Research

Left atrial volume measurement with automated border detection by 3-dimensional echocardiography: comparison with magnetic resonance imaging

Ramin Artang¹ , Raymond Q Migrino^1,2 , Leanne Harmann¹ , Mark Bowers¹ and Timothy D Woods¹

¹  Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

²  Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

author email corresponding author email

Cardiovascular Ultrasound 2009, 7:16doi:10.1186/1476-7120-7-16

Published:	31 March 2009

Abstract

Objective

Left atrial size is an important marker for adverse cardiovascular events. There is general consensus that left atrial volume index (LAVI) is the best measurement of size. The current LAVI measurement techniques are laborious. Semi-automated measurement with a 3-dimensional echocardiography (3DE) system may be a practical clinical alternative to measure LAVI, but it has not been adequately evaluated against Magnetic Resonance Imaging (MRI) gold standard. The aim of this study was to compare the accuracy of a commercially available 3D algorithm for measurement of LAVI against LAVI obtained from MRI and Area Length Method (ALM).

Design

In 27 consecutive subjects referred for cardiac MRI (age 54 ± 13 years, 63% male), LAVI was measured using 3 imaging modalities: 3DE, ALM, MRI and the results were correlated. ALM was measured using standard American Society of Echocardiography guidelines. The time required to measure LAVI by 3DE and ALM were compared.

Results

There was a significant correlation in systolic and diastolic LA volumes and left atrial ejection fraction between 3DE and MRI (r = 0.86 for systole, r = 0.76 for diastole, r = 0.88 for ejection fraction, P < 0.0001 for all). There was also significant correlation of diastolic volumes between 3DE and ALM (r = 0.77, P < 0.0001). The time to obtain LAVI was shorter using 3DE versus ALM (56 ± 8 vs 135 ± 55 seconds, P < 0.0001).

Conclusion

Three-dimensional echocardiography with semiautomatic border detection is a practical alternative for obtaining the left atrial volume in a time-efficient manner compared to the current standard.