Noga Michelle, Luan Jiali, Krishnaswamy Deepa, Morgan Brendan, Cockburn Ross, Punithakumar Kumaradevan
Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Canada.
Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute, Edmonton, Canada.
PLOS Digit Health. 2023 Mar 8;2(3):e0000215. doi: 10.1371/journal.pdig.0000215. eCollection 2023 Mar.
The use of three-dimensional (3D) technologies in medical practice is increasing; however, its use is largely untested. One 3D technology, stereoscopic volume-rendered 3D display, can improve depth perception. Pulmonary vein stenosis (PVS) is a rare cardiovascular pathology, often diagnosed by computed tomography (CT), where volume rendering may be useful. Depth cues may be lost when volume rendered CT is displayed on regular screens instead of 3D displays. The objective of this study was to determine whether the 3D stereoscopic display of volume-rendered CT improved perception compared to standard monoscopic display, as measured by PVS diagnosis. CT angiograms (CTAs) from 18 pediatric patients aged 3 weeks to 2 years were volume rendered and displayed with and without stereoscopic display. Patients had 0 to 4 pulmonary vein stenoses. Participants viewed the CTAs in 2 groups with half on monoscopic and half on stereoscopic display and the converse a minimum of 2 weeks later, and their diagnoses were recorded. A total of 24 study participants, comprised of experienced staff cardiologists, cardiovascular surgeons and radiologists, and their trainees viewed the CTAs and assessed the presence and location of PVS. Cases were classified as simple (2 or fewer lesions) or complex (3 or more lesions). Overall, there were fewer type 2 errors in diagnosis for stereoscopic display than standard display, an insignificant difference (p = 0.095). There was a significant decrease in type 2 errors for complex multiple lesion cases (≥3) vs simpler cases (p = 0.027) and improvement in localization of pulmonary veins (p = 0.011). Subjectively, 70% of participants stated that stereoscopy was helpful in the identification of PVS. The stereoscopic display did not result in significantly decreased errors in PVS diagnosis but was helpful for more complex cases.
三维（3D）技术在医学实践中的应用正在增加；然而，其应用在很大程度上未经检验。一种3D技术，即立体容积渲染3D显示，可以改善深度感知。肺静脉狭窄（PVS）是一种罕见的心血管疾病，通常通过计算机断层扫描（CT）进行诊断，容积渲染在其中可能有用。当容积渲染的CT在普通屏幕而非3D显示器上显示时，深度线索可能会丢失。本研究的目的是确定与标准单视场显示相比，容积渲染CT的3D立体显示是否能改善PVS诊断所衡量的感知。对18名年龄在3周至2岁的儿科患者的CT血管造影（CTA）进行容积渲染，并在有和没有立体显示的情况下进行展示。患者有0至4处肺静脉狭窄。参与者分为两组观看CTA，一组观看单视场显示，另一组观看立体显示，至少2周后两组互换，记录他们的诊断结果。共有24名研究参与者，包括经验丰富的心脏科医生、心血管外科医生和放射科医生及其受训人员，他们观看CTA并评估PVS的存在和位置。病例分为简单型（2个或更少病变）或复杂型（3个或更多病变）。总体而言，立体显示诊断中的II类错误比标准显示少，差异不显著（p = 0.095）。复杂多病变病例（≥3个）与较简单病例相比，II类错误显著减少（p = 0.027），肺静脉定位有所改善（p = 0.011）。主观上，70%的参与者表示立体显示有助于识别PVS。立体显示并没有显著减少PVS诊断中的错误，但对更复杂的病例有帮助。
