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3D Mode Hemodynamics
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Education>Expert TTE>Quantitative Assessment and Hemodynamics>3D Mode Hemodynamics>1
Quantitative 3D Echocardiography
3D Echocardiography allows quantitation, currently, by measuring diameters, and areas from 3D images and offline calculation of volumes from automatic border detection from a 3D volume set.
Real-time measurements of diameters and areas are possible (offline also) of 3D images. For example, measurement of the LVOT diameter by 2D is typically done in the parasternal long axis view. However, calculating the LVOT area by measuring the LVOT diameter assumes a circular LVOT. Studies of the LVOT anatomy have shown that the LVOT is more ovoid than circular and the most accurate measurement of the LVOT area is by directly tracing the LVOT area by a 3D imageGet References. Calculating the LVOT area by a single diameter assumes a circular LVOT area. Direct measurement of the LVOT area should be more accurate.

Offline measuring the left ventricular volume by 3D by automatic border detection allows the calculation of the LVEDV, LVESV, SV, and LVEF. Doppler measurements do not have to be performed or tedious drawing of the left ventricular volume when using the Method of Discs to calculate left ventricular volumes.
Other measurements from a 3D echocardiography exam are the synchronization of the left ventricle. If the left ventricular contraction is not synchronized, then unsynchronized contractions between opposing walls can rob the left ventricle of performance and ejection fraction. Typically, the #3 (mid-septal) and #6 (mid-lateral) segments are synchronized. If there is a marked delay between the onset of contraction from the #3 segment and the #6 segment then the left ventricular contraction is not synchronized which results in decreased ejection fraction of the left ventricle despite good wall motion for each segment.
Also, parametric reports can be elucidated from the 3D echocardiography exam. A parametric report will have a report on the onset of contraction (the timing report) and the degree of excursion (the excursion report). The excursion report will indicate which segments and to what degree they exhibit segmental wall motion. The timing report will indicate the onset of excursion and the synchronicity of the onset of that timing event for each segment.
Lastly, the mitral valve can be evaluated off line for various measurements after performing a tedious offline analysis of the mitral valve. Measurements of the mitral valve annulus, annular shape, leaflet area, prolapsing volume, and more can be performed.
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