Taking Command of Three-Dimensional Stitching Artifacts: From an Annoyance to an Easy Tool for Navigating Three-Dimensional Transesophageal Echocardiography

J Am Soc Echocardiogr. 2023 Jan;36(1):105-110. doi: 10.1016/j.echo.2022.09.013. Epub 2022 Sep 26.

Abstract

Despite many recent advances in three-dimensional (3D) transesophageal echocardiography (TEE) imagining, the process of orienting 3D TEE images is nonintuitive and uses assumptions based on idealized anatomy. Correlating two-dimensional TEE cross-sectional images to 3D reconstructions remains an additional challenge. In this article, we suggest the repurposing of the stitching artifact generated in 2-beat electrocardiogram-gated 3D TEE as a means of exactly orienting 3D images within a patient's unique anatomy. We demonstrate the application of this strategy to assess a normal mitral valve to localize scallops of mitral valve prolapse and to visualize typical left atrial appendage two-dimensional cuts in a 3D space. By taking command of stitching artifacts, cardiac imagers can successfully navigate the complex structures of the heart for optimal, individualized echocardiographic views.

Keywords: 3D TEE; Artifact; Image processing; Stitching.

MeSH terms

  • Artifacts
  • Echocardiography, Three-Dimensional* / methods
  • Echocardiography, Transesophageal / methods
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve Prolapse* / diagnostic imaging
  • Mitral Valve Prolapse* / surgery