Assessment of Pulmonary Artery Stenosis Using Freehand
"Flock of Birds" Digital Color Three-Dimensional Echocardiographic Reconstruction
SUTHEP WANITKUN, M.D.*,
ROSEMARY A. RUSK, M.D.**,
DAVID J, SAHN,M.D.**
Affiliation : * Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol
University, Bangkok 10400, Thailand.
** The Clinical Care Center for Congenital Heart Disease, Oregon Health and Science University, Portland, Oregon, USA.
AbstractPulmonary artery (PA) trunk or branch PA stenosis is commonly found in patients with
congenital heart disease. The aim of the present study was to evaluate the freehand "Flock of Birds"
color Doppler three-dimensional (3D) reconstruction on a modeled-segment imitating PA stenosis.
First, a PA model was created from latex tubes to simulate the main PA and its main branches with
baseline cross-sectional areas (CSA) of 0.7 cm2* A series of narrowed segments in the right and left
PA were created. The cross-sections of the smallest area ranged from 0.13 to 0.59 cm2 and stenotic
segmental length ranged from 0.17 to 1.80 em. The dimensions of these elements mounted on to the
model were verified by intravascular ultrasound (IVUS) imaging. Next, pulsatile flows at 60 beats/
min were generated through the system. A GENingMed System FiVe with magnetic locator system
(Flock of Birds) on a 3.5 MHz transducer was used to acquire a freehand sweep for ECG gated 3D
data acquisition of color Doppler flows through the model. The images were reconstructed by EchoPac
3D software and the morphology of the stenotic elements were determined. The results revealed that
the narrowest CSA determined by the 3D color flow cast of the pulmonary artery were in excellent
agreement with IVUS CSA (r=0.98, p
Keywords : Three-Dimensional Echocardiography, Color Doppler Echocardiography, Pulmonary
Artery Stenosis
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