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Three-dimensional color Doppler: a clinical study in patients with mitral regurgitation
R De Simone1, G Glombitza, C F Vahl
1University of Heidelberg, Germany. r.de.simone@urz.uni-heidelberg.de
Insights
Three-dimensional (3D) Doppler echocardiography effectively visualizes mitral regurgitation jets. This new method accurately quantifies both central and asymmetric mitral regurgitation, improving clinical assessment.
Area of Science:
- Cardiovascular imaging
- Echocardiography
- Medical physics
Background:
- Two-dimensional (2D) color Doppler has limitations in visualizing and quantifying asymmetric mitral regurgitation.
- Previous clinical studies on 3D reconstruction of Doppler signals in original color coding have not been performed.
- A novel procedure for 3D reconstruction of color Doppler has been developed.
Purpose of the Study:
- To assess the clinical feasibility of three-dimensional (3D) reconstruction of color Doppler signals.
- To evaluate the effectiveness of 3D Doppler in patients with mitral regurgitation.
Main Methods:
- Transesophageal 3D echocardiography was performed on 58 patients.
- Jet area was assessed by planimetry and jet volumes by 3D Doppler.
- Regurgitant fractions, volumes, and angiographic degree of mitral regurgitation were assessed and compared between central and eccentric jets.
Main Results:
- Jet areas and volumes significantly correlated with angiographic grading, regurgitant fraction, and regurgitant volume in all patients.
- Jet volumes, assessed by automated voxel count, showed significant correlations with angiography, regurgitant fraction, and regurgitant volume in patients with eccentric jets.
- 3D Doppler demonstrated its capability in quantifying asymmetric jets.
Conclusions:
- Three-dimensional Doppler provides novel visualization of complex mitral regurgitation jet geometry.
- Automated voxel count for jet volume assessment by 3D Doppler is independent of manual planimetry or subjective estimation.
- 3D Doppler is clinically feasible and effective for quantifying both central and asymmetric mitral regurgitation.
Objectives:
The purpose of this study was to assess the clinical feasibility of three-dimensional (3D) reconstruction of color Doppler signals in patients with mitral regurgitation.
Background:
Two-dimensional (2D) color Doppler has limited value in visualizing and quantifying asymmetric mitral regurgitation. Clinical studies on 3D reconstruction of Doppler signals in original color coding have not yet been performed in patients. We have developed a new procedure for 3D reconstruction of color Doppler.
Methods:
We studied 58 patients by transesophageal 3D echocardiography. The jet area was assessed by planimetry and the jet volumes by 3D Doppler. The regurgitant fractions, the volumes, and the angiographic degree of mitral regurgitation were assessed in 28 patients with central jets and compared with those of 30 patients with eccentric jets.
Results:
In all patients, jet areas and jet volumes significantly correlated with the angiographic grading (r = 0.73 and r = 0.90), the regurgitant fraction (r = 0.68 and r = 0.80) and the regurgitant volume (r = 0.66 and r = 0.90). In patients with central jets, significant correlations were found between jet area and angiography (r = 0.86), regurgitant fraction (r = 0.64) and regurgitant volume (r = 0.78). No significant correlations were found between jet area and angiography (r = 0.53), regurgitant fraction (r = 0.52) and regurgitant volume (r = 0.53) in the group of patients with eccentric jets. In contrast, jet volumes significantly correlated with angiography (r = 0.90), regurgitant fraction (r = 0.75) and regurgitant volume (r = 0.88) in the group of patients with eccentric jets.
Conclusions:
Three-dimensional Doppler revealed new images of the complex jet geometry. In addition, jet volumes, assessed by an automated voxel count, independent of manual planimetry or subjective estimation, showed that 3D Doppler is also capable of quantifying asymmetric jets.