A Single-Center Retrospective Analysis of the Diagnostic Efficacy of Transthoracic Echocardiography in the Classification of Patent Ductus Arteriosus

Background: This study aimed to investigate the diagnostic efficacy of transthoracic echocardiography (TTE) in classifying patent ductus arteriosus (PDA). Methods: A total of 616 patients diagnosed with PDA underwent TTE. TTE measurements were obtained using the parasternal short-axis view of the great arteries and the suprasternal fossa aortic long-axis view. Using digital subtraction angiography (DSA) as the gold standard, the diagnostic efficacy of TTE for PDA classification was evaluated. Results: Among true-positive cases correctly diagnosed by both TTE and DSA, the sensitivity for tubular PDA was 100.00%, and the specificity was 50.74%. For funnel-type PDA, the sensitivity was 50.57%, and the specificity was 100.00%. For a window-type PDA, the sensitivity was 60.00%, and the specificity was 100.00%. The internal diameters of the tubular PDA and the pulmonary artery side of the funnel-type PDA measured by TTE showed good agreement with those measured by DSA. In addition, in the suprasternal long-axis view of the ascending aorta (SSLAX-AA) of TTE among true-positive cases, the sensitivity for diagnosing tubular PDA was 100.00%, and the specificity was 75.25%; the sensitivity for funnel-type PDA was 75.51%, and the specificity was 100.00%; the sensitivity for window-type PDA was 66.67%, and the specificity was 100.00%. The diagnostic efficacy of this view was improved compared with the overall TTE, which may be due to the similarity between this view and the DSA view. Conclusions: Among true-positive cases, TTE has high sensitivity for diagnosing tubular PDA and high specificity for diagnosing funnel-type PDA. Meanwhile, TTE shows good agreement with DSA in measuring key parameters. Furthermore, TTE demonstrates stability in the diagnostic classification of PDA, with no significant influence from operator variability. TTE could serve as a reliable basis for clinical decision-making to aid in the diagnostic classification of PDA.