A comparison study between 3D TTE and 2D TTE with focus on right ventricular dimension and function

Sammanfattning

Background: Three-dimensional echocardiography has proven valuable for evaluating the right ventricular, whose complex structure limits 2D assessment. Reference values have been established, and many studies confirm its correlation with Cardiovascular Magnetic Resonance (CMR), the golden standard for volumetric heart measurements. However, results may vary between software and vendors. This study aimed to evaluate the agreement between 2D and 3D with focus on the right ventricular function and dimension, to help guide equipment calibration. Method: This study prospectively gathered 2D and 3D data from 28 patients who underwent transthoracic echocardiography, from autumn 2024 to spring 2025. The data collected consisted of measurements relating to the right ventricular function and dimension, which were Right Ventricular Dimension 1(RVD1), Tricuspid Annular Plane Systolic Excursion (TAPSE) and Fractional Area Change (FAC). The inclusion criteria for the study were sinus rhythm and good quality of the ultrasound images. Statistical analyses were conducted to assess the agreement between the two methods. Results: There was an agreement between the two methods which varied between the parameters that were analysed. The best agreement was seen for FAC with a difference of -0,3 ± 6,2 % (p>0,05) between the measurement from 2D versus 3D. For TAPSE and RVD1 the difference was 2,6 ± 5,2 mm respectively -4,0 ± 5,2 mm (p<0,05). Conclusion: FAC demonstrates a promising level of agreement between 2D and 3D measurements, while both TAPSE and RVD1 showed significant under- and overestimations. These discrepancies highlight the need for equipment calibration to ensure reliable measurement and to support broader clinical use of the method.