Real-time 3-Dimensional Echocardiographic Imaging of Congenital Heart Disease Using Matrix-array Technology: Freehand Real-time Scanning Adds Instant Morphologic Details Not Well Delineated by Conventional 2-Dimensional Imaging - 16/08/11

Doi : 10.1016/j.echo.2005.09.009

Mohamed A. Seliem, MD ^⁎ : FACC, Anysia Fedec, RDCS, Meryl S. Cohen, MD : FACC, Stanford Ewing, MD : FACC, Paul E. Farrell, MD : FACC, Jack Rychik, MD : FACC, Amy H. Schultz, MD, J. William Gaynor, MD : FACC, Thomas L. Spray, MD : FACC
Cardiac Center at The Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

Reprint requests: Mohamed A. Seliem, MD, Cardiac Center, Children’s Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104

Résumé

Objective

We sought to investigate whether real-time (RT) 3-dimensional echocardiography (RT3D) using matrix-array technology could resolve a specific morphologic detail that could not be well resolved during conventional 2-dimensional (2D)/Doppler echocardiographic imaging of congenital heart disease.

Background

Although 2D echocardiography is currently the primary imaging modality of congenital heart disease, there are still some anatomic details that cannot be well delineated by that modality.

Methods

In all, 70 patients underwent RT3D examination using matrix-array transducer. Applying the standard sweeping technique as for 2D imaging, freehand RT imaging was used for immediate feedback. The 2D examinations of the last 23 consecutive patients were used to validate the additional value of RT3D by 3 examiners blinded to the findings of RT3D.

Results

The adequacy of 2D imaging to resolve the morphologic detail in question ranged from 30% to 70%, whereas RT3D imaging was considered successful in delineating the morphologic detail in 80% to 100% of patients instantly. The image resolution was superior or equivalent to that obtained by 2D imaging. Heart valves, septal defects, and volumetric valvular and vascular color flow morphologies were well delineated by RT3D.

Conclusion

Matrix-array RT3D is a significant breakthrough technology that allowed instant visualization of cardiac anatomic details that could not be well delineated by 2D imaging. Further improvements of some technical limitations should make RT3D matrix-array cardiac imaging a significant modality in the field of echocardiographic imaging of congenital cardiac anomalies.

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