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Roberto M. Lang - One of the best experts on this subject based on the ideXlab platform.
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Three-Dimensional Echocardiography
Oxford Medicine Online, 2016Co-Authors: Luigi P. Badano, Roberto M. Lang, Alexandra GoncalvesAbstract:The advent of fully-sampled matrix array transthoracic transducers has enabled advanced digital processing and improved image formation algorithms and brought Three-Dimensional Echocardiography (3DE) technology into clinical practice. Currently, 3DE is recognized as an important echocardiographic technique, demonstrated to be superior to two-Dimensional Echocardiography in various clinical scenarios. This chapter focuses on the technology of 3DE matrix transducers, physics of 3D imaging, data set acquisition (multiplane, real-time, full-volume, zoom, and colour), and display (volume rendering, surface rendering and multislice) modalities. The chapter also addresses the issues of training in 3DE, and main clinical indications and reporting of transthoracic and transoesophageal 3DE.
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Textbook of Real-Time Three Dimensional Echocardiography - Textbook of real-time Three-Dimensional Echocardiography
2011Co-Authors: Luigi P. Badano, Roberto M. Lang, Josae Luis ZamoranoAbstract:Textbook of real-time Three Dimensional Echocardiography , Textbook of real-time Three Dimensional Echocardiography , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی
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Three-Dimensional Echocardiography for assessment of mitral valve regurgitation.
Current opinion in cardiology, 2009Co-Authors: Lissa Sugeng, Sonal Chandra, Roberto M. LangAbstract:PURPOSE OF REVIEW Estimation of severity has become a significant predictor of outcomes and a pivotal factor in the management of mitral regurgitation. The flow convergence formula has become one of the most important quantitative methods for valve regurgitation in Echocardiography. Nevertheless, it has many assumptions leading to over or underestimations. With recent development of a much improved Three-Dimensional volumetric imaging, there have been efforts in trying to overcome these two-Dimensional limitations using Three-Dimensional approaches. Hence, this review is mainly focused on Three-Dimensional color flow and techniques of quantifying the severity of mitral regurgitation using Three-Dimensional Echocardiography. RECENT FINDINGS Investigators have found that imaging the proximal flow convergence region (PFCR) and measuring the vena contracta area are highly feasible. The shape of the PFCR may vary, being a hemisphere, prolate or oblate hemispheroid, or hemi-ellipsoid, based on these findings; Three-Dimensional formulas have a stronger correlation, less underestimation and better accuracy than the two-Dimensional proximal isovelocity surface area method. Direct measurements of the effective regurgitant orifice are also feasible and serve as an alternative to hemodynamic formulas. SUMMARY Three-Dimensional Echocardiography has made major advances with the Three-Dimensional matrix transesophageal echo and will be a clinically viable tool as probe technology and software evolve.
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Real-time Three-Dimensional Echocardiography for rheumatic mitral valve stenosis evaluation: An accurate and novel approach
Journal of the American College of Cardiology, 2004Co-Authors: José Luis Zamorano, Lissa Sugeng, Lynn Weinert, Pedro Cordeiro, Leopoldo Pérez De Isla, Carlos Macaya, Enrique Rodríguez, Roberto M. LangAbstract:Abstract Objectives Our aim was to assess which echo-Doppler method has the best agreement with the mitral valve area (MVA) invasively evaluated by the Gorlin′s formula. We also evaluated the feasibility and reproducibility of real-time Three-Dimensional Echocardiography (RT3D) for the estimation of MVA and the Wilkins score in patients with rheumatic mitral stenosis (RMVS). Background Real-time Three-Dimensional Echocardiography is a novel technique that allows us to visualize the mitral valvular anatomy in any desired plane orientation. The usefulness and accuracy of this technique for evaluating RMVS has not been established. Methods We studied a series of consecutive patients with RMVS from two tertiary care hospitals. Mitral valvular area was determined by conventional echo-Doppler methods and by RT3D, and their results were compared with those obtained invasively. Real-time Three-Dimensional Echocardiography planimetry and mitral score were measured by two independent observers and then repeated by one of them. Results Eighty patients with RMVS comprised our study group (76 women; 50.6 ± 13.9 years). Compared with all other echo-Doppler methods, RT3D had the best agreement with the invasively determined MVA (average difference between both methods and limits of agreement: 0.08 cm2[−0.48 to 0.6]). Interobserver variability was as good for RT3D (intraclass correlation coefficient [ICC] = 0.90) as for pressure half-time (PHT) (ICC = 0.95). For PHT and RT3D, the intraobserver variability was similar (ICC 0.92 and 0.96, respectively). Real-time Three-Dimensional Echocardiography valvular score evaluation showed a better interobserver agreement with RT3D than with 2D Echocardiography. Conclusions Real-time Three-Dimensional Echocardiography is a feasible, accurate, and highly reproducible technique for assessing MVA in patients with RMVS. Real-time Three-Dimensional Echocardiography has the best agreement with invasive methods.
