Enhanced comprehension of dynamic cardiovascular anatomy by three-dimensional echocardiography with the use of mixed shading techniques.

Advances in ultrasound instrumentation and computer technology provide us an opportunity to develop methods to perform three-dimensional echocardiography in patients. Optimal methods of displaying three-dimensional images are critical for the perception of depth and distances. We examined the utility of various shading techniques in volume-rendered three-dimensional images in 22 patients with a variety of cardiac defects. Distance coding, gray level gradient shading, texture shading, and mixtures of these shading techniques were used. Our observations suggest that the mixture of shading techniques portray the dynamic three-dimensional anatomy better than a single type of shading. Appropriate mix of shadings could provide dynamic three-dimensional echocardiograms of clinical utility.