项目编号NVKP_16-1-2016-0017（"国家心脏计划"）已在匈牙利国家研究，发展和创新基金的支持下实施，该基金由NVKP_16资助计划资助。该研究由匈牙利创新和技术部的专题卓越计划（2020-4.1.1.-TKP2020）资助，在塞梅尔威斯大学的治疗开发和生物成像主题计划的框架内。

该协议遵循塞梅尔威斯大学科学与研究伦理区域和机构委员会的指导方针。本协议适用于特定供应商。尽管无论使用超声机和后处理软件，某些步骤仍然有效，但如果使用其他供应商的解决方案，则可能存在重要差异。
1. 技术要求
<ol><li>利用能够进行3D成像的超声心动图机。</li>
	<li>连接具有 3D 经胸超声心动图功能的相控阵换能器。</li>
	<li>应用超声系统的内置3导联心电图，使系统能够将记录和分析同步到心脏周期。</li>
</ol>2. 采集3D超声心动图图像
<ol><li>将患者置于左侧侧卧位（患者躺在左侧，左臂伸展到头顶上方）。</li>
	<li>确保屏幕上的心电图追踪质量良好。 注意:这是后处理的先决条件，因为软件将根据ECG信号检测心脏周期的不同点。</li>
	<li>解冻图像，并开始用换能器检查患者。可视化传统的顶点四腔视图。</li>
	<li>通过将扇区宽度调整为左心宽，降低深度以截断左心房以及使用轻微的过度加气来优化图像质量。 注意:确保整个左心室内膜和心外膜表面可见。</li>
	<li>按 4D 按钮切换到 3D 模式。 注意:通过按触摸屏上的" 多切片..." 按钮，将有四个选项（5、7、8、12 切片）使用标准的短轴和长轴切割来概览 3D 数据集。如果需要，可以校正探头定位，以确保将整个左心室壁厚度从顶端到二尖瓣水平纳入金字塔3D数据集。建议使用 12 个切片（具有 9 个可调节的短轴视图）。</li>
	<li>使用多拍或单拍模式采集 3D 图像。<ol>
<li>使用 Multi Beat 模式实现更高的空间和时间分辨率，其中数据集将从 2、3、4 或 6 个心脏周期重建（可在屏幕上设置） - 患者呼气结束呼吸和稳定的换能器定位，以最大限度地减少拼接伪影。 注: 单拍 采集的空间和时间分辨率较低。然而，大多数现代传感器具有更好的质量，因此可用于获取适当的3D数据集，而无需重建以进行进一步分析。作为一般建议，建议使用每秒超过 15 卷的音量率进行进一步分析。</li>
		<li>当从子卷重建全卷并且整个LV可见时，冻结图像。使用"周期选择"和"循环次数"旋钮，选择获得最佳获得的心脏周期，然后按"图像存储"。 注:拼接伪像在空间上或暂时未对齐的子卷彼此相邻。具有显著左心室壁凹陷或具有拼接伪影的数据集通常不适合进一步分析。可以使用多切片模式仔细检查已获取的 3D 数据集的质量。</li>
	</ol>
</li>
</ol>3. 后处理以量化左心室形态和功能
<ol><li>选择适合进一步分析的 3D 数据集。 注意:该协议的这一部分需要先前获取和保存的高质量3D图像，并且可以在超声机器和单独的工作站上执行。</li>
	<li>单击" 测量|音量，然后选择 "4D 自动 LVQ"。</li>
	<li>在四屏（三个顶面视图:四个、两个和三个腔室视图，以及一个短轴视图，后者可以通过长轴视图上的水平平面进行调整）上，软件会要求 修改顶点切片与标准视图的对齐方式。如果需要，通过倾斜和旋转手动校正顶点视图以显示相应的标准视图，从而消除透视收缩。设置倾斜以通过在长轴视图上拖动和移动卡钳来将卡钳与LV的长轴对齐。通过机床上相应的或 "全部旋转" 旋钮或通过调整短轴图像上的卡钳来设置旋转。 注:可通过按下 "自动对齐 "按钮重置软件建议。</li>
