In the United States, economists estimate the cardiographic ultrasound market’s value at over $1.4 billion. The value has steadily increased in the past decade as technology improved.
Today, echocardiogram readings are more accurate, precise, and cost-effective than they’ve ever been. Moreover, cardiographic and medical ultrasound technology has evolved into distinct branches.
Each technological branch grants unique benefits for diagnosis and treatment. Whether a team wants to treat heart disease or evaluate an organ for transplant, it’s critical to keep up with the evolution of medical imaging.
This piece, then, functions as an annotated checklist for healthcare facilities. Discover ten things you should know about echocardiogram readings. Then, use that knowledge to improve the standards of care for your cardio patients.
1. How to Evaluate Echocardiogram Readings
A medical team must know how to read an echocardiogram correctly. It’s vital to get a professional interpretation of any result.
To determine the difference between a normal vs abnormal echocardiogram, consult with an expert.
Typically, a registered diagnostic cardiac sonographer or clinical scientist conducts the exam. Then, a cardiologist interprets the results.
Sometimes, a patient cannot immediately see their cardiologist after the test. Then, it’s helpful for the sonographer to read the results to the patient. Sonographers learn the basics of how to read an echocardiogram report for certification.
But, in most cases, the echo-cardio data is best assessed by an ABIM-certified cardiologist.
2. Types of Echocardiogram Tests—and When To Order Them
Echocardiogram tests vary in process and impact. Healthcare leaders should know the differences between the most common types. And, critically, they should know when to order which one.
Transthoracic Echocardiogram (TTE)
This is an external echocardiogram. The sonographer runs a TTE with gel and a probe. The probe creates images using waves, like sonar. Cardiologists order this test most often.
3D Echocardiograms use a similar process. But, the affiliated software renders a 3D graphic version of the organ image. When the result is a video that shows how the heart changes over a period of time, that’s a 4D echo.
Intracardiac Echocardiogram (ICE)
ICE exams can take images from inside the heart. It uses a catheter to send sound waves through the chest wall.
M-mode echocardiography uses a higher frequency. It gets you a single line of information at a high frame rate, rather than a 2D or 3D image.
It produces an accurate measurement of linear dimensions—like the thickness of a wall of one of the heart’s chambers
A stress echocardiogram generates a diagnostic image. It’s taken after the patient’s heart rate and blood pressure are raised. It generates two contrasting images of the heart: one at rest, and one under stress.
Transesophageal Echocardiogram (TEE)
The TEE requires an internal probe. The probe functions similarly to the probe in a TTE test. The difference is, the TEE generates images from inside the esophagus.
Doppler echocardiography measures blood flow. Like a typical echocardiogram, a Doppler echocardiogram uses ultrasound waves to create an image.
Doppler echocardiograms take advantage of the doppler effect to track the movement and speed of blood cells. The Doppler effect states that sound waves change in frequency when they move, relative to the listener.
Echocardiograms vs Other Medical Imaging Tests
It’s also useful to understand how echocardiograms differ from other medical imaging tests. This breakdown is not a complete guide. But, it’s a useful starting point when you begin making comparisons.
Echocardiogram vs EKG (ECG)
An EKG is an electrocardiogram. Electrocardiograms do not generate images. Instead, they record the electrical pulses (signals) in the heart.
An EKG result looks like a graph of voltage over time. Typically, if you see a heart monitor attached to a patient’s chest with adhesive sensors, that’s an ECG. A continuous, portable ECG is a Holter monitor.
It’s also wise for a healthcare team to familiarize themselves with the following tests:
- Carteroid ultrasound
- Venous ultrasound
- Computed Tomography Angiography (CTA)
- Nuclear cardiology (imaging)
Each of these tests can deliver key diagnostic information.
3. Features, Drawbacks, and Typical Use of Transducer Options
It’s wise to know how your transducer can affect an echocardiogram reading.
Transducers send ultrasonic waves, then receive the echoes of the waves that reflect from tissues. Only piezoelectric materials can transmit and receive these waves. So, transducers utilize either piezoelectric crystals or ceramic.
The acoustic resistance between the piezoelectric materials empowers the transducer. The materials must be well-placed. Poor placement results in noise, which leaves the image less clear.
When choosing a transducer, consider its materials and design. Also, consider its shape and beam profile. The shape alters the resulting image’s clarity at different depths. It also changes the footprint of the image.
The transducer’s beam profile impacts how the handler directs it. Transducers use different arrays to generate 1D or 2D images. A sonographer must steer a 2D probe to create a 3D image.
