback on the effectiveness of surgical interventions. In this article, we review the published reports that have provided the scientific basis for the clinical use of 3D ultrasound imaging of the heart and discuss its potential future applications.

Abbreviations and Acronyms   2D = 2-dimensional   3D = 3-dimensional   EF = ejection fraction   LV = left ventricle/ventricular   MRI = magnetic resonance imaging   TEE = transesophageal echocardiography

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