	<li>完成视图对齐后，单击下一步 EDV。舒张末期 （ED） 帧使用心电图信号自动检测，但如有必要，可以手动校正。</li>
	<li>左心室内膜和心外膜表面的半自动检测<ol><li>在任何顶点视图上手动选取两个地标点。首先，在任何顶点视图中识别左心室顶点，然后确定左心室基底的中间（二尖瓣环空水平）。该算法将自动勾勒整个左心室的心内膜边界。 注意:还有两个选项: 手动，这意味着在每个顶点视图中应设置两个基础和一个顶点，以及 自动初始化，它将自动勾勒左心室轮廓，而无需任何用户交互。</li>
		<li>检查三个顶点视图、三个不同级别的短轴视图和第四个用户控制的短轴中的等值线可信度，以便对检测到的表面进行视觉验证。通过手动添加点，可以进行等值线校正，然后将这些点合并到等值线中。 注意:使用 "撤消"时，可以删除以前添加的点。 "重置 "按钮可重置轮廓，以从头开始整个部分。可以调整轮廓可见性，以便在灰度图像上欣赏心内膜表面。心内膜和心外膜轮廓应以准确和一致的方式进行。有关详细建议，请查看以下参考资料6。</li>
		<li>选择下一步，即 ESV。</li>
		<li>重复上述相同的程序（3.5.1-3.5.2），以识别和纠正收缩末期框架上的心内膜轮廓。 注:收缩末期（ES）框架使用ECG信号自动检测，但如有必要，可以手动校正。舒张末期体积 （EDV）、收缩末期体积 （ESV）、射血分数 （EF）、心率 （HR）、每搏量 （SV）、心输出量 （CO） 和球形指数 （SpI） 的值已显示在屏幕上。</li>
		<li>按 音量波形 进行下一步。该软件显示左心室的动态3D模型以及时间体积曲线，因为它在整个心脏周期中逐帧跟踪心内膜表面（图1）。 注意:在这里，可以在任何帧处编辑心内膜边界。</li>
		<li>对于下一步，按 左心室质量。该软件自动勾勒舒张末期框架上的左心室外膜轮廓，并计算左心室肿块（EDMass）。 注意:如有必要，通过添加点以在任何短轴或长轴平面中包括（与前面描述的方法相同）来编辑心外膜表面的轮廓。可以选择要调整的轮廓:Endo，Epi或Endo + Epi。</li>
		<li>按 4D 应变 ROI 进行下一步。该软件自动勾勒收缩末期框架上的左心室外膜轮廓，并计算左心室收缩末期质量（ESMass）。 注意:如有必要，编辑心外膜表面的收缩末期轮廓，方法是添加点以在任何短轴或长轴平面中包括（与前面描述的方法相同）。ESMass 应具有与 EDMass 相似的价值。此步骤对于通过斑点跟踪计算 3D 应变值至关重要。</li>
		<li>按 4D 应变结果 进行下一步。该软件可逐帧可视化多个短轴和长轴平面上的 3D 心肌跟踪，以及整个心脏周期中 17 个标准左心室段的相应应变值。还显示了时间应变曲线和牛眼图。计算并可以演示以下参数:纵向应变，圆周应变，径向应变，面积应变，旋转和扭转。 注意:如果通过对图像的目视观察或基于时间应变曲线认为特定左心室段具有低跟踪质量，则有可能将其从分析中排除。但是，默认情况下，软件建议在段批准或拒绝时进行审批或拒绝。通过更改"布局"，可以在LV的动态3D模型上可视化颜色编码的应变值。</li>
	</ol></li>
	<li>要终止分析，请按 批准并退出。</li>
</ol>

<ol>
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左心室形态学和功能测量是心脏病诊断、管理和随访的基石。此外，它们是结果的强大预测因素。通常，现行实践指南建议对左心室进行基于二维超声心动图的评估。然而，3D超声心动图已被证明更准确，因为它没有关于LV形状的几何假设7，8。通过斑点跟踪进行变形成像是评估心肌应变不同方向的可靠方法，可以更灵敏地量化壁运动异常5<...