In 2017, the National Research Foundation funded and published an analysis of transducer components and applications. Healthcare teams should study this, and newer materials, to learn the features and applications of different probes.
4. The Effect of Frame Rate on Image Quality, Workflow
Hospital teams should know the effect of frame rate on the image quality of an echocardiogram. The frame rate also affects the workflow. Ultra-high frame rates can reduce clutter on soft tissue images.
Understanding the dynamic between these factors lets administrators make informed equipment choices. And, it helps you predict daily and weekly workflow more accurately.
The frame rate will also affect the sonographer’s beamforming choices. Strong parallel processing empowers the device to generate accurate images faster. This compounds the positive impact on image quality.
5. Special Considerations for Pediatric Echocardiograms
Pediatric echocardiogram readings require a slightly different framework than those for adults. Medical professionals also need different tools to run an echocardiogram on a child.
Pediatric surgeons released new guidelines for echocardiography procedures during the Covid-19 outbreak. Hospitals must mitigate any increased risk of vulnerability.
As a result, experts have updated the appropriate use criteria for pediatric echocardiograms.
Transesophageal echocardiograms are the most typical cardio imaging test USD on children. The TEE requires a pediatric transducer to conduct properly.
Recent innovations make elastography a viable diagnostic tool for child patients. Pilot studies have used non-invasive cardiac shear wave elastography to assess myocardial stiffness in children.
MR elastography of the heart may become more viable. Then, it will be increasingly vital to know when to choose elastography instead of—or in addition to—echocardiography.
6. Recent Advances in 3D Quantitative Analysis
Healthcare facilities should stay on top of advances in quantitative image analysis. Technological innovations have accelerated accurate 3D imaging processes.
At the same time, volumetric flow assessments are increasingly accurate. Knowing advances as they come up lets medical teams stay one step ahead.
7. The Benefits and Utility of 4D Imaging, Assessment Tools
4D echocardiography generates a 3D image, then incorporates the variable of time. Cardiologists have developed methods to determine dense 3D myocardial motion accurately.
Automated and AI-driven assessment tools are making echocardiographic diagnostics faster. And they can make medical imaging generally less invasive. Biomechanical modeling can predict critical variations in patient physiology.
The value of time as a variable in biomechanical modeling cannot be overstated. When you know the benefits of 4D imaging and AI-driven assessment models, you will drive echocardiology forward.
8. How to Compare Echo Software, Reporting, and Networking Solutions
It’s important to learn how to compare solutions among echo cardio ultrasound systems. Different systems are not necessarily compatible. Consider your system’s:
To compare systems, consult with cardiologists. You may also consider advice from cardiac ultrasound engineers and developers. Then, map out integrations of any new system with your facility’s current equipment.
9. Evolving Standards of Quantitative Imaging
Discover how standards for echocardiogram readings are evolving. Currently, there is no set international standard for reading medical images. But, many medical and healthcare groups have been collaborating to change that.
The NCI’s Quantitative Imaging Network to develop standards for reading radiomic features.
NCI and partners intend the standards to be functional across diverse software packages. They’re also compatible with a wide range of digital reference objects. The group published data from its experiment in standard development in 2020.
The analysis aimed to determine and evaluate radiomic agreement among image features. The experiment compared calculated (quantified) features determined by different groups.
Each group used different ultrasound software.
Radiomic agreement is a method to quantify the visual and linear qualities of medical images. Data-characterization algorithms can reveal patterns in images by analyzing vast datasets.
These patterns would otherwise be invisible to us.
Machine learning continues to inform standard medical image reading. Diagnosticians must update their processes.
10. Key Features and Utility of Portable Ultrasound Systems
Finally, learn how echocardiogram readings differ on portable ultrasounds.
Portable ultrasound systems aren’t identical to their stationary counterparts. You’re most likely to use a portable cardiography ultrasound in:
- Emergency medicine
- Point-of-care contexts
Staff can move a portable ultrasound system through a hospital campus as needed. A portable ultrasound may not have the highest definition image quality.
But, the quality must be high enough to be readable at a glance.
In an emergency, you may not have time to parse a complicated image. In this same vein, efficient quantification software improves a portable system’s efficacy.
Portable ultrasounds often enable multiple transducer attachments. This enables 4D multiplanar reconstruction on higher-end models. It also enables physicians to run a range of echocardiogram tests at a patient’s bedside.
End-to-End Cardio Imaging Solutions
Discover everything you need to know about echocardiogram readings with Specialist Direct. Our telecardiology services bring world-class cardio expertise to your facility.
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