Ultrasound imaging is best known for pictures of developing fetuses; 3D is typically associated with monster movies. But when you put the two together and aim the technology at the heart, they create a valuable tool that is changing the way heart disease is treated. Three-dimensional echocardiography is a cutting edge imaging technique used to obtain a detailed look at a patient’s heart in motion, figure out what may be wrong, and determine the best way to fix it.
The high-definition images collected by “3D Echo” can detect holes in the heart, problems with the valves that let blood pass between chambers, and irregularities in muscle contraction and blood flow. Information gathered during an echocardiogram can help surgeons create detailed plans for procedures to correct heart problems and can give them immediate feedback in the operating room after the surgery to make sure it was successful. For the increasing number of procedures that can be performed with cardiac catheterization instead of open heart surgery, a 3D echocardiogram provides live information to help guide cardiologists in their repairs.
“This is progressing very quickly and in many diseases, it really, really changes the way that people think about cardiology,” said Roberto Lang, professor of medicine and the director of the Noninvasive Cardiac Imaging Lab at the University of Chicago Medical Center. “We can look at the heart and tell the surgeon what he or she is going to encounter at the time of surgery.”
At this month’s American Heart Association meeting in Chicago, Lang presented research and participated in panels on the latest uses of 3D echocardiography. Since its submarine-sonar-inspired origin in 1953, the sonogram has been applied to cardiac function in many ways, through 2D images (similar to today’s fetal ultrasounds), through 3D reconstructions built from 2D data, to today’s instantaneous 3D view. Though real-time 3D imaging was only made possible 8 years ago, it is rapidly sweeping into the hospitals around the world, and new uses are still being discovered as the technology improves further.
During the AHA meeting, Lang presented what he calls “fusion imaging,” a combination of 3D Echo and computed tomography (CT) scanning to help determine the best place to implant a pacemaker for restoring normal heart contraction. Another presentation focuses on how 3D Echo can collect information about problems with the mitral valve – the portal between the left atrium and left ventricle of the heart. The precise location of leaks and other abnormalities can be mapped from the same angle the surgeon will see during surgery, Lang said, minimizing surprises on the operating table.
The best way to grasp the value of 3D echocardiograms is to see one, and last year, a production company came to the Medical Center and filmed Lang at work and talking about his field. Watch the results below.
“When we do these studies, we use all the different modalities and integrate them into a simple study,” Lang says in the video. “You want to be a detective and find out exactly what is happening to the patient, so you use all the technologies available and integrate them in order to come up with a good question or a good answer.”
[Thanks to Philips and Tomorrow Media for the video footage.]