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What is 4d echo cardiology?

Phillip D’Amato

What is 4d echo cardiology?

Today both 3d echo and 4d echocardiography have brought profound change to the field of echocardiography. They are very similar in how the data sets are obtained, however, there are fundamental differences between the two respective modalities

4d echocardiography used the added perspective of motion to depict a cinematic type viewing experience of the ultrasound.

What is 4D echo cardiology?

3D echo was invented by Olaf Van Ramm and Stephen Smith at Duke University in 1987.4d echo must follow the same standard rules as 3D echo in order for the technology to produce useful images.

4D echo uses a patented GE technique to produce the images of fetal or adult heart.Specifially,Spaital Temporal imaging correlation performs triggering automatically and allows b mode technique to capture images of the cardiac cycle(Szymkiewicz ,2008)

Technical 4D echo The fetal heart has been a area that has

undergone tremendous study with 4D echocardiolgy.The fetal heart beats very fast so STIC is required to be able to perform these exams. For example, for a volume acquisition time of ten seconds, at the angle of 25 degrees 1500 b mode images are stored in a pyramidal fashion(Szymkiewicz , 2008).STIC algorithm smoothes out the fetal heart and produces only images of the same cycle are incorporated in the data set (Szymkiewicz ,2008)

Technical 4D echo.

Cardiac volumes with motion are mainly comprised of 1000 2D images which allow for heart beat to be displayed in real time cardiac motion (Szymkiewicz 2008).The main caveat to note is the better the 2D image the better volume dataset can be obtained for the clinician.

Rendering of the images is also important to produce good 4d datasets. Rendering allows for a spatial 3d image of the heart.

4D echo in fetal patients .

Fetal echo is tailor made for 4D echocardiology.4D echo cardiology allows for the user to change and select alternatives views that would difficult to achieve via traditional two dimensional echo.

For example, fetal echo patients have very complex congenital disorders that would be impossible to fully visualize with 2d echo.

4D core clinical areas.

1. Fetal echocardiography.

2.Congential Heart Disease.

3.Quantification.

Stress echocardiography.

Fetal echocardiography.

4D echo has become the premier method of assessing heart disease in fetal echo. The ability of this technology to provide clear views and show real time anatomical data form any vantage point has made it the go to option in assessing fetal heart disease.

The added advantage is that images can be improved or processed off line.

Congenital Heart disease.4D echo is currently undergoing daily software

and image experimentation in the field ASD repair.

One area that is undergoing experimentation is tracking algorithm of atria sepal defect rim motion during repair. Researchers have begun work on the block flow technique.

Block flow uses energy computation for the velocity estimation for the entire block of data and not just the voxel(Marius ,et al 2007)

Congenital heart disease.Block matching gives the coarse velocity ,that

is common for all voxels(Marius, et al 2007).This method is considerable faster than previous methods and produces greater quality images.

This is still a technological work in progress but preliminary data looks promising.

4D ECHO in Quantification.

4d echo has also begun to be used to calculate strain and other forms of left ventricle output.

4d echo strain uses a patented technique to track acoustic markers over time in naturally moving myocardial tissue(Heidal )The technique will use all bulls eye display to display the motion of tissue over time.

4d echo Quantification. Research on 4D echo in myocardial strain has

very promising in recent years.

4D echo uses the concept called Drift to assess if any errors of tracking are present(Heimdal ).

4D strain tool from GE has been clinically validated in a study using 22 datasets(Heimdal).

4D echo in stress echo.

Researchers have also begun to just to start exploring the potential use of this technolgy.There is a great advantage in using this technique due to the fast acquisition and ability to due post processing.

References.Marius ,George; Vasiliyev, Nikolay,Vasiliyev;Marx, Gerald;

et al.(2008).Fast blood flow tracking of atria septal defects in 4d echocardiography.Medical image analysis .12,397-412.

Szymkiewicz,Joanna. (2008).3D/4d echocardiography STIC.Journal of ultrasound obstetrics and Gynecology. 2(4):22-28.

Heimdal, Andreas.4D strain. Advanced research application for quantitative echocardiography.