Burgan, S.

Lerch, R.

Ricou., F.

Rutishauser, W.

Vuille, C.

Weber, F.

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Three- and Four-Dimensional Cardiovascular Ultrasound ImagingC. Vuille, R. Lerch, F. Ricou. S. Burgan, F. Weber, W. RutishauserCardiology Center, University Hospital, Ceneva, SwitzerlandAmong the clinical appl icat ions ofu l t rasound in medicine, echocardio-graphy has evolved to becorae the mostcommonly used diagnostic method incardiology. Multiple -two-dimensional(2D) slices of the heart are obtained inorder to f ully assess the card iacst ructures . This method howeverrequires that the examiner performs amental three-dimensional (3D) recon-struction of the heart to integrate 2Dimages recorded in various planes. Real3D reconstruction should allow for directvisualization of the cotnplex anatomy ofthe heart, thereby helping to assessvarious cardiac abnormalities, even fornon-specialists.Until recently a t tempts to obtain 3Dimages of the heart were hampered bythe difficulty to record good quali tyimages throughout several cardiaccycles with accurate spatial location andto account for respiration. In additionsuch methods were extremely labor-intensive, and display of 3D "images11were unsatisfactory.We have used a recently developedprogram for 3D reconstruction of theheart (TomTec, Münich, Gerraany) basedon images sequences acquired bytransesophageal echocardiography witha commercially available u l t rasoundSystem (Hewle t t -Packard , Andover,U.S.A.). Images of the heart wereacquired from a fixed point using atransesophageal probe with a 5MHzphased-array rotating transducer at thetip, under ECG- and respiration-gating.Data of a complete cardiac cycle wererecorded every 2' d u r i n g a 180*computer-controlled rotational scan,They were t ransferred online to theComputer and digitized. The procedureadded only 3 to 5 min to the normaldurat ion of a diagnostic transesophagealstudy.3D reconstruction was then performedoff-line. In the spatial region scannedby the u l t rasound beam, backscatterintensity frora each volume element(voxel) was determined to compute a.gray scale volurae. Within this volume,structures of interest could be displayedfrom any point. Image processing alsoallowed for f o u r - d i m e n s i o n a l echo-cardiography, i.e. dynamic display of thestructures throughout the cardiac cycle.thereby providing a better sense ofperspective and an assessment of themotion of cardiac structures.Thus f a r , this approach has provenuseful particularly for the localization ofatrial and ventricular masses, äs well ästhe assessment of valvular morphologyand of ventricular function. Validationof m e a s u r e m e n t of ca rd iac cavityvolumes, without the need for geometrica s s u m p t i o n s äs r e q u i r e d for 2Dechocardiography, is presently inprogress.In conclusion, 3D echocardiography novoffers realist ic d i sp lay of cardiacanatomy and function, and has theP o t e n t i a l f o r h igh ly a c c u r a t equantitation of volurae.Biomedizlni$ch· Technik. Band 39 · Erganzungsband · 1994

Three- and Four-Dimensional Cardiovascular Ultrasound Imaging

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