Real-time three-dimensional fetal echocardiography - optimal imaging windows

Deng, Jing; Sullivan, Ian D.; Yates, Robert; Vogel, Michael; McDonald, D.; Linney, AD; Rodeck, Charles H.; Anderson, Robert H.

doi:10.1016/s0301-5629(02)00560-4

Cited by 44 publications

(59 citation statements)

References 31 publications

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“…Three-dimensional [45][46][47][48][49][50][51] and, more recently, four-dimensional ultrasonography of the fetal heart [52][53][54][55][56][57][58] have the potential for making the examination less operator-dependent. Once a volume dataset is acquired, the heart can be examined using multiple planes of section, some of which are unobtainable with two-dimensional ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Gonçalves

Espinoza

Romero

et al. 2005

The Journal of Maternal-Fetal & Neonatal Medicine

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Methods.A technique was developed to obtain dynamic multiplanar images of the left ventricular outflow tract (LVOT) and right ventricular outflow tract (RVOT) from volume datasets acquired with STIC. Volume datasets were acquired from fetuses with normal cardiac anatomy. Twenty volume datasets of satisfactory quality were pre-selected by one investigator. The data was randomly assigned for a blinded review by two independent observers with previous experience in fetal echocardiography. Only one volume dataset was used for each fetus. After a training session, the observers obtained standardized cardiac views of the LVOT and RVOT, which were scored on a scale of 1 to 5, based on diagnostic value and image quality (1 = unacceptable, 2 = marginal, 3 = acceptable, 4 = good, and 5 = excellent). Median scores and interquartile range, as well as inter-and intraobserver agreement were calculated for each view. Results. The mean menstrual age at the time of volume acquisition was 25.5 + 4.5 weeks. Median scores (interquartile range) for LVOT images, obtained by the first and second observers, were 3.5 (2.25-5.00) and 4 (3.00-5.00), respectively. The median scores (interquartile range) for RVOT images obtained by the first and second observers were 3 (3.00-5.00) and 3 (2.00-4.00), respectively. The interobserver intraclass correlation coefficient for the LVOT was 0.693 (95% CI 0.380-0.822), and 0.696 (95% CI 0.382-0.866) for the RVOT. For the intraobserver agreement analysis, observer 1 gave higher scores to the LVOT the second time the volumes were analyzed [LVOT: 3.50 (2.25-5.00) vs. 5.00 (4.00-5.00, p = 0.008)]. Conclusion. STIC can be reproducibly used to evaluate fetal cardiac outflow tracts by independent examiners. Slightly better image quality rating scores during the intraobserver variability trial suggests the presence of a learning curve for the manipulation and analysis of volume data obtained by STIC.

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Section: Introductionmentioning

confidence: 99%

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Gonçalves

Espinoza

Romero

et al. 2005

The Journal of Maternal-Fetal & Neonatal Medicine

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show abstract

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Rapid and facile, 3D imaging allows the acquisition of a volume data set in a matter of seconds, in comparison with the more prolonged interval typically required for conventional fetal cardiac imaging. Thus, whereas conventional fetal cardiac imaging requires a great deal of expertise, acquisition of volume data sets appears far less dependent on operator expertise.…”

Section: B Amentioning

confidence: 99%

“…12,13,15 Previous investigations have shown instantaneous high-quality reformatted planar displays. 12,15 However, rendered displays have involved cumbersome, time-consuming offline processing and have had poor image quality.…”

mentioning

confidence: 99%

“…12,13,15 Although reconstructive techniques acquire a series of planar images over several seconds, real-time approaches acquire entire volumes (rather than single planes) instantaneously, using specialized 2D matrix, phased array transducers. As a result, real-time imaging avoids the need for cardiac gating and avoids artifacts related to arbitrary fetal motion during the acquisition.…”

mentioning

confidence: 99%

“…12,15 However, rendered displays have involved cumbersome, time-consuming offline processing and have had poor image quality. 13 Recently, a high-resolution real-time 3D sonographic imaging platform was developed that provides instantaneous rendered displays. Because of the enormous clinical potential for real-time 3D echocardiographic fetal imaging using rendered displays, we sought to assess this technique's ability to image the fetal heart.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Real-time 3-Dimensional Fetal Echocardiography With an Instantaneous Volume-Rendered Display

Sklansky

DeVore²,

Wong

2004

Journal of Ultrasound in Medicine

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Objective. Random fetal motion, rapid fetal heart rates, and cumbersome processing algorithms have limited reconstructive approaches to 3-dimensional fetal cardiac imaging. Given the recent development of real-time, instantaneous volume-rendered sonographic displays of volume data, we sought to apply this technology to fetal cardiac imaging. Methods. We obtained 1 to 6 volume data sets on each of 30 fetal hearts referred for formal fetal echocardiography. Each volume data set was acquired over 2 to 8 seconds and stored on the system's hard drive. Rendered images were subsequently processed to optimize translucency, smoothing, and orientation and cropped to reveal "surgeon's eye views" of clinically relevant anatomic structures. Qualitative comparison was made with conventional fetal echocardiography for each subject. Results. Volume-rendered displays identified all major abnormalities but failed to identify small ventricular septal defects in 2 patients. Important planes and views not visualized during the actual scans were generated with minimal processing of rendered image displays. Volume-rendered displays tended to have slightly inferior image quality compared with conventional 2-dimensional images. Conclusions. Real-time 3-dimensional echocardiography with instantaneous volume-rendered displays of the fetal heart represents a new approach to fetal cardiac imaging with tremendous clinical potential.

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New fetal cardiac imaging techniques

Deng

Rodeck

2004

Prenatal Diagnosis

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Rapid advances in graphics computing and micro-engineering have offered new techniques for prenatal cardiac imaging. Some of them can be non-invasively applied to both clinical and laboratory settings, including dynamic three-dimensional echocardiography, myocardial Doppler imaging, harmonic ultrasound imaging, and B-flow sonography. With clinical constraints, a few others have been mainly used in laboratories, such as endoscopic ultrasound, magnetic resonance imaging and biomicroscopy. Appropriate use and co-use of these new tools will not only provide unique information for better clinical assessment of fetal cardiac disease but also offer new ways to improved understanding of cardiovascular development and pathogenesis.

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Real-time three-dimensional fetal echocardiography - optimal imaging windows

Cited by 44 publications

References 31 publications

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Real-time 3-Dimensional Fetal Echocardiography With an Instantaneous Volume-Rendered Display

New fetal cardiac imaging techniques

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