The continuing enigma of the fetal echogenic intracardiac focus in prenatal ultrasound

Abstract

The origin of ICEF remains unclear. It is considered a normal developmental variant, but either inflammatory or hypoxic processes could be involved in its appearance. In low-risk populations for aneuploidy, the presence of an ICEF is not an indication for invasive procedures. In high-risk populations this depends on the previous calculated risk. In euploid fetuses, cardiac function is not significantly altered but further studies in specific populations may be justified. Fetuses with diffuse myocardial calcification or multiple foci may need further investigations.

Echogenic intracardiac foci and fetal cardiac anomalies: A review of cases from a tertiary care center in China

“…Reports indicate that, in fetuses, right-sided and bilateral EIFs carry greater significance than a left-sided EIF. 4,[8][9][10] However, these conclusions were based on a small number of observations, and a larger number of fetuses is needed to evaluate this issue fully. Therefore, we undertook this study to determine whether the ventricular location of an EIF influences the risk of cardiac anomalies.…”

Isolated Intracardiac Echogenic Focus on Routine Ultrasound: Implications for Practice

“…An isolated finding of ICEF in a woman whose screening tests reported a low risk for trisomy 21 has a low predictive value for trisomy 21 and does not predict later cardiac function . However, the finding can cause the woman and her partner to worry about the fetus’ health.…”

“…The echogenicity probably represents microcalcifications of the papillary muscles or chordae tendinae . ICEF is present at the midtrimester ultrasound in 3.5% of euploid fetuses and in 15% to 30% of fetuses with trisomy 21 . There can be one or multiple echogenic areas in the heart; they are most commonly found in the left ventricle .…”

“…stated that she would want to be prepared if her INTRODUCTION About 3.5% to 5% of routine, midgestation pregnancy ultrasounds detect ICEF in the fetus. 1,2 Although ICEF can be associated with trisomy 21, it has a low sensitivity and specificity and a high false-positive rate for this condition. [1][2][3] In fact, there is disagreement in the literature concerning whether the detection of soft markers such as ICEF is even valuable for the detection of trisomy 21.…”

“…About 3.5% to 5% of routine, midgestation pregnancy ultrasounds detect ICEF in the fetus . Although ICEF can be associated with trisomy 21, it has a low sensitivity and specificity and a high false‐positive rate for this condition .…”