Volume Measurement of the Left Ventricle in Children Using Real- Time Three-Dimensional Echocar- diography: Comparison With Ven- triculography

OBJECTIVES: Recently, a real-time three-dimensional echocardiography (RT3DE) volume scanning technique was developed and used clinically. For precise ventricular volumetry, independent of mathematical assumptions, imaging techniques such as three-dimensional echocardiography are required in children with heart disease. This study evaluated whether RT3DE is suitable for left ventricular volumetry in children, and whether left ventricular volumes measured by RT3DE correlate sufficiently well with those measured by left ventriculography (LVG). METHODS: Twenty-five children with heart disease, 17 boys and 8 girls aged from 8 months to 18 years (mean age 5.9 +/- 5.3 years), underwent cardiac catheterization at our institution. RT3DE was performed within 30 min after LVG using the Philips SONOS 7500 ultrasound system with an electronic sector probe consisting of a X 4 matrix phased array transducer (center frequency of 2-4 MHz). Ultrasound images of the ventricle were calculated offline using TomTec 4D Cardio-View RT 1.2 software. Left ventricular volumes by LVG were calculated using Siemens Hicor T.O.P. Finally, the left ventricular volumes by RT3DE and LVG were compared. RESULTS: Left ventricular volumes measured by RT3DE correlated and agreed well with those measured by LVG(r = 0.996, Y = 0.566 + 0.964 X, mean difference -0.29 +/- 1.90ml; left ventricular end-systolic volume, r = 0.979, Y=-0.187 + 0.897 X, mean difference -6.76 +/- 10.58ml; left ventricular end-diastolic volume). CONCLUSIONS: RT3DE is suitable for left ventricular volumetry in children. There was a good correlation between RT3DE and LVG, but the volume of left ventricular end-diastolic volume estimated by RT3DE was smaller than that by LVG.