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Accuracy of four‐dimensional spatiotemporal image correlation echocardiography in the prenatal diagnosis of congenital heart defects
Author(s) -
Bennasar M.,
Martínez J. M.,
Gómez O.,
Bartrons J.,
Olivella A.,
Puerto B.,
Gratacós E.
Publication year - 2010
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.7720
Subject(s) - medicine , concordance , fetal echocardiography , gestational age , heart disease , medical diagnosis , radiology , autopsy , population , gestation , pregnancy , ultrasound , cardiology , prenatal diagnosis , fetus , environmental health , biology , genetics
Abstract Objective To evaluate the accuracy of four‐dimensional (4D) spatiotemporal image correlation (STIC) echocardiography for the diagnosis of fetal congenital heart disease (CHD) in a selected high‐risk population. Methods Three hundred and sixty‐three pregnant women referred for suspected CHD on screening ultrasound were evaluated by means of conventional echocardiography between 14 and 41 weeks' gestation and 4D‐STIC volumes were obtained (including gray‐scale and color Doppler information). Stored volumes were analyzed, at least 1 year after they had been acquired, by examiners blinded to the patients' identities and outcomes. The STIC diagnoses were compared to those made on conventional two‐dimensional echocardiography and the accuracy of diagnosis was assessed with respect to postnatal examination, or autopsy in cases of termination of pregnancy or perinatal death. Results The mean gestational age at volume acquisition was 24 + 5 weeks. STIC evaluation was possible in 98% of cases. Twenty‐one cases were lost to follow‐up, with a total of 167 normal hearts and 175 cases of CHD diagnosed at postnatal evaluation. The overall accuracy, sensitivity, specificity and positive and negative predictive values of STIC in determining the presence or absence of CHD were 91.6, 94.9, 88.1, 89.7 and 94.0%, respectively. Absolute concordance with the final specific diagnosis among cases with confirmed CHD was 74.3% for STIC echocardiography, compared with 81.7% for real‐time evaluation. Conclusion 4D‐STIC echocardiography performed by experienced operators can be used in fetuses at risk for cardiac anomalies in order to reliably provide reassurance of normality or to accurately diagnose major structural heart defects. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.