INCREMENTAL VALUE OF 3-DIMENSIONAL ECHOCARDIOGRAPHY OVER TRANSESOPHAGEAL MULTIPLANE 2-DIMENSIONAL ECHOCARDIOGRAPHY IN QUALITATIVE AND QUANTITATIVE ASSESSMENT OF CARDIAC MASSES AND DEFECTS

In the present study, we compared three-dimensionally (3-D) reconstruc ted images with multiplane two-dimensional (2-D) transesophageal echoc ardiographic (TEE) images in 17 patients with various cardiac masses a nd defects. To overcome the problem of making measurements from 3-D re constructed images, we carefully ''dissected'' the 3-D dataset using p araplane and anyplane 2-D sections, which were then used to obtain the maximum sizes of the cardiac masses and defects. Of the 15 vegetation s and 9 abscesses detected by 3-D TEE in 7 patients, only 8 (53%) vege tations and 4 (44%) abscesses were detected by multiplane 2-D TEE (P < 0.02). Also, the exact anatomical location, shape, geometry, and exte nt of various cardiac masses and defects were more clearly delineated by 3-D than 2-D TEE. The maximum dimensions of cardiac masses and defe cts were larger by 3-D than by 2-D TEE in 17 (89%) of the 19 lesions a vailable for comparison (P < 0.002). In addition, 3-D TEE correlated m ore closely than 2-D TEE when compared to surgical measurements in, th ree patients in whom they were available. Thus, it would appear that i n several instances, the exact size of the cardiac lesion could only b e assessed by analysis of the 3-D volumetric dataset. Our preliminary study has demonstrated the superiority of transesophageal 3-D reconstr uction over multiplane 2-D TEE in both qualitative and quantitative as sessment of various cardiac mass lesions and pathological defects.