Table 1.

Strengths and Limitations of RV Imaging Modalities

	2DE	3DE	CMR	CT
Technical aspects
Availability	High	Moderate	Moderate	Low
Cost	Low	Low	High	Moderate
Typical scan duration, min	25–30	30–35	40–60	10–15
Safety	High	High	Contraindicated in patients with metallic implants, claustrophobia; potentially nephrotoxic contrast, allergic reaction to contrast; restricted only to hemodynamically stable patients	Ionizing radiation; potentially nephrotoxic contrast, allergic reaction to contrast
Imaging window dependence	Present	Present	Absent	Absent
Temporal resolution	+++	++	++	+
Spatial resolution	+++	++	+++	++++
3D acquisition	No	Yes	Only in selected sequences	Yes
Real‐time 3D imaging	No	Yes	Yes, but with limitations	No
Assessment of RV geometry, size, and function
Evaluation of RV wall thickness	Yes	Yes	Yes	Yes
Determination of RV diameters	++	+++	++++	++++
Accuracy of RV volume	−	+++	++++	++++
Accuracy of RVEF	−	+++	++++	++++
Parameters of RV systolic function	FAC, TAPSE, s	RVEF	RVEF	RVEF
Estimation of RV diastolic function	Only used in clinical practice	Not used	Not used	Not used
Evaluation of RV mechanics	+++	+	++++	+++
Major limitations	Inability to acquire the whole RV in 1 view; geometric assumptions; poor visualization of RV endocardial border; lack of spatial orientation	Stable cardiac rhythm; visualization of RV endocardial border; no data about RV mass	Cost; low availability	Ionizing radiation; potentially nephrotoxic contrast; stable cardiac rhythm with a low heart rate for image acquisition

Abbreviations: 2DE, 2‐dimensional echocardiography; 3DE, 3‐dimensional echocardiography; CMR, cardiac magnetic resonance; CT, computed tomography; FAC, fractional area change; RV, right ventricle/ventricular; RVEF, right ventricular ejection fraction; s, systolic velocity across lateral segment of tricuspid annulus; TAPSE, tricuspid annular plane systolic excursion.

⁺= low, ++ = moderate, +++ = high, ++++ = very high, and − signifies a major limitation of the modality.