Tricuspid regurgitation calculator: PISA quantification
Find the measurements, acquisition guidance and sources behind EchoSuite’s tricuspid regurgitation quantification tool.
Method
EROA = 2πr²Vₐ ÷ Vmax; RVol = EROA × VTI
Use the measurement units shown below. Some fields apply only to a selected method or condition; follow the interactive tool’s method choices. The interactive tool keeps missing measurements incomplete and provides its method-specific results and reference context.
Measurements and acquisition
Measurement
Enter the measured value in the displayed unit
- PISA
- Vena contracta
- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.
PISA radius cm
Color Doppler · peak-flow frame
- Zoom on the valve and center the flow-convergence region.
- Shift the color baseline until the shell is as hemispheric as possible.
- Measure from the regurgitant orifice to the first aliasing boundary along the jet centerline.
Aliasing velocity cm/s
Shifted color scale · absolute cm/s
- Use the same color-Doppler frame used for the radius.
- Read the Nyquist limit after baseline shift, not the jet velocity.
- Enter the absolute displayed value in cm/s.
TR Vmax m/s
Continuous-wave Doppler
- Align the CW cursor as parallel as possible to the jet.
- Acquire a dense, complete envelope without truncation.
- Measure the highest absolute velocity on the selected envelope.
TR VTI cm
Continuous-wave Doppler trace
- Use the same aligned CW recording as the peak velocity.
- Trace the outer edge of the dense envelope for the relevant phase.
- Use the machine-reported VTI in centimeters.
Vena-contracta width cm
Enter the measured value in the displayed unit
- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.
Single jet, neck well resolved
Enter the measured value in the displayed unit
- Yes
- Limited / multiple jets
- Not assessed
- Confirm the variable matches the selected formula.
- Use the unit displayed beside the field.
- Keep measurements from the same representative hemodynamic state.
Sources and method context
American Society of Echocardiography · 2017 · Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation · TR Table 13 pp. 46–47 · Table 14 p. 48 · Figures 30–31 pp. 49–50 · TR quantitation pp. 48–51
- PISA acquisition & limitations · Table 13 pp. 46–47 · TR quantitation pp. 48–50
Baseline shift, hemispheric-shell optimization, aligned TR CW peak/VTI, and limitations from low right-sided pressure, noncircular, eccentric, constrained, or multiple jets.
- Quantitative ranges · Table 14 p. 48 · Figure 31 p. 50
EROA and regurgitant-volume ranges; Table 14 VC widths <0.3, 0.3–0.69 and ≥0.7 cm. This tool explicitly follows the table's ≥0.7 endpoint; narrative/flowchart wording uses >0.7. Severe PISA radius and other findings support integration.
- Integrative interpretation · Figure 31 p. 50 · integrative discussion p. 51
Lower validation than MR or AR, no validated four-grade subdivision, and indeterminate classification when image quality, quantitative findings, or clinical data are discordant.
Catalogue review status: Exact guideline locator mapped · clinical sign-off pending
These pages describe the educational tool. Interpret measurements with the complete clinical context and the method’s acquisition limitations.
Keep exploring
- RV inflow acquisition guide · Open in Probe Lab
- Apical four chamber acquisition guide · Open in Probe Lab
- Subcostal four chamber acquisition guide · Open in Probe Lab
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- Mitral regurgitation PISA calculator: EROA and regurgitant volume
- Mitral regurgitation calculator: continuity method