Quantitative analysis of transesophageal echocardiograms for the intraoperative setting: clinical need and initial experience

Two computerized analysis systems that provide objective interpretation of transesophageal echocardiography (TEE) images are described. A semi-automated system has been used to study systolic wall thickening (SWT) as a means of assessing the effects of anesthetics on TEE. Representative data are presented, showing marked decrease in SWT as a result of halothane administration. Initial experience with this system has demonstrated persistently high interexamination variability of SWT measurements, which is largely the result of its reliance on manual, user-dependent description of the cardiac outlines. In order to correct this problem, as well as to be able to utilize the analysis process into the real-time interoperative environment, development of a more fully automated system that incorporates computed detection and estimation of cardiac boundaries has begun. The implementation of the system and the procedure it uses are described. A number of steps to improve the automated boundary detection process are given