CVUS: Real-time 3D echo quickly, accurately quantifies left atrial volume
Researchers found that 3D echocardiography with semiautomatic border detection is a practical alternative for obtaining the left atrial volume in a time-efficient manner, compared with MRI measurements and 2D echo algorithms, according to a study published in the April issue of Cardiovascular Ultrasound.
Ramin Artang, MD, and colleagues from the division of cardiovascular medicine at the Medical College of Wisconsin in Milwaukee said that the aim of this study was to compare the accuracy of a commercially available real-time 3D echo algorithm (Philips Healthcare) for measurement of left atrial volume index (LAVI) against LAVI obtained from MRI and Area Length Method (ALM).
In 27 consecutive subjects referred for cardiac MRI for any reason (median age 54, 63 percent male), the researchers measured LAVI using three imaging modalities: 3DE, ALM, MRI and the results were correlated. ALM was measured using standard American Society of Echocardiography (ASE) guidelines. Exclusion criteria included patients with supraventricular or ventricular tachyarrhythmias at the time of imaging, known congenital heart disease and the presence of prosthetic valves.
The investigators found that there was a significant correlation in systolic and diastolic LA volumes and left atrial ejection fraction between 3D echo and MRI (r = 0.86 for systole, r = 0.76 for diastole, r = 0.88 for ejection fraction). There was also significant correlation of diastolic volumes between 3D echo and ALM (r = 0.77).
Artang and colleagues also reported that the time to obtain LAVI was shorter using 3D echocardiography versus ALM (56 vs. 135 seconds). "In a busy echocardiography imaging laboratory, the time saved by the sonographers and readers to calculate such parameters might have significant impact on the efficiency of the lab as well as better patient care," the authors wrote.
The researchers concluded that their "findings suggest that in laboratories equipped with 3D matrix-array transducers and an offline quantification application, the 3D echocardiography is the most time-efficient method of LA volume quantification. This finding, along with good MRI correlation and reproducibility, implies this may be the preferred method of LAVI measurement except in cases when poor image quality prevents automated border detection."
Ramin Artang, MD, and colleagues from the division of cardiovascular medicine at the Medical College of Wisconsin in Milwaukee said that the aim of this study was to compare the accuracy of a commercially available real-time 3D echo algorithm (Philips Healthcare) for measurement of left atrial volume index (LAVI) against LAVI obtained from MRI and Area Length Method (ALM).
In 27 consecutive subjects referred for cardiac MRI for any reason (median age 54, 63 percent male), the researchers measured LAVI using three imaging modalities: 3DE, ALM, MRI and the results were correlated. ALM was measured using standard American Society of Echocardiography (ASE) guidelines. Exclusion criteria included patients with supraventricular or ventricular tachyarrhythmias at the time of imaging, known congenital heart disease and the presence of prosthetic valves.
The investigators found that there was a significant correlation in systolic and diastolic LA volumes and left atrial ejection fraction between 3D echo and MRI (r = 0.86 for systole, r = 0.76 for diastole, r = 0.88 for ejection fraction). There was also significant correlation of diastolic volumes between 3D echo and ALM (r = 0.77).
Artang and colleagues also reported that the time to obtain LAVI was shorter using 3D echocardiography versus ALM (56 vs. 135 seconds). "In a busy echocardiography imaging laboratory, the time saved by the sonographers and readers to calculate such parameters might have significant impact on the efficiency of the lab as well as better patient care," the authors wrote.
The researchers concluded that their "findings suggest that in laboratories equipped with 3D matrix-array transducers and an offline quantification application, the 3D echocardiography is the most time-efficient method of LA volume quantification. This finding, along with good MRI correlation and reproducibility, implies this may be the preferred method of LAVI measurement except in cases when poor image quality prevents automated border detection."