3-DIMENSIONAL ECHOCARDIOGRAPHY USING A TRANSESOPHAGEAL IMAGING PROBE - POTENTIALS AND TECHNICAL CONSIDERATIONS

Appreciation of three-dimensional relationships could be useful in car diac diagnosis, decision making and planning of surgery. However, curr ent ultrasound techniques provide only two-dimensional views. A recent ly developed echocardiographic computerized tomography unit allows rec onstruction of three-dimensional images from a series of transoesophag eal slices. To evaluate the potentials and limitations of this techniq ue we performed echo computer tomographic examinations in 104 patients with a total number of 227 scans. All but two patients tolerated the procedure well and no serious complications were encountered. Indicati ons for echo computer tomography included coronary artery disease, val vular heart disease, atrial masses, myocardial infarction, mitral and aortic valve replacement, aortic aneurysm and congenital defects. Most of the anatomical structures could be visualized with the best result s obtained for the left atrium, the left ventricular outflow tract and the aortic and mitral valve apparatus. However, a variety of technica l factors must be considered to achieve optimal results and to avoid m isinterpretation. In 86% of patients the underlying pathology could be visualised by echo-computed tomography, particularly con genital defe cts such as those of the atrial or ventricular septa, but mitral valve pathologies provided the best results. Tn these cases three-dimension al imaging led to a better perception and understanding of structural relationships. In conclusion, despite current limitations in data acqu isition, processing and computing power, echo computer tomography has the potential to provide relevant information in selected clinical set tings.