Quantitative three-dimensional wall motion analysis predicts ischemic region size and location.

Stress echocardiography is an important screening test for coronary artery disease. Currently, cardiologists rely on visual analysis of left ventricular (LV) wall motion abnormalities, which is subjective and qualitative. We previously used finite-element models of the regionally ischemic left ventricle to develop a wall motion measure, 3DFS, for predicting ischemic region size and location from real-time 3D echocardiography (RT3DE).

Region-based endocardium tracking on real-time three-dimensional ultrasound.

Matrix-phased array transducers for real-time 3-D ultrasound enable fast, noninvasive visualization of cardiac ventricles. Typically, 3-D ultrasound images are semiautomatically segmented to extract the left ventricular endocardial surface at end-diastole and end-systole. Automatic segmentation and propagation of this surface throughout the entire cardiac cycle is a challenging and cumbersome task.

Model-based screening of wall motion measures for detection of ischemia in three-dimensional cardiac images.

Quantitative measurement of left ventricular wall motion can improve clinical diagnosis by providing a more objective approach than qualitative analysis, which is subject to large inter-observer variability. We have developed novel techniques for quantifying left ventricular wall motion in three-dimensional image data sets. In this study, finite element models simulating regional ischemia in the left ventricle were used to screen potential wall motion measures for their capability to detect and evaluate the size of an ischemic region.

Dynamic cardiac information from optical flow using four dimensional ultrasound.

Quantitative analysis of cardiac motion is of great clinical interest in assessing ventricular function. Real-time 3-D (RT3D) ultrasound transducers provide valuable three-dimensional information, from which quantitative measures of cardiac function can be extracted. Such analysis requires segmentation and visual tracking of the left ventricular endocardial border.

Feasibility of using a real-time 3-dimensional technique for contrast dobutamine stress echocardiography.

This is the first feasibility study using real-time 3-dimensional (3D) (RT3D) transthoracic contrast echocardiography with full-volume acquisition to evaluate left ventricular wall motion in patients undergoing dobutamine stress echocardiography. RT3D contrast and noncontrast 3D images were obtained at rest and peak dose dobutamine infusion and reviewed for image quality. A total of 14 patients underwent complete rest and stress RT3D contrast and noncontrast imaging.

Parameterization of left ventricular wall motion for detection of regional ischemia.

While qualitative wall motion analysis has proven valuable in clinical cardiology practice, quantitative analyses remain too time-consuming for routine clinical use. Our long-term goal is therefore to develop automated methods for quantitative wall motion analysis. In this paper, we utilize a finite element model of the regionally ischemic canine left ventricle to demonstrate a new approach based on parameterization of the left ventricular endocardial surface in prolate spheroidal coordinates.