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real time Three Dimensional Echocardiography using a novel matrix array transducer
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 2003Co-Authors: Lissa Sugeng, Lynn Weinert, Karl Thiele, Roberto M. LangAbstract:Three-Dimensional Echocardiography has multiple advantages over two-Dimensional Echocardiography, such as accurate left ventricular quantification and improved spatial relationships. However, clinical use of Three-Dimensional Echocardiography has been impeded by tedious and time-consuming methods for data acquisition and post-processing. A newly developed matrix array probe, which allows real-time Three-Dimensional imaging with instantaneous on-line volume-rendered reconstruction, direct manipulation of thresholding, and cut planes on the ultrasound unit may overcome the aforementioned limitations. This report will review current methods of Three-Dimensional data acquisition, emphasizing the real-time methods and clinical applications of the new matrix array probe. (Echocardiography, Volume 20, October 2003)
Lissa Sugeng - One of the best experts on this subject based on the ideXlab platform.
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The Mitral Valve by Three-Dimensional Echocardiography
Current Cardiovascular Imaging Reports, 2010Co-Authors: Lissa Sugeng, Lynn WeinertAbstract:A comprehensive evaluation of patients with mitral valve disease must include an echocardiographic examination of the mitral valve apparatus and resultant hemodynamic changes due to mitral pathology. Three-Dimensional Echocardiography has impacted on the diagnosis of mitral valve prolapse but has mostly existed in a research realm. After decades of development, Three-Dimensional Echocardiography is now easily performed and readily incorporated in the assessment of mitral valve disease in daily clinical practice. Unique anatomic views of the mitral valve, accurate quantitative assessment of the mitral valve orifice area, and delineation of segmental prolapse are several advantages of Three-Dimensional Echocardiography. Moreover, there is a wealth of data that can be derived from a Three-Dimensional volume, enabling more detailed analysis of mitral valve apparatus and valve annular dynamics. This review highlights current applications of Three-Dimensional Echocardiography in the routine evaluation of mitral valve disease.
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Three-Dimensional Echocardiography for assessment of mitral valve regurgitation.
Current opinion in cardiology, 2009Co-Authors: Lissa Sugeng, Sonal Chandra, Roberto M. LangAbstract:PURPOSE OF REVIEW Estimation of severity has become a significant predictor of outcomes and a pivotal factor in the management of mitral regurgitation. The flow convergence formula has become one of the most important quantitative methods for valve regurgitation in Echocardiography. Nevertheless, it has many assumptions leading to over or underestimations. With recent development of a much improved Three-Dimensional volumetric imaging, there have been efforts in trying to overcome these two-Dimensional limitations using Three-Dimensional approaches. Hence, this review is mainly focused on Three-Dimensional color flow and techniques of quantifying the severity of mitral regurgitation using Three-Dimensional Echocardiography. RECENT FINDINGS Investigators have found that imaging the proximal flow convergence region (PFCR) and measuring the vena contracta area are highly feasible. The shape of the PFCR may vary, being a hemisphere, prolate or oblate hemispheroid, or hemi-ellipsoid, based on these findings; Three-Dimensional formulas have a stronger correlation, less underestimation and better accuracy than the two-Dimensional proximal isovelocity surface area method. Direct measurements of the effective regurgitant orifice are also feasible and serve as an alternative to hemodynamic formulas. SUMMARY Three-Dimensional Echocardiography has made major advances with the Three-Dimensional matrix transesophageal echo and will be a clinically viable tool as probe technology and software evolve.
