title: Visualization of patent ductus arteriosus using real-time three-dimensional echocardiogram: Comparative study with 2D echocardiogram and angiography.
abstract: OBJECTIVE
  To determine the feasibility and accuracy of real time 3D echocardiography (RT3DE) in determining the dimensions and anatomical type of the patent ductus arteriosus (PDA).
  
  
  METHODS
  The study included 42 pediatric patients with a mean age of 3.6 years (ranging from 2 months to 14 years) who were referred for elective percutaneous PDA closure. All patients underwent full 2D echocardiogram as well as RT3DE with off line analysis using Q lab software within 6 h from their angiograms. The PDA was studied as regard the anatomical type, length of the duct as well as the ampulla and the pulmonary end of the PDA. Data obtained by RT3DE was compared against 2D echocardiogram and the gold standard angiography.
  
  
  RESULTS
  Offline analysis of the PDA was feasible in 97.6% of the cases while determination of the anatomical type using gated color flow 3D acquisitions was achieved in 78.5% of the cases. The pulmonary end of the duct was rather elliptical using 3D echocardiogram. There was significant difference between the pulmonary end measured by 3D echocardiogram and angiography (P < 0.001). There was no significant difference between either the length or the ampulla of the PDA measured by 3D echocardiogram and that measured by angiography (P value = 0.325 and 0.611, respectively). There was a good agreement between both 2D or 3D echocardiogram and angiography in determining the anatomical type of the PDA (K = 0.744 and 0.773, respectively). However 3D echocardiogram could more accurately determine type A and type E ductus compared to 2D echocardiogram.
  
  
  CONCLUSIONS
  3D echocardiogram was more accurate than 2D echocardiogram in determining the length and the ampulla of the PDA. The morphologic assessment of the PDA using gated 3D color flow was achieved in 78.5% of the patients. Nevertheless the use of 3D echocardiogram in assessment of small vascular structures like PDA in children with rapid heart rates is still of limited clinical value.
authors: Cardiology Department, Ain Shams University Hospital, Cairo.
authors: Alaa
authors: A
authors: Roushdy
authors: Azza El
authors: AE
authors: Fiky
authors: Dina Ezz El
authors: DE
authors: Din
keywords: 2D, two-dimensional; 3D, three-dimensional; CHD, congenital heart disease; Congenital heart disease; MPR, multiplane reformatted mode; PDA; PDA, patent ductus arteriosus; RAO, right anterior oblique; RT3DE; RVOT, right ventricular outflow tract; Three-dimensional echocardiography
references: Am J Cardiol. 1989 Apr 1;63(12):877-80
references: 2929450
references: Eur J Echocardiogr. 2005 Dec;6(6):443-54
references: 16293531
references: Pediatr Cardiol. 2009 Apr;30(3):293-300
references: 19083142
references: Int J Cardiovasc Imaging. 2007 Apr;23(2):167-75
references: 16960754
references: Echocardiography. 2011 May;28(5):E101-3
references: 21395670
references: Circulation. 2009 Sep 22;120(12):e92-3
references: 19770408
references: J Am Soc Echocardiogr. 2006 Feb;19(2):121-9
references: 16455415
references: Echocardiography. 2004 Jul;21(5):443-8
references: 15209727
references: Eur J Echocardiogr. 2010 Apr;11(3):245-9
references: 19946119
references: Circulation. 2006 Oct 24;114(17):1873-82
references: 17060397
references: Ann Thorac Surg. 1997 Feb;63(2):434-7
references: 9033315
references: J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63
references: 16376782
references: Ann Thorac Surg. 2008 Sep;86(3):875-81
references: 18721576
references: Am Heart J. 2004 Dec;148(6):1091-5
references: 15632898
references: J Am Soc Echocardiogr. 2008 Sep;21(9):979-89; quiz 1081-2
references: 18765173