Measurement of Volumetric Flow by Real-time 3-Dimensional Doppler Echocardiography in Children

Background: We sought to assess the accuracy and reproducibility of an automated real-time (RT) 3-dimensional (3D) Doppler echocardiography (RT3DDE) technique for measuring volumetric flow (VF) in children. Methods: A total of 19 healthy children (age = 11.5 ± 3.5 years) were studied to measure VF through mitral valve (MV), aortic valve (AV), pulmonary valve (PV), and tricuspid valve (TV) by RT3DDE. RT 3D echocardiography was also performed to measure left ventricular (LV) end-systolic volume, LV end-diastolic volume, and stroke volume (stroke volume = LV end-diastolic volume - LV end-systolic volume), which served as a reference standard for comparison with VF by RT3DDE. Results: Compared with stroke volume by RT 3D echocardiography, the correlation with VF was excellent for MV (r = 0.91), good for AV (r = 0.89) and PV (r = 0.89), but poor for TV (r = 0.20) by RT3DDE. There were good agreements for AV (bias = 0.9 ± 5.0 mL), PV (bias = -0.4 ± 5.7 mL), and MV (bias = 4.1 ± 4.7 mL), and marked underestimation for TV (bias = -24.4 ± 14.6 mL). Conclusions: Our data demonstrated that VF measurement by RT3DDE is feasible and reasonably accurate for MV, AV, and PV but problematic for TV.