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Three-dimensional echocardiographic virtual endoscopy for the diagnosis of congenital heart disease in children.

Xue H, Sun K, Yu J, Chen B, Chen G, Hong W, Yao L, Wu L - Int J Cardiovasc Imaging (2010)

Bottom Line: Diagnostic accuracy of VE was significantly higher than that of 2DE for TOF and DORV except for ASD and VSD.The receiver operating characteristic (ROC) curve for VE was closer to the optimal performance point than was the ROC curve for 2DE.The area under the ROC curve was 0.96 for VE and 0.93 for 2DE.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.

ABSTRACT
Virtual endoscopy (VE) is a new post-processing method that uses volumetric data sets to simulate the tracks of a "conventional" flexible endoscope. However, almost all studies of this method have involved virtual visualizations of the cardiovascular structures applied to computed tomography (CT) and magnetic resonance (MR) datasets. This paper introduces a novel visualization method called the "three-dimensional echocardiographic intracardiac endoscopic simulation system (3DE IESS)", which uses 3D echocardiographic images in a virtual reality (VR) environment to diagnose congenital heart disease. The aim of this study was to analyze the feasibility of VE in the evaluation of congenital heart disease in children and its accuracy compared with 2DE. Three experienced pediatric cardiologists blinded to the patients' diagnoses separately reviewed 40 two-dimensional echocardiographic (2DE) datasets and 40 corresponding VE datasets and judged whether abnormal intracardiac anatomy was present in terms of a five-point scale (1 = definitely absent; 2 = probably absent; 3 = cannot be determined; 4 = probably present; and 5 = definitely present). Compared with clinical diagnosis, the diagnostic accuracy of VE was 98.7% for ASD, 92.4% for VSD, 92.6% for TOF, and 94% for DORV, respectively. Diagnostic accuracy of VE was significantly higher than that of 2DE for TOF and DORV except for ASD and VSD. The receiver operating characteristic (ROC) curve for VE was closer to the optimal performance point than was the ROC curve for 2DE. The area under the ROC curve was 0.96 for VE and 0.93 for 2DE. Kappa values (range, 0.73-0.79) for VE and 2DE indicated substantial agreement. 3D echocardiographic VE can enhance our understanding of intracardiac structures and facilitate the evaluation of congenital heart disease.

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Virtual endoscopic view of double outlet right ventricle viewed above the interventricular septum by 3DE IESS. LV left ventricle, RV right ventricle, IVS interventricular septum, VSD ventricular septal defect; Ao aorta, PA pulmonary artery
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Fig3: Virtual endoscopic view of double outlet right ventricle viewed above the interventricular septum by 3DE IESS. LV left ventricle, RV right ventricle, IVS interventricular septum, VSD ventricular septal defect; Ao aorta, PA pulmonary artery

Mentions: Images of the atrial septum were captured from either the right or left atrial sides. VE was oriented towards the atrial septal surface, and a left atrial head-on view could be observed. Similarly, the interventricular septum could be visualized head-on from either the left or right ventricles (Figs. 1, 2, 3, 4).Fig. 1


Three-dimensional echocardiographic virtual endoscopy for the diagnosis of congenital heart disease in children.

Xue H, Sun K, Yu J, Chen B, Chen G, Hong W, Yao L, Wu L - Int J Cardiovasc Imaging (2010)

Virtual endoscopic view of double outlet right ventricle viewed above the interventricular septum by 3DE IESS. LV left ventricle, RV right ventricle, IVS interventricular septum, VSD ventricular septal defect; Ao aorta, PA pulmonary artery
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2991166&req=5

Fig3: Virtual endoscopic view of double outlet right ventricle viewed above the interventricular septum by 3DE IESS. LV left ventricle, RV right ventricle, IVS interventricular septum, VSD ventricular septal defect; Ao aorta, PA pulmonary artery
Mentions: Images of the atrial septum were captured from either the right or left atrial sides. VE was oriented towards the atrial septal surface, and a left atrial head-on view could be observed. Similarly, the interventricular septum could be visualized head-on from either the left or right ventricles (Figs. 1, 2, 3, 4).Fig. 1

Bottom Line: Diagnostic accuracy of VE was significantly higher than that of 2DE for TOF and DORV except for ASD and VSD.The receiver operating characteristic (ROC) curve for VE was closer to the optimal performance point than was the ROC curve for 2DE.The area under the ROC curve was 0.96 for VE and 0.93 for 2DE.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.

ABSTRACT
Virtual endoscopy (VE) is a new post-processing method that uses volumetric data sets to simulate the tracks of a "conventional" flexible endoscope. However, almost all studies of this method have involved virtual visualizations of the cardiovascular structures applied to computed tomography (CT) and magnetic resonance (MR) datasets. This paper introduces a novel visualization method called the "three-dimensional echocardiographic intracardiac endoscopic simulation system (3DE IESS)", which uses 3D echocardiographic images in a virtual reality (VR) environment to diagnose congenital heart disease. The aim of this study was to analyze the feasibility of VE in the evaluation of congenital heart disease in children and its accuracy compared with 2DE. Three experienced pediatric cardiologists blinded to the patients' diagnoses separately reviewed 40 two-dimensional echocardiographic (2DE) datasets and 40 corresponding VE datasets and judged whether abnormal intracardiac anatomy was present in terms of a five-point scale (1 = definitely absent; 2 = probably absent; 3 = cannot be determined; 4 = probably present; and 5 = definitely present). Compared with clinical diagnosis, the diagnostic accuracy of VE was 98.7% for ASD, 92.4% for VSD, 92.6% for TOF, and 94% for DORV, respectively. Diagnostic accuracy of VE was significantly higher than that of 2DE for TOF and DORV except for ASD and VSD. The receiver operating characteristic (ROC) curve for VE was closer to the optimal performance point than was the ROC curve for 2DE. The area under the ROC curve was 0.96 for VE and 0.93 for 2DE. Kappa values (range, 0.73-0.79) for VE and 2DE indicated substantial agreement. 3D echocardiographic VE can enhance our understanding of intracardiac structures and facilitate the evaluation of congenital heart disease.

Show MeSH
Related in: MedlinePlus