Three-dimensional echocardiography of the thoracic aorta

The feasibility and diagnostic potential of three-dimensional echocardiography, using transoesophageal multiplane echocardiography for the assessment of thoracic aortic pathology, has not been evaluated.

We studied 21 patients (10 women, 11 men), mean age 52.1 years (range 20-78). Images for three-dimensional reconstruction were acquired during a diagnostic multiplane transoesophageal echocardiographic examination. In all, 30 acquisitions were performed: 19 of the ascending aorta and 11 of the arch and descending aorta. Three-dimensional reconstruction was performed to visualize normal aortic segments in three patients with a normal thoracic aorta, postoperative anatomy in seven, chronic aortic dissection in two, non-dissecting aneurysm in seven (three patients had coexisting thrombi) and protruding aortic atheroma in two.

Three-dimensional image quality was scored excellent in 17 acquisitions (57%), adequate in 10 (33%) and inadequate in three (10%). Anyplane two-dimensional views of regions of interest of the aorta were reconstructed off-line from the data sets, which provided improved analysis with potential for quantitation. Advanced computer-assisted imaging modalities (electronic vivisection, lumen cast display, detail extraction) were feasible.

We conclude that three-dimensional echocardiography of the thoracic aorta is feasible. Adequate image quality is obtained in the vast majority of patients, which adds additional qualitative and quantitative information to routine multiplane transoesophageal echocardiographic studies.