Doppler myocardial imaging: A new method of data acquisition for three-dimensional echocardiography

doi:10.1016/S0894-7317(96)90493-9

Journal of the American Society of Echocardiography

Volume 9, Issue 6, November–December 1996, Pages 918-921

https://doi.org/10.1016/S0894-7317(96)90493-9 Get rights and content

Abstract

The precise morphologic characteristics of any intracardiac tumor have important implications regarding surgical planning and operative repair. Three-dimensional echocardiography has proved to be a valuable clinical technique in this field. Current methods of three-dimensional reconstruction of two-dimensional images are based on the standard gray-scale imaging technique. However, precordial gray-scale data-set information is frequently of suboptimal quality because of data degradation caused by ultrasound attenuation by chest wall structures. This has limited the use of the transthoracic three-dimensional technique to “echogenic” patients. Doppler myocardial imaging (DMI), a new ultrasound technique based on the Doppler principle, is influenced less by chest wall attenuation and in addition offers a better boundary detection algorithm for the cardiac structures. To determine if there may be a potential benefit of DMI to acquire data for three-dimensional reconstruction, a 33-year-old woman with a large intracardiac mass was studied. In this case three-dimensional gray-scale and DMI data sets were compared and contrasted with pathologic information. DMI allowed both the quantification of mass volume and the correct definition of the morphology of the mass. It was also possible to identify the precise site of attachment of the mass to the mitral valve leaflets. The information thus obtained was correlated with both operative and pathologic findings.

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Citation Excerpt :
Chambers and structures previously seen in a two-dimensional format can now be viewed in new and varied ways, which could serve not only to enhance the diagnostic capability but also aid in the planning of operative interventions.1 One of the main limitations of two-dimensional color Doppler assessment of blood flow is the inability to visualize the entire jet.59 Although a centrally directed jet may be quantified adequately with two-dimensional imaging, the spatial distortion associated with eccentric jets may lead to inaccurate assessment of their severity.
Transesophageal echocardiography (TEE) first came onto the scene in the early 1970s.31, 91, 95 As a diagnostic modality, it was a new method that allowed the heart to be viewed with better image quality than conventional transthoracic echocardiography. For the first time, the images obtained could be viewed with less attenuation because of shadowing from structures, such as the lung, bone, and soft tissue. The facility to perform Doppler presented the clinician with the ability to functionally assess the hemodynamics and flow disorders in greater detail.³¹ As much as this advance changed the face of echocardiography, it is still essentially a two-dimensional mode of imaging and is limited in portraying the three-dimensional human heart anatomically. Every facet of the heart, its pathology, and function are three-dimensional in nature. Two-dimensional echocardiography is limited in providing a clear uninhibited look at the heart in all views. It was left to the examiner to mentally form a three-dimensional picture of the heart from all the data obtained from the two-dimensional images. A method was needed that could visualize the heart in a three-dimensional format.
An attempt to develop three-dimensional imaging was first undertaken in the early 1970s.29, 69 In its infancy, three-dimensional echocardiography was used mainly to measure left ventricular volumes using manual tracing methods from multiple cross-sectional images.3, 63 Three-dimensional echocardiography was laborious and time-consuming initially, but soon it was realized that the potential of three-dimensional echocardiography was an opportunity waiting to be harnessed.49, 81, 85 Although three-dimensional echocardiography can be performed by way of transthoracic and transesophageal methods, the improved image resolution obtained from TEE makes it much more useful for three-dimensional image reconstruction, the quality of which is dependent on the raw two-dimensional images.¹¹ Today, three-dimensional TEE is emerging as an extremely useful imaging tool with a multitude of clinical applications.82, 94, 101, 104, 105, 109
Evolving era of multidimensional medical imaging
1999, Mayo Clinic Proceedings
Currently, computer-assisted imaging can visualize very fast or very slow nonvisible motion events. We can create measurable geometric representations of physiology, including transformation, blood flow velocity, perfusion, pressure, contractility, image features, electricity, metabolism, and a vast number of other constantly changing parameters. The greatest attribute is the ability to present physiologic phenomena as easily understood geometric images more suited to the human's four-dimensional comprehension of reality. The key research challenges are to discover new visual metaphors for representing information, understand the analysis tasks that they support, and associate relevant information to create new information.
Three-dimensional echocardiographic evaluation of left ventricular volume: Comparison of Doppler myocardial imaging and standard gray-scale imaging with cineventriculography-an in vitro and in vive study
1998, American Heart Journal
Background: Standard gray-scale imaging (GSI), three-dimensional (3D) echocardiography has been shown to be superior to two-dimensional echocardiography in measuring left ventricular volume. However, the often relatively poor quality of transthoracic gray-scale data can limit the potential application of this technique. Doppler myocardial imaging (DMI) is a new ultrasound technique that potentially offers higher-quality 3D images with a transthoracic approach than the 3D GSI technique. This study was designed to compare the accuracy of standard GSI and DMI 3D left ventricular volume measurements in vitro and in vivo. Methods and Results: In vitro, the minimum and maximum volume of the contracting single-chamber, tissue-mimicking phantom was calculated by using both techniques. In vivo, GSI and DMI 3D left ventricular volume measurements were performed in 16 patients. End-diastolic and end-systolic left ventricular volumes were computed for both techniques and compared with those calculated by cineventriculography. In vitro, both methods tended to underestimate the true phantom volume, but the systematic error was smaller for DMI than for GSI (–1.2% ± 1.5% vs. –4.3% ± 3%; p < 0.01) and was more constant in the case of DMI over the range of different sizes of true volume. In vivo, for GSI the end-diastolic volume mean difference was –12.6 ml and the limits of agreement were ±18 ml, and for DMI the corresponding values were –4.2 and ±10.6 ml, respectively. The difference for end-systole was –6.5 ± 10.6 ml and –1.5 ± 10 ml for GSI and DMI, respectively. The magnitude of the difference in volume measurement between 3D echocardiography and cineventriculography was significantly smaller when using the Doppler technique. Conclusions: The results of this in vitro and in vivo study indicate that DMI is superior to GSI as a transthoracic acquisition technique for 3D volume computation. (Am Heart J 1998;135:970-9.)
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2011, Progress in Biomedical Optics and Imaging - Proceedings of SPIE
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Case reportDoppler myocardial imaging: A new method of data acquisition for three-dimensional echocardiography

Abstract

J Am Soc Echocardiogr

Ultrasound Med Biol

J Am Soc Echocardiogr

J Am Soc Echocardiogr

Am Heart J

Case report
Doppler myocardial imaging: A new method of data acquisition for three-dimensional echocardiography