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Updated: Feb 12, 2026

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
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Real-Time Three-Dimensional Echocardiography of the Left Ventricle-Pediatric Percentiles and Head-to-Head Comparison

Kristina Krell1, Kai Thorsten Laser2, Robert Dalla-Pozza3

  • 1Department of Pediatric Cardiology, Children's Hospital, University of Bonn, Bonn, Germany.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|April 2, 2018
PubMed

Insights

Real-time three-dimensional echocardiography (RT3DE) provides reproducible left ventricular (LV) assessments in children. Software choice impacts measurements, necessitating software-specific reference percentiles for accurate pediatric LV function evaluation.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Pediatric Health

Background:

  • Real-time three-dimensional echocardiography (RT3DE) shows promise for assessing left ventricular (LV) volumes and function.
  • Pediatric reference values for RT3DE measurements are currently limited.
  • Establishing these values is crucial for accurate clinical assessment in children.

Purpose of the Study:

  • To establish comprehensive pediatric reference percentiles for LV volumes using RT3DE in a large cohort.
  • To compare the influence of different software platforms on RT3DE measurements.
  • To provide a basis for accurate interpretation of pediatric cardiac function.

Main Methods:

  • A multicenter prospective study enrolled 497 healthy children (1 day to 219 months).
  • RT3DE imaging of the LV was performed, with volume analysis using QLab 9.0 and TomTec 4DLV2.7 (two contour-finding settings).
  • Cole's LMS method was used for percentile computation; cardiovascular magnetic resonance imaging (CMR) served as a reference in a subset.

Main Results:

  • Adequate data sets were obtained from 74.4% of subjects.
  • LV volumes correlated significantly with age, body size, and gender; sex-specific, body surface area-indexed percentiles were derived.
  • Good intra- and interobserver variability was observed for both software platforms, but intervendor agreement showed notable differences, particularly in younger children.

Conclusions:

  • RT3DE enables reproducible, noninvasive assessment of pediatric LV volumes and function.
  • Significant intertechnique variability exists between different software solutions.
  • Software-specific percentiles derived from this large pediatric cohort are essential references for commonly used quantification programs.
Abstract

Keywords:
3D echocardiographyChildrenLeft heartNomogramPediatricVolumetry

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