Feasibility of measurements of valve dimensions in en-face-3D transesophageal echocardiography

Abstract

Newest 3D software allows measurements directly in the en-face-3D TEE mode. Aim of the study was to ascertain whether measurements performed in the en-face-3D TEE mode are comparable with conventional measurement methods based on 2D TEE and 3D using the multiple plane reconstruction mode with the Qlab software. En-face-3D TEE is used more frequently in daily clinical routine during cardiac operations. So far measurements could only be done based on 2D images or with the use of multi planar reconstruction mode with additional software. Measurement directly in the 3D image (en-face-3D TEE) would make measurements faster and easier to use in clinical practice. After approval by the local ethic committee and written informed consent from the patients additionally to a comprehensive perioperative 2D TEE examination a real time (RT) 3D zoom- dataset was recorded. Routine measurements of the length of anterior and posterior mitral valve leaflets as well as mitral valve and aortic valve areas were performed in en-face-3D TEE, multiplanar reconstruction mode using Qlab-software (Philips, Netherlands) and 2D TEE standard views. Twenty nine patients with a mean age of 67 years undergoing elective cardiac surgery/interventions were enrolled in this study. Direct measurements in en-face-3D TEE mode lead to non significant underestimation of all parameters as compared to Qlab and 2D TEE measurements. Measurements in en-face-3D TEE are feasible but lead to non significant underestimation compared to measurements performed with Qlab or in 2D TEE views.

Measurement of mitral valve area in patients with mitral stenosis by 3D echocardiography: A comparison between direct planimetry on 3D zoom and 3D quantification

“…Our 3DE findings suggested that 3DQ overestimated the MVA size in comparison with direct planimetry on 3D zoom. To our knowledge, there are few studies on the comparison of these 3D modalities . Nevertheless, Biaggi et al similarly declared that the MVA assessed by 3DQ was significantly larger than the absolute value by another 3DTEE modality, the MV quantification (MVQ) method.…”

“…The results of our study are concordant with those recently published by Eibel et al, who found that measurements in en‐face 3DTEE, albeit feasible, could lead to a nonsignificant underestimation by comparison with measurements performed with QLab or in 2DTEE views.…”

Three-dimensional transesophageal echocardiography measurement of mitral valve area in patients with rheumatic mitral stenosis: multiplanar reconstruction or 3D direct planimetry?

“…However, the analysis must be done off-line. 3D direct planimetry, a technology developed in recent years, permits direct measurements within the 3D dataset, without the need to export the dataset into special software for offline analysis [13]. 3D-TEE provides a unique en-face view of the mitral valve orifice, and direct planimetry of the MVA could, therefore, be performed in a method similar to 2D echocardiography [14].…”

Intraoperative Measurement of the Tricuspid Annulus: To 3D or not to 3D?

“…14 Eibel et al sought to compare the measurements of the mitral and aortic valves using en face 3D and MPR 3D and 2D images in 29 patients. 12 They found that en face 3D measurements resulted in nonsignificant underestimation of mitral and aortic valve areas, anterior and posterior mitral leaflet lengths, and mitral annular and intercomissural diameters. There are no data available comparing en face 3D with other techniques when evaluating the TV.…”

“…Previously, 3D measurements required the need to export datasets to special software for offline analysis. 12 The software programs used for analysis have proprietary names for each manufacturer but essentially perform similar functions using MPR. Earlier studies using MPR software found that 3D TEE and direct surgical measurements of mitral leaflet height did not differ significantly, whereas 2D TEE measurements significantly overestimated height at P1 and A2 of the mitral valve.…”