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Three-Dimensional Transesophageal Echocardiography (TEE) and Other Future Directions - 05/09/11

Doi : 10.1016/S0733-8651(05)70186-7 
K. Gunasegaran, MD a, c, Jiefen Yao, MD a, c, Stefano De Castro, MD d, H. Joachim Nesser, MD e, Natesa G. Pandian, MD a, b, c
a Departments of Medicine (KG, JY, NGP) 
b Radiology (NGP), Tufts University School of Medicine 
c Cardiovascular Imaging and Hemodynamic Laboratory, New England Medical Center (KG, JY, NGP), Boston, Massachusetts 
d Department of Clinical Medicine, “La Sapienza” University of Rome, Rome, Italy (SD) 
e Second Department of Medicine, General Hospital of Elisabethinen, Linz, Austria (HJN) 

Resumen

Transesophageal echocardiography (TEE) first came onto the scene in the early 1970s.31, 91, 95 As a diagnostic modality, it was a new method that allowed the heart to be viewed with better image quality than conventional transthoracic echocardiography. For the first time, the images obtained could be viewed with less attenuation because of shadowing from structures, such as the lung, bone, and soft tissue. The facility to perform Doppler presented the clinician with the ability to functionally assess the hemodynamics and flow disorders in greater detail.31 As much as this advance changed the face of echocardiography, it is still essentially a two-dimensional mode of imaging and is limited in portraying the three-dimensional human heart anatomically. Every facet of the heart, its pathology, and function are three-dimensional in nature. Two-dimensional echocardiography is limited in providing a clear uninhibited look at the heart in all views. It was left to the examiner to mentally form a three-dimensional picture of the heart from all the data obtained from the two-dimensional images. A method was needed that could visualize the heart in a three-dimensional format.

An attempt to develop three-dimensional imaging was first undertaken in the early 1970s.29, 69 In its infancy, three-dimensional echocardiography was used mainly to measure left ventricular volumes using manual tracing methods from multiple cross-sectional images.3, 63 Three-dimensional echocardiography was laborious and time-consuming initially, but soon it was realized that the potential of three-dimensional echocardiography was an opportunity waiting to be harnessed.49, 81, 85 Although three-dimensional echocardiography can be performed by way of transthoracic and transesophageal methods, the improved image resolution obtained from TEE makes it much more useful for three-dimensional image reconstruction, the quality of which is dependent on the raw two-dimensional images.11 Today, three-dimensional TEE is emerging as an extremely useful imaging tool with a multitude of clinical applications.82, 94, 101, 104, 105, 109

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 Address reprint requests to Natesa G. Pandian, MD, Tufts–New England Medical Center, Box 32, 750 Washington Street, Boston, MA 02111, e-mail: npandian@lifespan.org


© 2000  W. B. Saunders Company. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 18 - N° 4

P. 893-910 - novembre 2000 Regresar al número
Artículo precedente Artículo precedente
  • Transesophageal Echocardiography (TEE) in Congenital Heart Disease with Focus on the Adult
  • Wanda C. Miller-Hance, Norman H. Silverman

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