Rapid and accurate quantification of right ventricular volume and stroke volume by real-time 3-dimensional triplane echocardiography

Abstract

Background: Previous studies have demonstrated that 3-Dimensional (3-D) echocardiography can determine right ventricular (RV) volume accurately. However, this technique has not been feasible in everyday clinical practice because of the necessity of time-consuming off-line processes. Hypothesis: A newly developed real-time 3-D triplane echocardiography, which acquires 3 apical rotational cross-sectional images simultaneously, holds the promise to resolve these problems. Methods and Results: Sixteen excised formalin fixed porcine hearts and 24 healthy human subjects underwent real-time 3-D triplane echocardiography. In an anatomic in vitro study, the actual volume of RV was obtained by spilling water in the RV cavity into a graduated cylinder for measurement, which served as a reference standard for comparison. For healthy subjects, the RV stroke volume (SV) was measured by triplane echocardiography which was compared with the left ventricular (LV) SV obtained by conventional 2-Dimensional echocardiography (2-DE). Excellent correlation and agreement between 3-D triplane imaging derived RV volume and the actual one for excised porcine hearts were observed (r = 0.979, p<0.001, mean difference 2.2 mL). In healthy human subjects, good correlation and agreement between 3-D triplane imaging derived RV SV and LV SV measured by 2-DE were obtained (r=0.970, p<0.001, mean difference 5.9 mL). Conclusions: Real-time 3-D triplane echocardiography provides us a new method for rapid and accurate quantification of RV volume. Furthermore, this new method holds the promise for evaluating RV volume and SV in routine clinical practice. © 2008 Wiley Periodicals, Inc.