Quantitative Assessment of Left Ventricle by Real-time Three-dimensional Echocardiography

The principal application of echocardiography is to provide a noninvasive and cost-effective method to answer the clinical questions about cardiac morphology and function, which may have impacts on the treatment strategy for many clinical conditions. However, due to inevitable geometric assumptions in assessing the morphology of the left ventricle (LV), both M-mode and two-dimensional echocardiography are suffering from inaccuracy in the measurements and drawbacks of conspicuous inter- and intraobserver variability. Although time-consuming and difficult in reconstruction, three-dimensional (3D) echocardiography was developed years ago to partly address these limitations. Previously, 3D echocardiographic images were marginal in quality and the acquisition was cumbersome. In recent years, as a result of the advances in computer processing and transducer construction techniques, a quantum leap in 3D imaging means that real-time transthoracic 3D echocardiography is now available from certain major ultrasound system manufacturers. Software programs to analyze the 3D datasets of LV are also readily on hand. The combination of new instrumentation and software has been shown to provide highly accurate analysis of LV morphology and function compared with cardiac magnetic resonance such that this methodology is likely to ensure echocardiography as the first-choice technique for non-invasive evaluation of LV.