DYNAMIC 3-DIMENSIONAL ECHOCARDIOGRAPHIC ASSESSMENT OF INTRACARDIAC BLOOD-FLOW JETS

Transthoracic dynamic 3-dimensional reconstruction of the heart with t issue depiction has been proved to be feasible when using various meth ods of data acquisition. The same method can theoretically be applied to color Doppler flows to generate dynamic 3-dimensional images of int racardiac blood flow lets. To explore the feasibility of this approach , we studied 41 patients with various valvular disorders or intracardi ac shunts. We acquired sequential 2-dimensional images along with colo r Doppler information using rotational scanning from a transthoracic o r a subcostal window. Images were digitized and processed for 3-dimens ional reconstruction using dedicated software. After adequate segmenta tion, the flow lets were displayed in 3 dimensions in a gray scale for mat. With use of this approach, 3-dimensional reconstruction of color Doppler flows was possible in all but 1 patient. Still frames allowed immediate appreciation of the shape of the jets, their location in the cardiac chambers, and their size related to that cavity. Dynamic disp lay was even more striking by showing the flow in real time. Dynamic 3 -dimensional images enabled visualization of flow jets in projections not available in conventional color flow Doppler, looking directly at the views of shunt and regurgitant flows, and also permitted 3-dimensi onal delineation of flow convergence zones. We conclude that dynamic v isualization of various intracardiac flows in 3 dimensions using trans thoracic echocardiography is possible. it provides a better understand ing of the shape and size of the jets, and can potentially aid in flow quantification by displaying the actual shape of flow convergence reg ions.