评估左心室 （LV） 形态和功能是心脏病学中一般甚至更具体检查的主要目的1。广泛可用的无创经胸超声心动图（TTE）可以提供大量信息，是方便，快速且具有成本效益的评估的首选方法。
低压质量、容量和随后的射血分数的测量具有重要的诊断价值和预后价值2。给定的度量值越准确，其值就越高。与金标准心脏磁共振（CMR）成像衍生值更好的相关性是对超声心动图技术的持续追逐。通常，临床实践指南推荐双平面辛普森方法测量左心室体积和射血分数3。然而，左心室是一种三维（3D）结构，其形状通常不规则，因此，在某些临床场景中，几个断层扫描平面无疑无法准确描绘左心室形态和功能。超声波硬件和软件技术的最新进展允许实时3D成像的发展，这彻底改变了超声心动图方案。
此外，需要对壁运动异常进行定量方法，导致变形成像的兴起4。应变和应变速率参数可以通过使用标准灰度图像的斑点跟踪来计算。3D 超声心动图还可以克服二维应变评估的几个缺点5。从昂贵的科学工具，3D超声心动图开始成为日常临床实践中使用的一种强大技术，而LV的定量无疑是这一突破的第一线。
本文旨在通过提供提示和技巧以及强调潜在的陷阱来引导读者通过详细的3D协议，以促进有关LV的这一重要技术的广泛但技术上合理的使用。

<table><tbody><tr><td>3V-D/4V-D/4Vc-D</td><td>General Electric</td><td>n.a.</td><td>ultrasound probe</td></tr><tr><td>4D Auto LVQ</td><td>General Electric</td><td>n.a.</td><td>software for analysis</td></tr><tr><td>E9/E95</td><td>General Electric</td><td>n.a.</td><td>ultrasound machine</td></tr><tr><td>EchoPac v203</td><td>General Electric</td><td>n.a.</td><td>software for analysis</td></tr></tbody></table>

evaluation of left ventricular structure and function using 3d echocardiography

左心室 （LV） 的三维 （3D） 定量在诊断准确性和各种心脏疾病的精确风险分层方面提供了显著的附加值。最近，3D超声心动图在常规心脏病学实践中变得可用;然而，高质量的图像采集和后续分析具有陡峭的学习曲线。本文旨在通过提供提示和技巧以及强调潜在的陷阱来引导读者通过详细的3D协议，以促进有关LV的这一重要技术的广泛但技术上合理的使用。首先，我们展示了以最佳空间和时间分辨率获取的高质量3D数据集。然后，我们通过使用应用最广泛的内置软件之一，介绍了对LV进行详细定量的分析步骤。我们将通过测量射血分数和心肌变形（纵向和圆周应变）来量化左心室体积，球形度，质量和收缩功能。我们将讨论并提供临床示例，说明强烈建议从传统的超声心动图方法过渡到基于3D的定量的基本场景。

左心室的 3D 分析在大多数患者中是可行的。病例1是一名健康的志愿者，心室容积和功能正常（图1）。病例 2（图 2）是一名 64 岁男性患者，伴有扩张型心肌病和宽 QRS 复合体（160 ms）左束支传导阻滞形态。黄金标准CMR测量值如下:舒张末期体积:243 mL，收缩末期体积:160 mL，射血分数:34%，左心室质量:163g。传统的线性超声心动图测...