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Real-time Three-Dimensional Echocardiography for rheumatic mitral valve stenosis evaluation: An accurate and novel approach
Journal of the American College of Cardiology, 2004Co-Authors: José Luis Zamorano, Lissa Sugeng, Lynn Weinert, Pedro Cordeiro, Leopoldo Pérez De Isla, Carlos Macaya, Enrique Rodríguez, Roberto M. LangAbstract:Abstract Objectives Our aim was to assess which echo-Doppler method has the best agreement with the mitral valve area (MVA) invasively evaluated by the Gorlin′s formula. We also evaluated the feasibility and reproducibility of real-time Three-Dimensional Echocardiography (RT3D) for the estimation of MVA and the Wilkins score in patients with rheumatic mitral stenosis (RMVS). Background Real-time Three-Dimensional Echocardiography is a novel technique that allows us to visualize the mitral valvular anatomy in any desired plane orientation. The usefulness and accuracy of this technique for evaluating RMVS has not been established. Methods We studied a series of consecutive patients with RMVS from two tertiary care hospitals. Mitral valvular area was determined by conventional echo-Doppler methods and by RT3D, and their results were compared with those obtained invasively. Real-time Three-Dimensional Echocardiography planimetry and mitral score were measured by two independent observers and then repeated by one of them. Results Eighty patients with RMVS comprised our study group (76 women; 50.6 ± 13.9 years). Compared with all other echo-Doppler methods, RT3D had the best agreement with the invasively determined MVA (average difference between both methods and limits of agreement: 0.08 cm2[−0.48 to 0.6]). Interobserver variability was as good for RT3D (intraclass correlation coefficient [ICC] = 0.90) as for pressure half-time (PHT) (ICC = 0.95). For PHT and RT3D, the intraobserver variability was similar (ICC 0.92 and 0.96, respectively). Real-time Three-Dimensional Echocardiography valvular score evaluation showed a better interobserver agreement with RT3D than with 2D Echocardiography. Conclusions Real-time Three-Dimensional Echocardiography is a feasible, accurate, and highly reproducible technique for assessing MVA in patients with RMVS. Real-time Three-Dimensional Echocardiography has the best agreement with invasive methods.
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real time Three Dimensional Echocardiography using a novel matrix array transducer
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 2003Co-Authors: Lissa Sugeng, Lynn Weinert, Karl Thiele, Roberto M. LangAbstract:Three-Dimensional Echocardiography has multiple advantages over two-Dimensional Echocardiography, such as accurate left ventricular quantification and improved spatial relationships. However, clinical use of Three-Dimensional Echocardiography has been impeded by tedious and time-consuming methods for data acquisition and post-processing. A newly developed matrix array probe, which allows real-time Three-Dimensional imaging with instantaneous on-line volume-rendered reconstruction, direct manipulation of thresholding, and cut planes on the ultrasound unit may overcome the aforementioned limitations. This report will review current methods of Three-Dimensional data acquisition, emphasizing the real-time methods and clinical applications of the new matrix array probe. (Echocardiography, Volume 20, October 2003)
Jos R.t.c. Roelandt - One of the best experts on this subject based on the ideXlab platform.
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Three-Dimensional Echocardiography.
Current opinion in cardiology, 1998Co-Authors: Jos R.t.c. Roelandt, J. Yao, Jarosław D. KasprzakAbstract:Three-Dimensional Echocardiography depicts the heart and its structures in their realistic forms. This capability decreases variability both in the quality and the interpretation of complex pathology, among investigators. Therefore, it is likely that the method will become the standard Echocardiography examination in the future. The availability and versatility in use of the volumetric data set allow us to retrieve an infinite number of cardiac cross-sections, and thus, more accurate and reproducible measurements of valve areas, masses, and cavity volumes by obviating geometric assumptions. In the future, new physiologic parameters will provide additional information and address new clinical questions.
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Three-Dimensional Echocardiography: the future today!
Acta cardiologica, 1998Co-Authors: Jos R.t.c. RoelandtAbstract:Three-Dimensional Echocardiography depicts the heart and its structures in their realistic forms. This capability decreases variability both in the quality and the interpretation of complex pathology, among investigators. Therefore, it is likely that the method will become the standard Echocardiography examination in the future. The availability and versatility in use of the volumetric data set allows to retrieve an infinite number of cardiac cross-sections which allow more accurate and reproducible measurements of valve areas, masses and cavity volumes by obviating geometric assumptions. In the future new physiologic parameters will provide additional information and will allow to address new clinical questions.
