Myocardial infarct reconstruction and sizing by three-dimensional echocardiography

Current 2-D echo methods are based on use of geometric assumptions that are likely to be invalid in the presence of infarction. 3-D echo eliminates these assumptions and uses a line of intersection display to position non-parallel, unevenly spaced, non-intersecting images of the ventricle. Chamber boundaries are traced and infarct margins marked. Using a polyhedral surface reconstruction algorithm total endocardial surface area (TESA) and infarct surface area (ISA) are computed. The accuracy of this method was assessed by using a pin model, fixed animal hearts, and in humans, by comparison to magnetic resonance imaging (MRI). Accuracies for TESA and ISA for the pin model were 1.36% and 2.13%, and for the fixed hearts were 1.61% and 3.48%. In 15 normal humans, 3-D TESA correlated very well with MRI TESA with a standard error of the estimate of 8 cm². 3-D echo accurately computes surface areas presented to it by the operator without the use of geometric assumptions