Three-dimensional echocardiographic reconstruction: qualitative and quantitative evaluation of ventricular function

Three-dimensional (3-D) images of the human left ventricle were reconstructed from 2-dimensional echocardiographic pictures. All images were recorded at held end-expiration from an optimal point where a high-quality parasternal long-axis view maximally visualizing the left ventricle could be obtained. Multiple short-axis views were obtained from the same reference point. Interactive computer techniques were used to reconstruct 3-D shells of endocardium and epicardium. End-diastolic and end-systolic outlines were superimposed after correcting for motion during the cardiac cycle to demonstrate wall motion. Images were displayed from different perspectives and regional wall thickness, thickening, and motion were then demonstrated using surface map displays. Volumes and derived indices of left ventricular function were calculated. The ejection fraction of normal patients was 69 +/- 9%, compared to 57 +/- 7% in infarct patients; the latter results correlated well with contrast angiography. 3-D echocardiographic reconstruction provides the observer with a spatial appreciation of left ventricular wall motion and thickness, as well as useful quantitative information. The system requires only a standard echocardiographic recorder and simple computer hardware.