Mês: agosto 2013

Experts and Beginners Benefit from Three-Dimensional Echocardiography: A Multicenter Study on the Assessment of Mitral Valve Prolapse
Journal of the American Society of Echocardiography
Issue: Volume 26(8), August 2013, p 828–834

Hien, Maximilian Dominik MDa,b,d; Grogasteiger, Manuel Cand Meda,dß; Rauch, Helmut MDd; Weymann, Alexander MDc; Bekeredjian, Raffi Prof, MDe; Rosendal, Christian MDf,*
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Background:: Three-dimensional (3D) transesophageal echocardiography (TEE) has been claimed to provide more information than two-dimensional (2D) TEE in the localization of mitral valve prolapse (MVP). However, most studies have been performed by experts in echocardiography, without accounting for differences in training or expertise. This multicenter study was designed to assess the differences between experts and inexperienced echocardiographers in localizing MVP and ruptured chordae tendineae using 2D and real-time 3D TEE.
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Results:: Both study groups scored significantly higher when interpreting 3D transesophageal echocardiographic images (P <= .001). The experts were superior in 2D MVP localization (14.8%; P <= .001), a difference that diminished with 3D TEE (1.4%; P = .41). The benefit of access to 3D information for MVP localization was greater for inexperienced echocardiographers compared with experts (P < .001).
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Conclusions:: The reported diagnostic advantage of 3D TEE over 2D TEE in MVP assessment for expert echocardiographers can be transferred to inexperienced echocardiographers. Inexperienced echocardiographers benefit from the technology to a greater extent than their expert colleagues.
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O blog alerta que o tridimensional será uma ferramente de igualdade entre os ecocardiografistas de todas as idades.

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Three-Dimensional Echocardiography in Mitral Valve Prolapse: Could Technology Replace Experience?
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Beraud, Anne-Sophie MD,Division of Cardiovascular Medicine, Stanford University Medical Center, 300 Pasteur Drive, Stanford, California
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In conclusion, should every echocardiographer buy high-end ultrasound platforms and 3D transesophageal transducers to improve his or her analysis of the mitral valve? If universal access to 3D were possible, it might improve the accuracy of mitral valve assessment at all levels of operators’ expertise and facilitate the echocardiographic learning process
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O blog EchoTalk insisti nessa afirmação há anos! Vejam aqui, e aqui e também aqui

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Get Closer to the Diagnosis in a Flash
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Circulation: Cardiovascular Imaging
Issue: Volume 5(2), March 2012, p 280–282
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A 15-year-old girl of Middle East origin was seen by a pediatrician because of suspected pituitary nanismus.
She had no cardiopulmonary symptoms, but the examination revealed a large nonobstructive, mobile, and apparently multicystic mass in the right ventricle.
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All blood tests were normal including her infectious parameters, and she did not have serum antibodies to any Echinococcus species. An FDG PET-CT scan did not show any particular FDG activity in the mass. Cardiac magnetic resonance showed no signs of tumor infiltration into the myocardium, a feature supporting the suggestion of a benign tumor (Figure 3). It was decided to perform a flash-contrast echocardiography to elucidate the vascularity of the mass and the cyst-like structures (Figure 4). For the contrast echocardiography, a Vivid 7 (GE, Horten, Norway) ultrasound scanner was used, equipped with a 2.5-MHz probe. The echocontrast agent (Sonovue, Bracco, Inc, Milan, Italy; diluted in 10 mL isotonic sodium chloride) was administered intravenously with isotonic sodium chloride (approximately 250 mL/h) at constant rate (approximately 1 mL/min), which kept the contrast dissolved during the infusion. The scanner was adjusted to a low mechanical index to diminish contrast disruption, followed by short bursts of high mechanical index to destroy the contrast in the field of view, including the tumor (Figure 3B). During 15 consecutive heart beats, the perfusion in the tumor was semiquantitatively assessed by comparing contrast replenishment in the interventricular septum with contrast replenishment in the tumor.
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