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A new dynamic three-dimensional digital color doppler method for quantification of pulmonary regurgitation: validation study in an animal model

Yoshiki Mori, MD^*, Rosemary A. Rusk, MD^*, Michael Jones, MD, Xiang-Ning Li, MD, PhD, Timothy Irvine, MD^*, Arthur D. Zetts and David J. Sahn, MD^*,*

^* Oregon Health and Science University, Portland, Oregon, USA
The Laboratory of Animal Medicine and Surgery, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
Philips Ultrasound, Bothell, Washington, USA

View larger version (88K): [in a new window]   Figure 1 Examples of selected three-dimensional velocity vectors of the forward flow in the right ventricular outflow tract (top) and the pulmonary regurgitation (PR) flow in the pulmonary artery (bottom). Note that the magnitudes of the components of the velocity vectors of the forward flow and PR flow were not the same.

View larger version (72K): [in a new window]   Figure 2 Examples of selected images of the pulmonary regurgitation (PR) flow (upper panel) and right ventricular forward flow (bottom panel). The program displayed the dynamic B-mode of the color Doppler image (left panel) and the cross-sectional area on the sample surface (right panel). The sampling arc was placed distal to the pulmonary valve for measurements of the PR flow volumes (upper left), and the flow rate curve at this point over one cardiac cycle was displayed (bottom in the upper panel). The sampling arc was placed proximal to the pulmonary valve for measurement of the right ventricular forward flow volumes (bottom left). Note that color-encoded velocity distribution in the cross-section of the right ventricular outflow tract (RVOT) and pulmonary artery (PA) is not uniform (dark and light). This indicates that the velocity profiles of both forward flow in the RVOT and PR flow in the PA are not uniform in the three-dimensional space.

View larger version (18K): [in a new window]   Figure 3 (A) Simple linear regression analysis of regurgitant volumes obtained by the electromagnetic (EM) flow meters versus those by the three-dimensional (3D) digital color Doppler method. (B) Agreements of regurgitant volumes obtained by the EM flow meters versus those by the 3D digital color Doppler technique according to the Bland-Altman method.

View larger version (18K): [in a new window]   Figure 4 (A) Simple linear regression analyses of regurgitant fraction obtained by the electromagnetic (EM) flow meters versus those by the three-dimensional (3D) digital color Doppler method. (B) Agreements of regurgitant fractions obtained by the EM flow meters versus those by the 3D digital color Doppler technique according to the Bland-Altman method.