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Accurate measurement of left ventricular ejection fraction by Three-Dimensional Echocardiography : A comparison with radionuclide angiography
Circulation, 1996Co-Authors: Youssef F.m. Nosir, Alessandro Salustri, Wim B. Vletter, Paolo M. Fioretti, Eric Boersma, Joyce Tjoa Postma, Ambroos E.m. Reijs, Folkert J. Ten Cate, Jos R.t.c. RoelandtAbstract:Background Three-Dimensional Echocardiography is a promising technique for calculation of left ventricular ejection fraction, because it allows its measurement without geometric assumptions. However, few data exist that study its reproducibility and accuracy in patients. Methods and Results Twenty-five patients underwent radionuclide angiography and Three-Dimensional Echocardiography that used the rotational technique (2° interval and ECG and respiratory gating). Left ventricular volume and ejection fraction were calculated by use of Simpson's rule at a slice thickness of 3 mm. Analyses were performed to define the largest slice thickness required for accurate calculation of left ventricular volume and ejection fraction. Three-Dimensional Echocardiography showed excellent correlation with radionuclide angiography for calculation of left ventricular ejection fraction (mean±SD, 38.9±19.8 and 38.5±18.0, respectively; r=.99); their mean difference was not significant (0.03±0.17; P=.3), and they had a close li...
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Three-Dimensional Echocardiography of a flail tricuspid valve.
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 1996Co-Authors: Giuseppe Trocino, Jos R.t.c. Roelandt, Alessandro Salustri, Tieneke Ansink, Lex A. Van HerwerdenAbstract:A 71-year-old man with an old myocardial infarction and blunt chest trauma 2 years previously came to our hospital with increasing dyspnea. Three-Dimensional Echocardiography was performed and a ruptured papillary muscle with flail anterior tricuspid valve was demonstrated from a surgical perspective (electronic atriotomy). These findings were confirmed during open-heart surgery with close similarity.
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Transthoracic Three-Dimensional Echocardiography in adult patients with congenital heart disease
Journal of the American College of Cardiology, 1995Co-Authors: Alessandro Salustri, S.e.c. Spitaels, Jackie Mcghie, Wim B. Vletter, Jos R.t.c. RoelandtAbstract:Objectives This study sought to assess both the feasibility and potential role of transthoracic Three-Dimensional Echocardiography for the evaluation of adult patients with congenital heart disease. Background The unrestricted views with depth perception provided by Three-Dimensional Echocardiography with dynamic volume-rendered display may enhance visualization of cardiac structures and detection of abnormalities in patients with congenital heart defects. Methods We studied 33 patients with various heart defects (mitral valve anomalies in 9, aortic valve anomalies in 5, subaortic membrane in 5, ventricular septal defect in 4, transposition of the great arteries in 3, tetralogy of Fallot in 2, other defects in 5). Cross-sectional images of the specific region of interest were acquired from either the parasternal or apical window with the rotational technique (2° interval with electrocardiographic and respiratory gating) and postprocessed for resampling in cubic format. From these Three-Dimensional data sets a multitude of cut planes were selected, presented in volume-rendered dynamic display and analyzed by two observers for comparison with standard two-Dimensional images to assess their additional information. Results Three-Dimensional reconstruction was possible in all patients. Structures of interest were evaluated from unusual viewpoints, providing both cardiologists and surgeons with immediate feedback. When compared with standard two-Dimensional images, additional information was provided for 12 patients (36%). The mitral valve, aortoseptal continuity and interatrial septum were the structures for which Three-Dimensional Echocardiography was most useful. Conclusions Transthoracic Three-Dimensional Echocardiography is feasible and facilitates spatial recognition of the intracardiac anatomy in a significant proportion of patients and enhances diagnostic confidence of complex congenital heart disease.
Peter S. Rahko - One of the best experts on this subject based on the ideXlab platform.
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Three-Dimensional Echocardiography and Mitral Valve Disease
Current cardiology reports, 2010Co-Authors: Carrie B. Chapman, Peter S. RahkoAbstract:Three-Dimensional Echocardiography is a growing imaging modality, particularly for the evaluation of mitral valve pathology. Functional anatomy in disease states such as mitral regurgitation and stenosis as well as prosthetic valves can be effectively studied, offering superior knowledge to treating physicians. Additionally, Three-Dimensional Echocardiography has the ability to help guide operative and percutaneous interventions, allowing for improved patient outcomes and advancement of clinical research. Continued experience with Three-Dimensional Echocardiography will further our knowledge of the mitral valve and refine current indications for cardiovascular imaging.
