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Comparison of real time 3-dimensional echocardiography with cardiovascular magnetic resonance for left ventricular volumetric assessment - a real world study
© Miller et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
To assess the accuracy and reproducibility of real time 3-dimensional echocardiography (RT3DE) for left ventricular (LV) volumetric assessment in consecutive, unselected patients.
The accuracy and reproducibility of RT3DE for LV volumetric assessment has been demonstrated in a number of clinical trials. We aimed to assess the 'real-world' accuracy and reproducibility of RT3DE in consecutive, unselected patients.
Sixty patients undergoing clinically indicated cardiac magnetic resonance imaging (CMR) also underwent RT3DE. CMR images were obtained using a 1.5 T scanner (Siemens Avanto, Germany) equipped with a 32-channel surface coil. RT3DE images were obtained using an IE33 scanner (Philips, USA). LV volumes and ejection fraction (EF) were measured by 2 independent observers for both modalities. RT3DE measurements were compared to those obtained by CMR. Inter-observer reproducibility was assessed, and 25% of scans were re-analysed to assess intra-observer reproducibility. RT3DE image quality was independently graded as good, adequate and non-analysable.
Mean difference +/- SD (%)
95% limits of agreement (%)
Range of Bland-Altman Limits of agreement (%)
RT3DE versus CMR
-2.0 +/- 4
-9 to 5
-0.5 +/- 9
-19 to 18
RT3DE Inter-observer reproducibility
1.2 +/- 3
-5 to 7
-1.2 +/- 6
-13 to 10
RT3DE Intra-observer reproducibility
0.1 +/- 2
-4 to 4
0.5 +/- 4
-7 to 8
In this real-world study, RT3DE LV volumetric assessment was comparable to CMR when RT3DE image quality was good. However, image quality was good in only 22% of patients. In the remaining 78%, image quality was such that RT3DE assessment was either not possible or accuracy and reproducibility were significantly lower. Because CMR can obtain good image quality in a greater proportion of patients, it remains the gold standard for LV volumetric assessment.
This article is published under license to BioMed Central Ltd.