4.5 Article

Taking Command of Three-Dimensional Stitching Artifacts: From an Annoyance to an Easy Tool for Navigating Three-Dimensional Transesophageal Echocardiography

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Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.echo.2022.09.013

Keywords

3D TEE; Stitching; Artifact; Image processing

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Despite advances in 3D transesophageal echocardiography imaging, orienting and correlating images remains challenging. This article suggests repurposing stitching artifacts in 2-beat electrocardiogram-gated 3D TEE to precisely orient 3D images in a patient's unique anatomy. The technique is demonstrated in assessing a normal mitral valve, localizing mitral valve prolapse scallops, and visualizing left atrial appendage in 3D space. Cardiac imagers can benefit from this method for optimal individualized echocardiographic views.
Despite many recent advances in three-dimensional (3D) transesophageal echocardiography (TEE) imagining, the process of orienting 3D TEE images is nonintuitive and uses assumptions based on idealized anatomy. Correlating two-dimensional TEE cross-sectional images to 3D reconstructions remains an additional chal-lenge. In this article, we suggest the repurposing of the stitching artifact generated in 2-beat electrocardiogram-gated 3D TEE as a means of exactly orienting 3D images within a patient's unique anat-omy. We demonstrate the application of this strategy to assess a normal mitral valve to localize scallops of mitral valve prolapse and to visualize typical left atrial appendage two-dimensional cuts in a 3D space. By tak -ing command of stitching artifacts, cardiac imagers can successfully navigate the complex structures of the heart for optimal, individualized echocardiographic views. (J Am Soc Echocardiogr 2023;36:105-10.)

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