Lynn Weinert - One of the best experts on this subject based on the ideXlab platform.
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The Mitral Valve by Three-Dimensional Echocardiography
Current Cardiovascular Imaging Reports, 2010Co-Authors: Lissa Sugeng, Lynn WeinertAbstract:A comprehensive evaluation of patients with mitral valve disease must include an echocardiographic examination of the mitral valve apparatus and resultant hemodynamic changes due to mitral pathology. Three-Dimensional Echocardiography has impacted on the diagnosis of mitral valve prolapse but has mostly existed in a research realm. After decades of development, Three-Dimensional Echocardiography is now easily performed and readily incorporated in the assessment of mitral valve disease in daily clinical practice. Unique anatomic views of the mitral valve, accurate quantitative assessment of the mitral valve orifice area, and delineation of segmental prolapse are several advantages of Three-Dimensional Echocardiography. Moreover, there is a wealth of data that can be derived from a Three-Dimensional volume, enabling more detailed analysis of mitral valve apparatus and valve annular dynamics. This review highlights current applications of Three-Dimensional Echocardiography in the routine evaluation of mitral valve disease.
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Real-time Three-Dimensional Echocardiography for rheumatic mitral valve stenosis evaluation: An accurate and novel approach
Journal of the American College of Cardiology, 2004Co-Authors: José Luis Zamorano, Lissa Sugeng, Lynn Weinert, Pedro Cordeiro, Leopoldo Pérez De Isla, Carlos Macaya, Enrique Rodríguez, Roberto M. LangAbstract:Abstract Objectives Our aim was to assess which echo-Doppler method has the best agreement with the mitral valve area (MVA) invasively evaluated by the Gorlin′s formula. We also evaluated the feasibility and reproducibility of real-time Three-Dimensional Echocardiography (RT3D) for the estimation of MVA and the Wilkins score in patients with rheumatic mitral stenosis (RMVS). Background Real-time Three-Dimensional Echocardiography is a novel technique that allows us to visualize the mitral valvular anatomy in any desired plane orientation. The usefulness and accuracy of this technique for evaluating RMVS has not been established. Methods We studied a series of consecutive patients with RMVS from two tertiary care hospitals. Mitral valvular area was determined by conventional echo-Doppler methods and by RT3D, and their results were compared with those obtained invasively. Real-time Three-Dimensional Echocardiography planimetry and mitral score were measured by two independent observers and then repeated by one of them. Results Eighty patients with RMVS comprised our study group (76 women; 50.6 ± 13.9 years). Compared with all other echo-Doppler methods, RT3D had the best agreement with the invasively determined MVA (average difference between both methods and limits of agreement: 0.08 cm2[−0.48 to 0.6]). Interobserver variability was as good for RT3D (intraclass correlation coefficient [ICC] = 0.90) as for pressure half-time (PHT) (ICC = 0.95). For PHT and RT3D, the intraobserver variability was similar (ICC 0.92 and 0.96, respectively). Real-time Three-Dimensional Echocardiography valvular score evaluation showed a better interobserver agreement with RT3D than with 2D Echocardiography. Conclusions Real-time Three-Dimensional Echocardiography is a feasible, accurate, and highly reproducible technique for assessing MVA in patients with RMVS. Real-time Three-Dimensional Echocardiography has the best agreement with invasive methods.
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real time Three Dimensional Echocardiography using a novel matrix array transducer
Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques, 2003Co-Authors: Lissa Sugeng, Lynn Weinert, Karl Thiele, Roberto M. LangAbstract:Three-Dimensional Echocardiography has multiple advantages over two-Dimensional Echocardiography, such as accurate left ventricular quantification and improved spatial relationships. However, clinical use of Three-Dimensional Echocardiography has been impeded by tedious and time-consuming methods for data acquisition and post-processing. A newly developed matrix array probe, which allows real-time Three-Dimensional imaging with instantaneous on-line volume-rendered reconstruction, direct manipulation of thresholding, and cut planes on the ultrasound unit may overcome the aforementioned limitations. This report will review current methods of Three-Dimensional data acquisition, emphasizing the real-time methods and clinical applications of the new matrix array probe. (Echocardiography, Volume 20, October 2003)