Watch this Scientific Journal Video about Evaluation of Left Ventricular Structure and Function using 3D Echocardiography at JoVE.com

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

在本文中，我们为通过3D超声心动图对左心室进行容量评估和斑点跟踪分析提供了分步采集和分析方案，特别关注最大化该技术可行性的实用方面。

使用3D超声心动图评估左心室结构和功能

Three-dimensional (3D) quantification of the left ventricle (LV) provides significant added value in terms of diagnostic accuracy and precise risk ...

evaluation-left-ventricular-structure-function-using-3d

Research

JoVE Journal

Bioengineering

3.8K 次观看.  Semmelweis University. 在本文中，我们为通过3D超声心动图对左心室进行容量评估和斑点跟踪分析提供了分步采集和分析方案，特别关注最大化该技术可行性的实用方面。

视频: Evaluation of Left Ventricular Structure and Function using 3D Echocardiography

Transthoracic Echocardiography in Mice

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene expression. Transgenic and gene targeting methods can be used to generate mice with altered cardiac size and function,1-3 and as a result, in vivo techniques are needed to evaluate their cardiac phenotype. Transthoracic echocardiography, pulse wave Doppler (PWD), and tissue Doppler imaging (TDI) can be used to provide dimensional measurements of the mouse heart and to quantify the degree of cardiac systolic and diastolic performance. Two-dimensional imaging is used to detect abnormal anatomy or movements of the left ventricle, whereas M-mode echo is used for quantification of cardiac dimensions and contractility.4,5 In addition, PWD is used to quantify localized velocity of turbulent flow,6 whereas TDI is used to measure the velocity of myocardial motion.7 Thus, transthoracic echocardiography offers a comprehensive method for the noninvasive evaluation of cardiac function in mice.

Transthoracic echocardiography offers a noninvasive method for the evaluation of cardiac function in mice. A combination of ultrasound and Doppler imaging modalities can be used to obtain dimensional measurements of the heart and intracardiac blood flow, which together provide an assessment of cardiac systolic and diastolic performance.

经胸超声心动图在小鼠

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene ...

科研

医学

Ultrasonic Assessment of Myocardial Microstructure

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and function. Ultrasonic assessments of cardiac tissue can include analyses of backscatter signal intensity within a given region of interest. Previously established techniques have relied predominantly on the integrated or mean value of backscatter signal intensities, which may be susceptible to variability from aliased data from low frame rates and time delays for algorithms based on cyclic variation. Herein, we describe an ultrasound-based imaging algorithm that extends from previous methods, can be applied to a single image frame&#160;and accounts for the full distribution of signal intensity values derived from a given myocardial sample. When applied to representative mouse and human imaging data, the algorithm distinguishes between subjects with and without exposure to chronic afterload resistance. The algorithm offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

Echocardiography is commonly used to noninvasively characterize and quantify changes in cardiac structure and function. We describe an ultrasound-based imaging algorithm that offers an enhanced surrogate measure of myocardial microstructure and can be performed using open-access image analysis software.

心肌微观结构超声波评估

Echocardiography is a widely accessible imaging modality that is commonly used to noninvasively characterize and quantify changes in cardiac structure and ...

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

Emerging clinical data support the notion that RV dysfunction is critical to the pathogenesis of cardiovascular disease and heart failure1-3. Moreover, the RV is significantly affected in pulmonary diseases such as pulmonary artery hypertension (PAH). In addition, the RV is remarkably sensitive to cardiac pathologies, including left ventricular (LV) dysfunction, valvular disease or RV infarction4. To understand the role of RV in the pathogenesis of cardiac diseases, a reliable and noninvasive method to access the RV structurally and functionally is essential.
A noninvasive trans-thoracic echocardiography (TTE) based methodology was established and validated for monitoring dynamic changes in RV structure and function in adult mice. To impose RV stress, we employed a surgical model of pulmonary artery constriction (PAC) and measured the RV response over a 7-day period using a high-frequency ultrasound microimaging system. Sham operated mice were used as controls. Images were acquired in lightly anesthetized mice at baseline (before surgery), day 0 (immediately post-surgery), day 3, and day 7 (post-surgery). Data was analyzed offline using software.
Several acoustic windows (B, M, and Color Doppler modes), which can be consistently obtained in mice, allowed for reliable and reproducible measurement of RV structure (including RV wall thickness, end-diastolic&#160;and end-systolic dimensions), and function (fractional area change, fractional shortening, PA peak velocity, and peak pressure gradient) in normal mice and following PAC.
Using this method, the pressure-gradient resulting from PAC was accurately measured in real-time using Color Doppler mode and was comparable to direct pressure measurements performed with a Millar high-fidelity microtip catheter. Taken together, these data demonstrate that RV measurements obtained from various complimentary views using echocardiography are reliable, reproducible and can provide insights regarding RV structure and function. This method will enable a better understanding of the role of RV cardiac dysfunction.

