Assessment of left ventricular function by three-dimensional echocardiography

Abstract

Accurate determination of LV volume, ejection fraction and segmental wall motion abnormalities is important for clinical decision-making and follow-up assessment. Currently, echocardiography is the most common used method to obtain this information. Three-dimensional echocardiography has shown to be an accurate and reproducible method for LV quantitation, mainly by avoiding the use of geometric assumptions. In this review, we describe various methods to acquire a 3D-dataset for LV volume and wall motion analysis, including their advantages and limitations. We provide an overview of studies comparing LV volume and function measurement by various gated and real-time methods of acquisition compared to magnetic resonance imaging. New technical improvements, such as automated endocardial border detection and contrast enhancement, will make accurate on-line assessment with little operator interaction possible in the near future.

Figure 1

Different methods of data acquisition for transthoracic 3D-echocardiography. Continuous rotation results, unlike stepwise rotational scanning, in a curved shape of the original images. Real-time imaging provides a pyramidal dataset instantly.

Figure 2

End-diastolic (A) and End-systolic (C) reconstruction of the left ventricle after semi-automated border analysis of the long-axis views (B). Time volume curve from which ejection fraction can be derived (D).