1. Three-dimensional echocardiographic virtual endoscopy for the diagnosis of congenital heart disease in children
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Kun Sun, Jianguo Yu, Guozhen Chen, Wenjing Hong, Li-Ping Yao, Lan-Ping Wu, Haihong Xue, and Binjin Chen
- Subjects
Heart Defects, Congenital ,Male ,medicine.medical_specialty ,China ,Heart disease ,Echocardiography, Three-Dimensional ,Pilot Projects ,Three-dimensional echocardiography ,Intracardiac injection ,Virtual reality ,User-Computer Interface ,Predictive Value of Tests ,Image Interpretation, Computer-Assisted ,Virtual endoscopy ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical diagnosis ,Child ,Cardiac imaging ,Congenital heart disease ,Observer Variation ,Original Paper ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Infant ,Reproducibility of Results ,Magnetic resonance imaging ,Endoscopy ,medicine.disease ,ROC Curve ,Radiology Nuclear Medicine and imaging ,Predictive value of tests ,Child, Preschool ,Feasibility Studies ,Female ,Radiology ,business ,Cardiology and Cardiovascular Medicine - 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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