Left ventricular volume and endocardial surface area by three-dimensional echocardiography: comparison with two-dimensional echocardiography and nuclear magnetic resonance imaging in normal subjects

J Am Coll Cardiol. 1993 Jul;22(1):258-70. doi: 10.1016/0735-1097(93)90842-o.


Objectives: We evaluated a three-dimensional echocardiographic method for ventricular volume and surface area determination that uses polyhedral surface reconstruction. Six to eight nonparallel, unequally spaced, nonintersecting short-axis planes were positioned with a line of intersection display to overcome limitations associated with two-dimensional echocardiography.

Background: Two-dimensional echocardiographic methods of ventricular volume and surface area determination are limited by assumptions about ventricular shape and image plane position.

Methods: Left ventricular end-diastolic and end-systolic volumes and endocardial surface areas determined by three-dimensional echocardiography and nuclear magnetic resonance (NMR) imaging were compared in 15 normal subjects (7 men, 8 women, aged 23 to 41 years, body surface area 1.38 to 2.17 m2). Ten of these subjects also underwent two-dimensional echocardiography; and end-diastolic and end-systolic volumes were determined by the apical biplane summation of discs method and compared with results of NMR imaging.

Results: Interobserver variability was 5% to 8% for three-dimensional echocardiography and 6% to 9% for NMR imaging. Both methods were in close agreement on end-diastolic volume (r = 0.92, SEE = 6.99 ml) and end-systolic volume (r = 0.81, SEE = 4.01 ml) and on end-diastolic surface area (r = 0.84, SEE = 8.25 cm2) and end-systolic surface area (r = 0.84, SEE = 4.89 cm2). Three-dimensional echocardiography and NMR imaging correlated significantly better for end-diastolic volume (r = 0.90, SEE = 7.0 ml) and end-systolic volume (r = 0.88, SEE = 3.1 ml) than did two-dimensional echocardiography and NMR imaging (r = 0.48, SEE = 20.5 ml for end-diastolic volume; r = 0.70, SEE = 5.6 ml for end-systolic volume).

Conclusions: Three-dimensional echocardiography is an in vivo method of measuring left ventricular end-diastolic and end-systolic volumes and endocardial surface area with results comparable to those of NMR imaging. Additionally, three-dimensional echocardiography is superior to the two-dimensional echocardiographic apical biplane summation method because the technique eliminates geometric assumptions and image plane positioning error.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Echocardiography / methods*
  • Endocardium / anatomy & histology
  • Endocardium / diagnostic imaging
  • Female
  • Heart Ventricles / anatomy & histology*
  • Heart Ventricles / diagnostic imaging*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Male
  • Stroke Volume