LEFT-VENTRICULAR VOLUME AND ENDOCARDIAL SURFACE-AREA BY 3-DIMENSIONALECHOCARDIOGRAPHY - COMPARISON WITH 2-DIMENSIONAL ECHOCARDIOGRAPHY ANDNUCLEAR-MAGNETIC-RESONANCE IMAGING IN NORMAL SUBJECTS

Objectives. We evaluated a three-dimensional echocardiographic method for ventricular volume and surface area determination that uses polyhe dral surface reconstruction. Six to eight nonparallel, unequally space d, nonintersecting short-axis planes were positioned with a line of in tersection display to overcome limitations associated with two-dimensi onal echocardiography. Background. Two-dimensional echocardiographic m ethods of ventricular volume and surface area determination are limite d by assumptions about ventricular shape and image plane position. Met hods. Left ventricular end-diastolic and end-systolic volumes and endo cardial surface areas determined by three-dimensional echocardiography and nuclear magnetic resonance (NMR) imaging were compared in 15 norm al subjects (7 men, 8 women, aged 23 to 41 years, body surface area 1. 38 to 2.17 m2). Ten of these subjects also underwent two-dimensional e chocardiography; and end-diastolic and end-systolic volumes were deter mined by the apical biplane summation of discs method and compared wit h results of NMR imaging. Results. Interobserver variability was 5% to 8% for three-dimensional echocardiography and 6% to 9% for NMR imagin g. Both methods were in close agreement on end-diastolic volume (r = 0 .92, SEE = 6.99 ml) and end-systolic volume (r = 0.81, SEE = 4.01 ml) and on end-diastolic surface area (r = 0.84, SEE = 8.25 cm2) and end-s ystolic surface area (r = 0.84, SEE = 4.89 CM2) . Three-dimensional ec hocardiography and NMR imaging correlated significantly better for end -diastolic volume (r = 0.90, SEE = 7.0 ml) and end-systolic volume (r = 0.88, SEE = 3.1 ml) than did two-dimensional echocardiography and NM R imaging (r = 0.48, SEE = 20.5 ml for end-diastolic volume; r = 0.70, SEE = 5.6 ml for end-systolic volume). Conclusions. Three-dimensional echocardiography is an in vivo method of measuring left ventricular e nd-diastolic and end-systolic volumes and endocardial surface area wit h results comparable to those of NMR imaging. Additionally, three-dime nsional echocardiography is superior to the two-dimensional echocardio graphic apical biplane summation method because the technique eliminat es geometric assumptions and image plane positioning error.