Evaluation of structure recognition with the multiscan echocardiograph. A cooperative study in 580 patients

Real time, two-dimensional, images of the heart can now be obtained with the multiscan ultrasound system recently introduced. To assess the clinical usefulness of this technique a cooperative study was carried out in four cardiac centers. This paper describes the experience with and the results in 580 patients with different ages and disorders. Since a unique feature of multiscan is the instantaneous display of cardiac geometry and anatomy, structure recognition was chosen as the most important parameter to analyze. Image quality or recognition levels for eight specific cardiac structures were documented. Results also include recognition levels for different age and disease groups and a comparison between the four centers. In addition, information was gathered on the general diagnostic capability of the multi-element system and the possibility of quantitation of dimensions. Aortic root, anterior mitral valve leaflet and left ventricular posterior wall were the structures most readily recognized. Excellent or good images were seen in two-thirds of all patients. Best visualization was obtained in young patients. A positive diagnosis could be made or confirmed in about one half of the patients with valvular, congenital or myocardial disease and in nearly all patients with pericardial effusion. As experience was gained, the diagnostic importance of the technique shifted from structure recognition towards analysis of left ventricular function. It is clear that the multiscan system does allow excellent orientation and yields quick, non-invasive information of pertinent clinical value. The method provides an immediate overall impression of the heart. It is foreseen that this technique in combination with existing time-motion recording methods will expand the use of echocardiography drastically.