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Standardization of the first‐trimester fetal cardiac examination using spatiotemporal image correlation with tomographic ultrasound and color Doppler imaging
Author(s) -
Turan S.,
Turan O. M.,
TyTorredes K.,
Harman C. R.,
Baschat A. A.
Publication year - 2009
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.6372
Subject(s) - medicine , ultrasound , great vessels , fetal echocardiography , artifact (error) , radiology , nuclear medicine , fetus , prenatal diagnosis , cardiology , pregnancy , artificial intelligence , genetics , biology , computer science
Objective The challenges of the first‐trimester examination of the fetal heart may in part be overcome by technical advances in three‐dimensional (3D) ultrasound techniques. Our aim was to standardize the first‐trimester 3D imaging approach to the cardiac examination to provide the most consistent and accurate display of anatomy. Methods Low‐risk women with normal findings on first‐trimester screening at 11 to 13 + 6 weeks had cardiac ultrasound using the following sequence: (1) identification of the four‐chamber view; (2) four‐dimensional (4D) volume acquisition with spatiotemporal image correlation (STIC) and color Doppler imaging (angle = 20°, sweep 10 s); (3) offline, tomographic ultrasound imaging (TUI) analysis with standardized starting plane (four‐chamber view), slice number and thickness; (4) assessment of fetal cardiac anatomy (four‐chamber view, cardiac axis, size and symmetry, atrioventricular valves, great arteries and descending aorta) with and without color Doppler. Results 107 consecutive women (age, 16–42 years, body mass index 17.2–50.2 kg/m 2 ) were studied. A minimum of three 3D volumes were obtained for each patient, transabdominally in 91.6%. Fetal motion artifact required acquisition of more than three volumes in 20%. The median time for TUI offline analysis was 100 (range, 60–240) s. Individual anatomic landmarks were identified in 89.7–99.1%. Visualization of all structures in one panel was observed in 91 patients (85%). Conclusion Starting from a simple two‐dimensional cardiac landmark—the four‐chamber view—the standardized STIC‐TUI technique enables detailed segmental cardiac evaluation of the normal fetal heart in the first trimester. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.