Right ventricle (RV) dysfunction is critical to the pathogenesis of cardiovascular disease, yet limited methodologies are available for its evaluation. Recent advances in ultrasound imaging provide a noninvasive and accurate option for longitudinal RV study. Herein, we detail a step-by-step echocardiographic method using a murine model of RV pressure overload.

右心室结构和功能的肺动脉缩窄经胸超声小鼠模型的评估

Emerging clinical data support the notion that RV dysfunction is critical to the pathogenesis of cardiovascular disease and heart failure1-3. Moreover, ...

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in rodents, with detailed descriptions of the appropriate methods for anesthesia, the echocardiographic windows used, the imaging planes and probe orientations for image acquisition, the methods for data analysis, and the limitations of emerging technologies for the evaluation of cardiac and valvular function. Importantly, we also highlight several future areas of research in cardiac and heart valve imaging that may be leveraged to gain insights into the pathogenesis of valve disease in preclinical animal models. We propose that using a systematic approach to evaluating cardiac and heart valve function in mice can result in more robust and reproducible data, as well as facilitate the discovery of previously underappreciated phenotypes in genetically-altered and/or physiologically-stressed mice.

This protocol provides a detailed description of the echocardiographic approach for comprehensive phenotyping of heart and heart valve function in mice.

超声心动图方法和协议心脏瓣膜疾病的综合表型特征小鼠

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in ...

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

The value of conventional echocardiography is limited by differences in inter-individual image interpretation and therefore largely dependent on the examiners&#39; expertise. Speckle tracking Echocardiography (STE) is a promising but technically challenging method that can be used to quantitatively assess regional and global systolic and diastolic myocardial performance. Myocardial strain and strain rate can be measured in all three dimensions&#160;&#8212; radial, circumferential, longitudinal &#8212; of myocardial deformation. Standard cross-sectional two-dimensional B-mode images are recorded and subsequently postprocessed by automated continuous frame-by-frame tracking and motion analysis of speckles within the myocardium. Images are recorded as digital loops and synchronized to a 3-lead EKG for timing purposes. Longitudinal deformation is assessed in the apical 4-, 3-, and 2-chamber views. Circumferential and radial deformation are measured in the parasternal short axis plane.
Optimal image quality and accurate tissue tracking are paramount for the correct determination of myocardial performance parameters. Utilizing transthoracic STE in a healthy volunteer, the present article is a detailed outline of the essential steps and potential pitfalls of quantitative echocardiographic myocardial deformation analysis.

Speckle tracking echocardiography is an emerging diagnostic imaging technique for the quantitative assessment of global and regional myocardial performance. Standard view echocardiographic motion images are recorded and deformation parameters are subsequently measured by automated continuous frame-by-frame tracking and motion analysis of speckles within the B-mode images of the myocardium.

经胸斑点跟踪超声心动图左室心肌变形的定量评价

The value of conventional echocardiography is limited by differences in inter-individual image interpretation and therefore largely dependent on the ...

