Three-Dimensional Echocardiography for Evaluation of the Right Ventricle—Updates on Image Acquisition and Analysis
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Purpose of Review
Review three-dimensional echocardiographic (3DE) acquisition and analysis of the right ventricular (RV) chamber, the recommended technique by the American Society of Echocardiography guidelines.
3DE acquisition and analysis of RV size and function is available in the majority of clinical echocardiographic laboratories. Recent publications showed this approach provides accurate information despite the challenging chamber anatomy and physiology, when compared to magnetic resonance imaging as reference. 3DE assessment directly measures RV volumes without geometric assumptions. Accordingly, 3DE analysis was found more accurate and reproducible than conventional 2DE methodology, which measures only surrogate parameters of RV function.
RV 3DE assessment is ready for routine clinical use and has direct implications for patient management. 3DE evaluation has the potential to expand the analysis not only to traditionally parameters of size and function, but to new indices including shape, which may become a new useful diagnostic and prognostic information.
KeywordsRight ventricle Acquisition and analysis Right ventricular volumes and function Three-dimensional echocardiography Contrast agents
Compliance with Ethical Standards
There are no issues related to this article that could be construed as a violation of ethical standards.
Conflict of Interest
Eric Kruse reports personal fees from Lantheus Medical Imaging outside of the submitted work. Roberto Lang reports grants from Philips and TOMTEC, outside of the submitted work. The other authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
2DE RV focused 4-chamber view. From a 2DE apical conventional 4-chamber view, the RV focused 4-chamber view is obtained by modifying the position of the transducer more laterally, and its angle more anterior. (MP4 2917 kb)
Top: an example of a good quality 3D RV dataset without contrast (left), in which endocardial border definition further improved with contrast enhancement (right). Bottom: an example of a suboptimal quality 3D RV dataset, in which the endocardial border is poorly visualized without contrast (left), but was considerably improved by contrast enhancement (right), specially for the RV free wall anterior and lateral segments. (MP4 2208 kb)
Two right ventricular generated beating models with a fixed end-diastolic mesh, without (left) and with (right) a 2-dimensional background. (MP4 1360 kb)
Papers of particular interest, published recently, have been highlighted as: • Of importance
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