Objectives To explore the inter‐ and intra‐observer reliability of Sonography‐based Volume Computer Aided Diagnosis (SonoVCAD) in the display of 8 diagnostic planes of fetal echocardiography and to evaluate its efficiency. Methods Three‐dimensional volume data sets of the 56 normal singleton fetuses were acquired from a 4‐chamber view by using a volume probe. After processing the data sets by using SonoVCAD, 8 cardiac diagnostic planes were displayed automatically. Three doctors with different experiences of performing fetal echocardiography evaluated each diagnostic plane and the success rates of 8 diagnostic planes were calculated. Inter‐observer and intra‐observer reliabilities were estimated by Cohen's kappa statistics. Results A total of 276 volume data sets acquired from the 56 normal fetuses were used for SonoVCAD analysis and display. The success rate of each diagnostic section was more than 90%, ranging from 90.6% to 99.6%. Among 276 volumes, 81.5% (225/276) of volumes were able to generate all 8 diagnostic views successfully. Moderate to substantial agreement (kappa, 0.509–0.794) was found between 2 less experienced operators. Moderate to near‐perfect agreement (kappa, 0.439–0.933) was found between an expert and 2 less experienced sonographers. Intra‐observer reliability was substantial to near‐perfect (kappa, 0.602–0.903). The efficiency of SonoVCAD was assessed. The expert spent less time than 2 less experienced examiners (P < 0.001) but no significant difference was found between 2 less experienced examiners (P = 0.176). Besides, SonoVCAD consumed significantly less time than 2‐dimensional ultrasound (P < 0.001). Conclusions SonoVCAD can significantly improve the success rates of 8 diagnostic planes in fetal echocardiography with low operator dependency, good reproducibility and high efficiency.
Background Congenitally corrected transposition of great arteries (CCTGA) is caused by atrioventricular and ventriculoarterial discordance. Cases of CCTGA with spontaneous chordae rupture of tricuspid valve have not been reported before. Case presentation Here we diagnosed a 38-year-old man, who was found CCTGA 14 years ago, as spontaneous chordae rupture by real-time three dimentional transesophageal echocardiography (RT-3D-TEE). The present case is the first report to describe a CCTGA patient combine with spontaneous chordae rupture in tricuspid valve. After tricuspid valve replacement, the patient was uneventful after 6 years’ follow-up. Conclusion We reported a rare case with spontaneous chordae rupture of tricuspid valve in a CCTGA patient and explored its etiology here. RT-3D-TEE is an important supplement to 2-dimentional transthoracic echocardiography and can provide more accurate detections in tricuspid valve diseases in CCTGA.
Background Mitral valve aneurysm (MVA) was a saccular bulging on mitral valves. It often occurred in anterior leaflet and commonly caused by aortic valve regurgitation complicated by infective endocarditis. Case presentation We reported a 68-year-old female with MVA of posterior leaflet without infective endocarditis. The aneurysm was large and the characteristics of its echo imaging was special, because the saccular structure did not collapse during diastole in real time three dimentional transesophageal echocardiography (RT-3D-TEE). But direct communication between the mass and the left ventricle was detected in this patient. This jet flow from left ventricle into the aneurysm help us distinguish MVA from mass. The patient was uneventful after mitral valve plasty surgery in 2 years’ follow-up. Conclusion We diagnosed a large MVA of posterior leaflet without endocarditis by RT-3D-TEE here. Large MVAs did not collapse in diastole, but the jet flow from left ventricle into the aneurysm can help us distinguish MVA from mass. Besides, RT-3D-TEE was more reliable to diagnose and assess MVA than 2-dimentional transthoracic echocardiography.
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