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Which Cardiac Structure Lies Nearby? Revisiting Two-Dimensional Cross-Sectional Anatomy


Faletra, Francesco F; Ho, Siew Yen; Leo, Laura Anna; Paiocchi, Vera Lucia; Mankad, Sunil; Vannan, Mani; Moccetti, Tiziano (2018). Which Cardiac Structure Lies Nearby? Revisiting Two-Dimensional Cross-Sectional Anatomy. Journal of the American Society of Echocardiography, 31(9):967-975.

Abstract

Two-dimensional (2D) transthoracic echocardiography is one of the most used diagnostic tools in clinical cardiology. Similarly, 2D transesophageal echocardiography is considered an indispensable tool for cardiologists and cardiac anesthesiologists worldwide. However, because of their tomographic nature, both techniques display only thin cut planes of a given area of the heart, which are far from representing the "anatomic reality." It is widely accepted that experienced echocardiographers are able to reconstruct mentally a three-dimensional image of any cardiac structure on the basis of their interpretation of multiple tomographic slices. However, this may not be the case with less experienced echocardiographers. In particular, the authors noticed that less experienced echocardiographers are almost totally unaware of which structures lie "nearby" a given 2D tomographic plane, that is, what is adjacent in the elevation plane. In this article, the authors report the use of three-dimensional transesophageal echocardiographic images to discover which structures are located nearby (i.e., "behind" and "in front") the corresponding 2D cross-sections. The authors believe that this novel use of three-dimensional echocardiography is a unique aid to disclose what cannot be seen in a given 2D cross-section, thereby expanding our understanding of 2D echocardiographic anatomy. This may be an effective method to encourage all to "think" in three dimensions, even when they use 2D echocardiography.

Abstract

Two-dimensional (2D) transthoracic echocardiography is one of the most used diagnostic tools in clinical cardiology. Similarly, 2D transesophageal echocardiography is considered an indispensable tool for cardiologists and cardiac anesthesiologists worldwide. However, because of their tomographic nature, both techniques display only thin cut planes of a given area of the heart, which are far from representing the "anatomic reality." It is widely accepted that experienced echocardiographers are able to reconstruct mentally a three-dimensional image of any cardiac structure on the basis of their interpretation of multiple tomographic slices. However, this may not be the case with less experienced echocardiographers. In particular, the authors noticed that less experienced echocardiographers are almost totally unaware of which structures lie "nearby" a given 2D tomographic plane, that is, what is adjacent in the elevation plane. In this article, the authors report the use of three-dimensional transesophageal echocardiographic images to discover which structures are located nearby (i.e., "behind" and "in front") the corresponding 2D cross-sections. The authors believe that this novel use of three-dimensional echocardiography is a unique aid to disclose what cannot be seen in a given 2D cross-section, thereby expanding our understanding of 2D echocardiographic anatomy. This may be an effective method to encourage all to "think" in three dimensions, even when they use 2D echocardiography.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Cardiocentro Ticino
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:September 2018
Deposited On:18 Feb 2019 12:12
Last Modified:18 Feb 2019 12:13
Publisher:Elsevier
ISSN:0894-7317
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.echo.2018.04.014
PubMed ID:29958761

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