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic pressure through echocardiography, as well as to obtain measurements of the Aorta and PA diameter in mice.
Mice older than 10 d of age can be analyzed using the present technique. The technique is composed of 3 main steps: set-up, image acquisition, and image analysis. The set-up step consists of getting the mouse anesthetized with 1% isoflurane, shaving it, and taping it in a supine position to a heated EKG board where the image acquisition will take place. The image acquisition step consists of learning to identify the cardiac structures and obtaining all the required images with its correspondent probe and axis in order to be able to calculate volumes and diameters. The image analysis step consists of measuring the previously acquired images with the aid of computer software.
Advantages of the proposed technique include a fast (15 min) procedure that would allow the researcher to evaluate interventions in a non-invasive, non-terminal approach and therefore follow the same mouse over time; each mouse can be used as its own control. This fact plus having the same operator perform all the acquisition and analysis for the entire experiment minimizes the limitation of operator-dependency. The present methodology is useful for mouse researchers in cardiovascular and pulmonary medicine.

The following protocol describes the methodology for the acquisition and analysis of echocardiographic images used to obtain the Left Atrial Volume (LAV), Aorta (Ao) diameter, and Pulmonary Artery (PA) diameter in mice. This technique is a non-invasive, non-terminal procedure that allows assessment of the cardiopulmonary function.

左心房，主动脉和肺动脉的超声心动图小鼠

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic ...

Three-Dimensional Echocardiographic Method for the Visualization and Assessment of Specific Parameters of the Pulmonary Veins

The dimensions of the pulmonary veins are important parameters when planning pulmonary vein isolation (PVI), especially with the cryoballoon ablation technique. Acknowledging the dimensions and anatomical variations of the pulmonary veins (PVs) may improve the outcome of the intervention. Conventional 2D transoesophageal echocardiography can only provide limited data about the dimensions of the PVs; however, 3D echocardiography can further evaluate relevant diameters and areas of the PVs, as well as their spatial relationship to surrounding structures. In previous literature data, parameters influencing the success rate of PVI have already been identified. These are the left lateral ridge, the intervenous ridge, the ostial area of the PVs and the ovality index of the ostium. Proper imaging of the PVs by 3D echocardiography is a technically challenging method. One crucial step is the collection of images. Three individual transducer positions are necessary to visualize the important structures; these are the left lateral ridge, the ostium of the PVs and the intervenous ridge of the left and right PVs. Next, 3D images are acquired and saved as digital loops. These datasets are cropped, which result in the en face views displaying spatial relationships. This step can also be employed to determine the anatomical variations of the PVs. Finally, multiplanar reconstructions are created to measure each individual parameter of the PVs.
Optimal quality and orientation of the acquired images are paramount for the appropriate assessment of PV anatomy. In the present work, we examined the 3D visibility of the PVs and the suitability of the above method in 80 patients. The aim was to provide a detailed outline of the essential steps and potential pitfalls of PV visualization and assessment with 3D echocardiography.

The dimensions of the pulmonary veins (PV) are important parameters when planning pulmonary vein isolation. 2D transoesophageal echocardiography can only provide limited data about the PVs; however, 3D echocardiography can evaluate relevant diameters and areas of the PVs, as well as their spatial relationship to surrounding structures.

用于肺静脉特定参数可视化和评估的三维超声心动图方法

The dimensions of the pulmonary veins are important parameters when planning pulmonary vein isolation (PVI), especially with the cryoballoon ablation ...

生物工程

Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats

The use of experimental animal models has become crucial in cardiovascular science. Most studies using rodent models are focused on two-dimensional imaging to study the cardiac anatomy of the left ventricle and M-mode echo to assess its dimensions. However, this could limit a comprehensive study. Herein, we describe a protocol that allows an assessment of the heart chamber size, left ventricular function (systolic and diastolic) and valvular function. A conventional medical ultrasound machine was used in this protocol and different echo views were obtained through left parasternal, apical and suprasternal windows. In the left parasternal window, the long and short axis were acquired to analyze left chamber dimensions, right ventricle and pulmonary artery dimensions, and mitral, pulmonary and aortic valve function. The apical window allows the measurement of heart chamber dimensions and evaluation of systolic and diastolic parameters. It also allows Doppler assessment with detection and quantification of heart valve disturbances (regurgitation or stenosis). Different segments and walls of the left ventricle are visualized throughout all views. Finally, the ascending aorta, aortic arch, and descending aorta can be imaged through the suprasternal window. A combination of ultrasound imaging, Doppler flow and tissue Doppler assessment have been obtained to study cardiac morphology and function. This represents an important contribution to improve the assessment of cardiac function in adult rats with impact for research using these animal models.

