Real-time three-dimensional echocardiography: Technological gadget or clinical tool?

Luigi P. Badano, Erica Dall'Armellina, Mark J. Monaghan, Mauro Pepi, Mara Baldassi, Margherita Cinello, Paolo M. Fioretti

Research output: Contribution to journalArticlepeer-review


The complex anatomy of cardiac structures requires three-dimensional spatial orientation of images for a better understanding of structure and function, thereby improving image interpretation. Real-time three-dimensional echocardiography is a recently developed technique based on the design of an ultrasound transducer with a matrix array that rapidly acquires image data in a pyramidal volume. The simultaneous display of multiple tomographic images allows three-dimensional perspective and the anatomically correct examination of any structure within the volumetric image. As a consequence, it is less operator-dependent and hence more reproducible. Dedicated software systems and technologies are based on high-performance computers designed for graphic handling of three-dimensional images by providing possibilities beyond those obtainable with echocardiography. This methodology allows simultaneous display of multiple superimposed planes in an interactive manner as well as a quantitative assessment of cardiac volumes and ventricular mass in a three-dimensional format without a pre-established assumption of cardiac chamber geometry. In addition, myocardial contraction and/or perfusion abnormalities are clearly identified. Finally, real-time three-dimensional colour Doppler flow mapping enables complete visualisation of the regurgitant jet and new ways of assessing regurgitant lesion severity. Thus, this technique expands the abilities of non-invasive cardiology and may open new doors for the evaluation of cardiac diseases. In this article, current and future clinical applications of real-time three-dimensional echocardiography are reviewed.

Original languageEnglish
Pages (from-to)144-162
Number of pages19
JournalJournal of Cardiovascular Medicine
Issue number3
Publication statusPublished - Mar 2007


  • Diagnosis
  • Three-dimensional echocardiography
  • Three-dimensional imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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