Aoki Hirosato, Toyoshima Katsuaki, Miyagi Megumi, Lin Tatsushi, Hawaka Hideyuki, Shimokaze Tomoyuki, Masutani Satoshi
Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
Division of Neonatal Intensive Care, Center of Perinatal Medicine, Nara Medical University Hospital, Kashihara, Japan.
Pediatr Cardiol. 2025 Aug;46(6):1694-1701. doi: 10.1007/s00246-024-03587-6. Epub 2024 Jul 17.
Three-dimensional echocardiography (3DE) provides better interobserver agreement than conventional methods. However, more evidence of whether there is good agreement between novice and experienced observers, especially in pediatric 3DE analysis, is required. We conducted 3DE analysis training in novice observers and investigated the agreement when analyzing 3DE images between novice and experienced observers. One experienced and 4 novice observers independently analyzed 60 3DE images obtained from neonates. The left and right ventricular end-diastolic volume (LVEDV and RVEDV), end-systolic volume (LVESV and RVESV), ejection fraction (LVEF and RVEF), left ventricular global longitudinal strain, and global circumferential strain (LVGLS and LVGCS) were calculated. The novices received hands-on instruction in the analysis procedure before the analysis and received further feedback after their first 40 analyses. Agreement between the novices and the experienced observer was evaluated by the intra-class correlation coefficient (ICC) and percentage difference in 3 groups of 20 images each (images 1-20, 21-40, and 41-60). The ICC of LVEDV was > 0.85 from the first 20 images and increased with experience. The ICCs for RVEDV and RVESV were low from the first 20 images but increased linearly, reaching an ICC > 0.9 in 3 of the 4 novice observers in the last 20 images. The range of the percentage difference was small for LVEDV, RVEDV, LVEF, and RVEF. Novices show an experienced level of 3DE analysis capability in LVEDV and RVEDV after analyzing 40 to 60 images. Training of novices is effective for analyzing LVEDV and RVEDV in 3DE images.
三维超声心动图（3DE）比传统方法具有更好的观察者间一致性。然而，对于新手和经验丰富的观察者之间是否存在良好一致性，尤其是在儿科3DE分析中，还需要更多证据。我们对新手观察者进行了3DE分析培训，并研究了新手和经验丰富的观察者在分析3DE图像时的一致性。一名经验丰富的观察者和4名新手观察者独立分析了从新生儿获取的60幅3DE图像。计算左、右心室舒张末期容积（LVEDV和RVEDV）、收缩末期容积（LVESV和RVESV）、射血分数（LVEF和RVEF）、左心室整体纵向应变和整体圆周应变（LVGLS和LVGCS）。新手在分析前接受了分析程序的实践指导，并在首次分析40幅图像后获得了进一步反馈。通过组内相关系数（ICC）和每组20幅图像（图像1 - 20、21 - 40和41 - 60）的百分比差异来评估新手与经验丰富的观察者之间的一致性。LVEDV的ICC从最初的20幅图像开始就>0.85，并随着经验增加。RVEDV和RVESV的ICC在最初的20幅图像中较低，但呈线性增加，在最后20幅图像中，4名新手观察者中有3名达到ICC>0.9。LVEDV、RVEDV、LVEF和RVEF的百分比差异范围较小。新手在分析40至60幅图像后，在LVEDV和RVEDV方面表现出经验丰富水平的3DE分析能力。新手培训对于分析3DE图像中的LVEDV和RVEDV是有效的。