A non-invasive protocol for transthoracic echocardiography assessment of cardiac anatomy and function for adult rats is presented in the current study. The heart valves, all four cardiac chambers and the ascending aorta, aortic arch and descending aorta are studied in detail.

成人大鼠心脏解剖与功能的超声心动图评估

The use of experimental animal models has become crucial in cardiovascular science. Most studies using rodent models are focused on two-dimensional ...

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Traditionally, it was believed that the right side of the heart has a minor role in circulation; however, more and more data suggest that right ventricular (RV) function has strong diagnostic and prognostic power in various cardiovascular disorders. Due to its complex morphology and function, assessment of the RV by conventional two-dimensional echocardiography is limited: the everyday clinical practice usually relies on simple linear dimensions and functional measures. Three-dimensional (3D) echocardiography overcame these limitations by providing volumetric quantification of the RV free of geometrical assumptions. Here, we offer a step-by-step guide to obtain and analyze 3D echocardiographic data of the RV using the leading commercially available software. We will quantify 3D RV volumes and ejection fraction. Several technical aspects may help to improve the quality of RV acquisition and analysis as well, which we present in a practical manner. We review the current opportunities and the limiting factors of this method and also highlight the potential applications of 3D RV assessment in current clinical practice.

Here, we provide a step-by-step acquisition and analysis protocol for the 3D volumetric assessment of the right ventricle, mainly focusing on the practical aspects that maximize the feasibility of this technique.

使用3D超声心动图对右心室进行形态学和功能评估

Traditionally, it was believed that the right side of the heart has a minor role in circulation; however, more and more data suggest that right ...

The Use of 3D Echocardiography in Surgical Planning of the Mitral Valve in Pediatric Cardiology

Mitral valve disease in pediatric cardiology is complex and can involve a combination of annular, leaflet, chordae tendineae and papillary muscle abnormalities. Transthoracic two-dimensional echocardiography (2DE) remains the primary diagnostic imaging technique utilized in pediatric surgical planning. However, given that the mitral valve is a three-dimensional (3D) structure, the addition of 3D echocardiography (3DE) to better define the mechanisms of stenosis and/or regurgitation is advantageous. Transthoracic 3DE technology has improved with advances in probe technology and ultrasound scanners, producing images with good spatial resolution and adequate temporal resolution. Specifically, the addition of pediatric 3D transducers with higher frequencies and a smaller footprint provides better 3DE imaging in children. Improved efficiency of 3DE acquisition and analysis allow 3D assessment of the mitral valve to be more easily integrated by the sonographer, the cardiologist and the surgeon in mitral valve assessment. This improvement was also made possible by the postprocessing software optimization.
In this method paper, we aim to describe the transthoracic 3DE assessment of the mitral valve in children and its use in the surgical planning of pediatric mitral valve disease. Firstly, the 3DE assessment begins by selecting the correct probe and by obtaining a view of the mitral valve. Then, the appropriate data acquisition method should be selected based on the individual patient. Next, optimization of the data set is critical in order to properly balance spatial and temporal resolution. During live scanning or following acquisition, the data set can be cropped using innovative tools that allow the user to quickly obtain an infinite number of cut planes or volumetric reconstructions. The cardiologist and surgeon can view the mitral valve en face; thus, accurately reconstructing its morphology in order to support medical or surgical planning. Finally, a review of some clinical applications is proposed, showing examples in pediatric mitral valve managements.

3D echocardiography of the mitral valve in pediatric cardiology produces full anatomic reconstructions that contribute to improved surgical management. Here, we outline a protocol for 3D acquisition and post-processing of the mitral valve in pediatric cardiology.