Incremental Value of Three-Dimensional Echocardiography Over Transesophageal Multiplane Two-Dimensional Echocardiography in Qualitative and Quantitative Assessment of Cardiac Masses and Defects |
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Authors: | NAVIN C NANDA MD SAYED MOHAMMED ABD-EL RAHMAN MD GAJENDRA KHATRI MD GOPAL AGRAWAL MD ADEL A EL-SAYED MD HASSAN A SHEHATA HASSANIAN MD MOHAMMAD KAMRAN MD JAMES KIRKLIN MD DAVID C McGIFFIN MD WILLIAM L HOLMAN MD ALBERT D PACIFICO MD |
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Institution: | Divisions of Cardiovascular Disease;Cardiovascular and Thoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama;Department of Medicine, Sohag School of Medicine, University of South Valley, Egypt |
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Abstract: | In the present study, we compared three-dimensionally (3-D) reconstructed images with multiplane two-dimensional (2-D) transesophageal echocardiographic (TEE) images in 17 patients with various cardiac masses and defects. To overcome the problem of making measurements from 3-D reconstructed images, we carefully "dissected" the 3-D dataset using paraplane and anyplane 2-D sections, which were then used to obtain the maximum sizes of the cardiac masses and defects. Of the 15 vegetations and 9 abscesses detected by 3-D TEE in 7 patients, only 8 (53%) vegetations and 4 (44%) abscesses were detected by multiplane 2-D TEE (P < 0.02). Also, the exact anatomical location, shape, geometry, and extent of various cardiac masses and defects were more clearly delineated by 3-D than 2-D TEE. The maximum dimensions of cardiac masses and defects were larger by 3-D than by 2-D TEE in 17 (89%) of the 19 lesions available for comparison (P < 0.002). In addition, 3-D TEE correlated more closely than 2-D TEE when compared to surgical measurements in three patients in whom they were available. Thus, it would appear that in several instances, the exact size of the cardiac lesion could only be assessed by analysis of the 3-D volumetric dataset. Out preliminary study has demonstrated the superiority of transesophageal 3-D reconstruction over multiplane 2-D TEE in both qualitative and quantitative assessment of various cardiac mass lesions and pathological defects. |
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Keywords: | three-dimensional echocardiography cardiac masses vegetations cardiac defects atrial septal defect abscesses prosthetic valve thrombosis endocarditis |
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