Assessment of Left Ventricular Volumes Using Simplified 3-D Echo and CT

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Assessment of Left Ventricular Volumes Using Simplified 3-D Echo and CT

Abstract and Background

Abstract


Objectives: To compare the accuracy of simplified 3-dimensional (3-D) echocardiography vs. multi-slice computed tomography (MSCT) software for the quantification of left ventricular (LV) volumes.
Design: Three-D echocardiography (3-planes approach) and MSCT-CardIQ software were calibrated by measuring known volumes of 10 phantoms designed to closely mimic blood-endocardium interface. Subsequently, LV volumes were measured with both the methods in 9 patients referred routinely for coronary angiography and the agreement between the measurements was evaluated.
Results: Simplified 3D-echocardiography provided higher degree of agreement between the measured and true phantom volumes (mean difference 0 ± 1 ml, variation range +4 to -4 ml) than MSCT software (mean difference 6 ± 5 ml; variation range +22 to -10 ml). The agreement between LV measurements in the patients was considerably poorer, with significantly larger volumes produced by MSCT (mean difference -23 ± 40 ml, variation between +93 and -138 ml).
Conclusion: Simplified 3-D echocardiography provides more accurate assessment of phantom volumes than MSCT-CardIQ software. The discrepancy between the results of LV measurements with the two methods is even greater and does not warrant their interchangeable diagnostic use.

Background


Echocardiography and x-ray based computed tomography provides possibilities of detailed evaluation of cardiac morphology and function and the introduction of these techniques constitutes without any doubt an important landmark in the history of diagnostic cardiology. Today, both the methods not only form a backbone of diagnostic cardiac procedures but also are much appreciated as sensitive research instruments. Recently, the diagnostic capacity of echocardiography has been further improved by the addition of 3-dimensional cardiac imaging.

An important link in the process of cardiac diagnostics is accurate estimation of left ventricular volume. In this respect, MSCT has been shown to be both feasible and accurate when compared with left ventriculography, magnetic resonance techniques, and 2-dimensional echocardiography. At the same time, the diagnostic performance of 3-D echocardiography has been demonstrated to be superior to that provided by 2-dimensional echocardiographic imaging and a strong correlation was observed between the results obtained with 3-D echocardiographic technique and magnetic resonance imaging.

However, the results of a recently published study indicate that even though both 3-D echocardiography and MSCT measurements correlate highly with magnetic resonance imaging, 3-D echocardiography compares more favourably in this respect than MSCT that tend to overestimate the magnetic resonance values. Therefore, the aim of this study was to evaluate further the accuracy of both methods in the assessment of LV volumes in clinical subjects and to verify the results of volume measurements in in vitro setting using phantoms.

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