Feasibility and Reproducibility of Two-Dimensional Wall Motion Tracking (WMT) in Fetal Echocardiography

Abstract

Objective The primary objective of this study was to determine the feasibility and reproducibility of 2-dimensional speckle tracking imaging based on the wall motion tracking (WMT) technique in fetal echocardiography. The secondary objective was to compare left and right ventricular global and segmental longitudinal peak strain values. Methods A prospective cross-sectional study was performed. Global and segmental longitudinal peak strain values of the left ventricle (LV) and right ventricle (RV) were assessed prospectively. Based on apical 4-chamber views, cine loops were acquired and digitally stored. Strain analysis was performed offline. Intra- and interobserver variabilities were analyzed. Results A total of 29 healthy fetuses with an echocardiogram performed between 19 and 37 weeks of gestation were included. Analysis was performed with a temporal resolution of 60 frames per second (fps). For both examiners, in all cases Cronbach?s alpha was>0.7. The interobserver variability showed a strong agreement in 50% of the segments (ICC 0.71?0.90). The global strain values for LV and RV were ?16.34 and ?14.65%, respectively. Segmental strain analysis revealed a basis to apex gradient with the lowest strain values in basal segments and the highest strain values in apical segments. Conclusion The assessment of fetal myocardial deformation parameters by 2D WMT is technically feasible with good reproducibility.

Wall‐motion tracking in fetal echocardiography—Influence of frame rate on longitudinal strain analysis assessed by two‐dimensional speckle tracking

“…The authors showed that already >30 fpc resulted in excellent strain accuracies for longitudinal and circumferential strain. 35 Further, the authors concluded that in contrast to previous publications on tissue Doppler imaging (TDI)-derived strain and strain rate, higher frame rates, for example, of >100 Hz, seem not to be needed for peak longitudinal circumferential or radial 2D strains. 34 This is in line with the results of our recent study on the feasibility and reproducibility of 2D WMT in fetal echocardiography.…”

“…In this study, we could achieve global and segmental LPSS values with high intra-and inter-observer correlations. 35 Further, the authors concluded that in contrast to previous publications on tissue Doppler imaging (TDI)-derived strain and strain rate, higher frame rates, for example, of >100 Hz, seem not to be needed for peak longitudinal circumferential or radial 2D strains. Especially in the field of TDI for proper acquisition of tissue velocities and the short duration of myocardial tissue movements, high frame rates are required in order to obtain an adequate temporal resolution.…”

Wall motion tracking in fetal echocardiography—Application of low and high frame rates for strain analysis

“…4,[6][7][8][9][10][11][12] The frame rate (FR) used to acquire ultrasound images is the primary determinant of temporal resolution and remains one of the most important considerations of the reliability of 2D STEderived myocardial deformation imaging; the degree of reliability appears to be influenced by the acquisition rate. [14][15][16][17][18][19][20] We have previously demonstrated feasibility and reproducibility with archived Digital Imaging and Communications in Medicine (DICOM) data with 30 and 60 frames per second (fps), 21,22 while others have been working with the original FR frequency ranging between 44 and 150 fps. [14][15][16][17][18][19][20] We have previously demonstrated feasibility and reproducibility with archived Digital Imaging and Communications in Medicine (DICOM) data with 30 and 60 frames per second (fps), 21,22 while others have been working with the original FR frequency ranging between 44 and 150 fps.…”

“…13 Currently there is a wide variation in the suggested FR utilized for STE-derived strain measurements in the fetus. [14][15][16][17][18][19][20] We have previously demonstrated feasibility and reproducibility with archived Digital Imaging and Communications in Medicine (DICOM) data with 30 and 60 frames per second (fps), 21,22 while others have been working with the original FR frequency ranging between 44 and 150 fps. [23][24][25][26][27] Reproducibility has also been shown to be most robust when cine loops are obtained with a specific FR-to-heart rate (HR) ratio.…”

“…Analogous to our current publications of feasibility and reproducibility and influence of FR on strain analysis, we used the same method to assess global and segmental LPSS 21,22. The tracking algorithm of the offline software for the speckle tracking is identical to the analysis tracking package available in the commercial system.…”