In vitro analysis of boundary identification techniques used in quantification of two-dimensional echocardiograms

Echocardiographic cross-sectional areas of 10 formalin-fixed animal left ventricles were determined by 5 independent observers using black-white (B-W) and mid-spot (M-S) endocardial boundary identification techniques. The echocardiographic cross-sectional areas were compared with the true anatomic cross-sectional areas of the same 10 hearts to determine the accuracy, variability and reliability of each technique. The results of these comparisons revealed that the M-S technique was more accurate than the B-W technique (3.3 +/- 7.2 vs 34.9 +/- 8.6% error). However, the B-W technique was more reliable in that it had a smaller interobserver and estimated intraobserver variability. The M-S technique had a 6% greater intraobserver variability.