3D transesophageal echocardiography accurately quantified mitral regurgitant volume, underestimating it by only 1.2% compared to MRI, whereas 2D TEE underestimated it by 21.3%.
Cross-Sectional (n=30)
Does 3D TEE improve the accuracy of mitral regurgitation quantification compared to 2D TEE, using MRI as a reference, in patients with mitral regurgitation?
3D TEE is more accurate than 2D TEE for quantifying mitral regurgitation severity, closely matching MRI reference measurements and reducing underestimation.
BACKGROUND: quantification of mitral regurgitation severity with 2-dimensional (2D) imaging techniques remains challenging. The present study compared the accuracy of 2D transesophageal echocardiography (TEE) and 3-dimensional (3D) TEE for quantification of mitral regurgitation, using MRI as the reference method. METHODS AND RESULTS: two-dimensional and 3D TEE and cardiac MRI were performed in 30 patients with mitral regurgitation. Mitral effective regurgitant orifice area (EROA) and regurgitant volume (Rvol) were estimated with 2D and 3D TEE. With 3D TEE, EROA was calculated using planimetry of the color Doppler flow from en face views and Rvol was derived by multiplying the EROA by the velocity time integral of the regurgitant jet. Finally, using MRI, mitral Rvol was quantified by subtracting the aortic flow volume from left ventricular stroke volume. Compared with 3D TEE, 2D TEE underestimated the EROA by a mean of 0.13 cm(2). In addition, 2D TEE underestimated the Rvol by 21.6% when compared with 3D TEE and by 21.3% when compared with MRI. In contrast, 3D TEE underestimated the Rvol by only 1.2% when compared with MRI. Finally, one third of the patients in grade 1 and ≥50% of the patients in grade 2 and 3, as assessed with 2D TEE, would have been upgraded to a more severe grade, based on the 3D TEE and MRI measurements. CONCLUSIONS: quantification of mitral EROA and Rvol with 3D TEE is feasible and accurate as compared with MRI and results in less underestimation of the Rvol as compared with 2D TEE.
Shanks et al. (2010) conducted a cross-sectional in Mitral regurgitation (n=30). 3D transesophageal echocardiography (TEE) vs. 2D TEE and cardiac MRI was evaluated on Accuracy of mitral effective regurgitant orifice area (EROA) and regurgitant volume (Rvol) quantification. 3D transesophageal echocardiography accurately quantified mitral regurgitant volume, underestimating it by only 1.2% compared to MRI, whereas 2D TEE underestimated it by 21.3%.
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