Transoesophageal echocardiography of aortic atherosclerosis: the additive value of three-dimensional over two-dimensional imaging. (9th October 2014)

• Record Type: Journal Article
• Authors: Weissler-Snir, Adaya; Greenberg, Gaby; Shapira, Yaron; Weisenberg, Daniel; Monakier, Daniel; Nevzorov, Roman; Sagie, Alexander; Vaturi, Mordehay
• Is Part Of: European heart journal. Volume 16:Number 4(2015:Apr.)
• Page Start: 389
• Page End: 394
• Publication Date: 2014-10-09
• Subjects: aortic atherosclerotic plaque -- transoesophageal echocardiography -- two-dimensional -- three-dimensional; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jeu195
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: Aims: Complex aortic atherosclerotic plaques (AAPs) carry a significant risk of embolism. Currently, two-dimensional (2D) transoesophageal echocardiography (TOE) is the principal diagnostic tool of AAPs. However, we hypothesized that the data obtained from three-dimensional (3D) imaging may improve AAPs' spatial assessment. Methods and results: The study included 67 patients (aged 70 ± 15 years, 35 men), who had routine TEE studies. The thoracic aorta was studied from arch to distal descending aorta, using the x -plane mode (simultaneous short- and long-axis views). If focal intimal thickening (suggestive of AAP) was detected, the 3D zoom algorithm was exercised on the specific site with further post-processing on a Q-lab workstation to measure its thickness in the X, Y, and Z dimensions. The AAP contour was defined qualitatively as regular or irregular in each mode. A total of 100 AAPs were investigated. The AAP thickness estimation was significantly greater in the 3D mode than in the 2D mode (0.51 ± 0.33 vs. 0.28 ± 0.20 cm, P < 0.001). The rate of complex AAPs (defined by AAP thickness of ≥4 mm) was two-fold higher with 3D imaging than with 2D imaging (27% with 2D imaging alone vs. 53% with the addition of 3D imaging). The rate of irregular AAPs increased from 29 to 65% when assessed with 3D imaging compared with 2D imaging. Conclusion: This study has shown a significant difference in the estimation of AAPs between 2D and 3D TEE. The significant shift to a more complex AAPs profile may suggest that 3D imaging is preferable for the assessment of aortic atherosclerosis burden.