3D echo is in the process of revolutionizing pediatric echocardiography. It is like the difference between looking at a crude snapshot of an infant’s heart in the womb, as opposed to a 3D movie of that same infant’s heart.
Many cities have 3D images of babies on their billboards advertising their hospitals, as if you have taken a picture of that baby in real time. This is a far cry from how we used to look at babies in the womb, grainy hard to see, black and white slices of a baby.
With typical 2D cardiac imaging, you are looking at a several millimeter slice of the heart, one looped image at a time, whereas with 3D, it as if you have inserted a video camera into the womb and are looking at the fetus’s heart as if you are holding it in your hand and watching it function.
This is made possible by the advancement from piezoelectric to composite transducers, not to mention the advancement in computer technology in the last few years. These new composite materials significantly improve bandwidth, sensitivity and resolution, and the newest technologies allow for much faster computer enhancement of image quality and manipulation.
This is a very important advancement in pediatric cardiology. For instance, many of these defects are very hard to visualize in a 2D format, but when utilized in a 3D format, they become much more understandable. Further, modern technology allows you to manipulate the image in any way you want, to see the heart in numerous views.
Endocardial cushion defects (AV canal) is a perfect example. Unless you have actually seen this defect with a real heart, this might be an easy defect to misdiagnose. Is there a cleft mitral valve? Is it partial or complete? Is there a VSD and or an ASD? Where are the bridging leaflets? Exactly how do the shunts occur? Is there a malaligned outflow tract?
In conclusion, 3D echocardiography in many ways is quantifiable, reproducible and comparable to MRI in many of the measurements used in cardiology. Volumes and ejection fractions are two examples. This is increasingly becoming an invaluable technique in invasive procedures (such as the closure of ASD’s).