Background

Intervendor consistency of left ventricular (LV) volume measurements using three-dimensional transthoracic echocardiography (3DTTE) has never been reported. Accordingly, we designed a prospective study to (1) compare head-to-head the accuracy of three three-dimensional echocardiography (3DE) systems in measuring LV volumes and ejection fraction (EF) against cardiac magnetic resonance (CMR); (2) assess the intervendor variability of LV volumes and EF; and (3) compare the accuracy of fully automated versus semiautomated (i.e., manually corrected) methods of LV endocardial delineation against CMR.

Methods

We studied 92 patients (64% males, 52 years [95% CI, 20-83]) with a wide range of end-diastolic volumes (from 87 to 446 mL) and EFs (from 16% to 77%) using three different 3DE platforms (iE33; Vivid E9; Acuson SC2000) during the same echo study. CMR was performed within 3 ± 5 hours from the 3DE study in 35 patients.

Results

LV volumes provided by the three 3DE systems correlated with CMR volumes: end-diastolic volume (iE33: R² = 0.93; E9: R² = 0.94; SC2000: R² = 0.94), end-systolic volume (iE33: R² = 0.93; E9: R² = 0.95; SC2000: R² = 0.94), and EF (iE33: R² = 0.79; E9: R² = 0.80; SC2000: R² = 0.77). In the 92 patients studied, LV volumes and EFs measured with the three systems were similar. Use of fully automated endocardial border detection algorithms significantly underestimated LV volumes, and the degree of underestimation was higher with larger LV volumes.

Conclusions

LV volumes and EFs measured with the three 3DE systems are consistent. Fully automated algorithms underestimated LV volumes. Our findings may help in the clinical interpretation of LV parameters obtained using different 3DE systems and encourage the clinical use of 3DTTE.

中文翻译：

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使用三维超声心动图测量左心室容积的供应商一致性和准确性

背景

从未报道过使用三维经胸超声心动图（3DTTE）测量左心室（LV）体积的供应商一致性。因此，我们设计了一项前瞻性研究，以（1）面对面地比较三种三维超声心动图（3DE）系统在测量LV体积和射血分数（EF）对抗心脏磁共振（CMR）时的准确性；（2）评估左心室容积和EF的供应商间变异性；（3）比较针对CMR的LV心内膜描记的全自动与半自动化（即，手动校正）方法的准确性。

方法

我们使用三种不同的方法研究了92例患者（男性64％，52岁[95％CI，20-83]）的舒张末期容积（从87到446 mL）和EFs（从16％到77％）广泛在相同回波研究期间的3DE平台（iE33； Vivid E9； Acuson SC2000）。在3DE研究之后的3±5小时内，对35例患者进行了CMR。

结果

由三个3DE系统提供的LV容积与CMR容积相关：舒张末期容积（iE33：R ²  = 0.93; E9：R ²  = 0.94; SC2000：R ²  = 0.94），收缩末期容积（iE33：R ²  = 0.93； E9：R ²  = 0.95； SC2000：R ²  = 0.94）和EF（iE33：R ²  = 0.79； E9：R ²  = 0.80； SC2000：R ² = 0.77）。在研究的92位患者中，使用这三种系统测得的左室容量和EF相似。全自动心内膜内膜边界检测算法的使用大大低估了左室容积，而低左室容积则低估程度更高。

结论

用三个3DE系统测得的LV体积和EF一致。全自动算法低估了LV量。我们的发现可能有助于使用不同3DE系统获得的LV参数的临床解释，并鼓励3DTTE的临床使用。