Value of real-time 3-dimensional echocardiography sectional diagnosis in complex congenital heart disease evaluated by receiver operating characteristic analysis

Objective: We sought to evaluate the value of real-time 3-dimensional (3D) echocardiography (RT-3DE) in the pathologic morphology of complex congenital heart disease (CHD) using receiver operating characteristic (ROC) analysis. Methods: Thirty patients with complex CHD were examined by 2-dimensional echocardiography (2DE) and RT-3DE. Their diagnoses of pathologic morphology were made by 3 echocardiographers blinded to clinical data. Their value was evaluated by ROC analysis using a 5-point categorical scale in major cardiovascular structures and spatial relationships among complex CHD. Results: Compared with surgical findings, there were 75.6% of the definitely correct in RT-3DE and 64.4% in 2DE. ROC curve for RT-3DE was located left-superior to that for 2DE, and the area under ROC curve for RT-3DE (A = 0.96) was higher than that for 2DE (A = 0.90). There was significant difference between them by the method of Z test (Z = 2.64, P = .0083). Conclusions: With the spatial 3D display of cardiovascular structural malformations, RT-3DE, coupled with conventional Doppler 2DE, may add information on complex CHD.