Three-dimensional Doppler - Techniques and clinical applications

Aims Colour Doppler is the most widely used technique for assessing valve d isease, but eccentric regurgitant jets cannot be visualized and measured by conventional 2D techniques. We have developed a new procedure for three-di mensional (3D) reconstruction of colour Doppler signals. Methods and Results Fifty patients with mitral regurgitation underwent tran soesophageal echocardiography and 3D acquisition. The severity of mitral re gurgitation was assessed by angiography and the regurgitant volumes were me asured by pulsed Doppler. The jet areas were calculated by planimetry from conventional colour Doppler, the jet volumes were obtained by 3D Doppler. A higher degree of mitral regurgitation was found in the patients with eccen tric jets. While jet areas showed poor correlation with regurgitant volumes (r = 0.61), jet volumes correlated significantly with regurgitant volumes (r = 0.93; P < 0.001). While jet areas failed to identify patients with dif ferent grades of regurgitation, jet volumes could so discriminate. Conclusions 3D Doppler revealed new patterns of regurgitant flow and allowe d a more accurate semiquantitative assessment of complex asymmetrical regur gitant jets. Three-dimensional colour Doppler has a great potential for bec oming a reference method for the assessment of patients with heart valve di sease.