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Prenatal screening for congenital heart disease using real‐time three‐dimensional echocardiography and a novel ‘sweep volume’ acquisition technique
Author(s) -
Sklansky M.,
Miller D.,
Devore G.,
Kung G.,
Pretorius D.,
Wong P.,
Chang R.K.
Publication year - 2005
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.1858
Subject(s) - medicine , fetal echocardiography , heart disease , cardiology , gold standard (test) , fetus , prenatal diagnosis , radiology , volume (thermodynamics) , fetal heart , pregnancy , genetics , physics , quantum mechanics , biology
Objectives Conventional prenatal screening for congenital heart disease (CHD) involves a time‐consuming and highly operator‐dependent acquisition of the four‐chamber view and outflow tracts. By acquiring the entire fetal heart instantaneously as a single volume, real‐time three‐dimensional echocardiography (RT3DE) may facilitate fetal cardiac screening. Methods Four reviewers, each experienced with fetal cardiac imaging, blindly and independently evaluated a single cardiac volume from each of 18 fetuses (11 normal, seven with CHD). Two‐dimensional echocardiography served as the gold standard. Three‐dimensional evaluation of each fetus included a series of volume acquisitions lasting 2–6 s each. A ‘sweep volume’ technique was developed to fit larger hearts into a single non‐gated volume. Results RT3DE had a high sensitivity for detecting CHD (93%), with only a single case being missed by two observers. Specificity for CHD was low (45%), with a high rate of ‘cannot determine’ responses and false positive artifacts. Conclusions These preliminary results suggest that RT3DE has the potential to function as a screening tool for fetal heart disease. However, artifacts must be recognized and minimized, resolution must improve, and substantial training will be necessary prior to widespread clinical use. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.