Study On Application Value Of STIC Technology In The Prenatal Diagnosis Of Congenital Heart Diseases

Objective: The aim of this study is to establish an optimal scheme for spatiotemporal image correlation(STIC)data acquisition,and to find the diagnostic value of STIC in the prenatal screening or diagnosis of congenital heart disease(CHD).Methods: Part I included 121 STIC images of normal fetal hearts.Multi-planar rending mode(MPR)was applied for offline analysis to obtain the required structures.The display rates of reconstructed structures and the influence factors were analyzed.T test and chi-square test were used for statistical analysis.The acquisition of Part II was based on the optimal acquisition scheme from Part I.Part II enrolled 169 cases for offline analysis and diagnosis and follow-up.The sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were analyzed for fetal echocardiography and STIC technology.Results: The proportion of successfully acquired STIC image was 79.3%(96/121).The display rates were: mitral valve(100.0%),the morphology of four chambers(98.2%),tricuspid valve(98.2%),abdominal view(97.5%),the connection of right ventricle and great artery(96.7%),atrioventricular junction(96.7%),the short axis view of great vessels(96.7%),the connection of left ventricle and great artery(94.2%),the three-vessel and trachea view(93.4%),ductal arch(89.3%),vena cava(86.0%),aortic arch(86.0%),foramen ovale(74.4%),pulmonary artery bifurcation(65.3%),the branches of aortic arch(55.4%),pulmonary venous return(53.7%),aortic valve(52.9%)and pulmonary valve(46.3%).The results of influence factors analysis showed that the original plane(P=0.0,P=0.014),shadowing(P=0.016,P=0.006),the orientation of the spine(P=0.0,P=0.003)and the difference value of volume angle and gestational age(P=0.003,P=0.042)had significant impacts in both criteria.The comparison of display rates of reconstructed structures between two parts suggested that left ventricular outflow tract(P=0.037),the aortic valve(P=0.016)and pulmonary valve(P=0.038)had a better vision in Part II than Part I.The display rates of short axis view of great vessels(P=0.0)and ductal arch(P=0.0)had lower display rates than Part I.The diagnostic sensitivity and specificity of two-dimensional fetal echocardiography for prenatal diagnosis of CHDs was 100%(42/42)and 95.9%(71/74)respectively,the PPV was 93.3%(42/45)and the NPV was 100%(71/71).The sensitivity and specificity of STIC in prenatal diagnosis of CHD was 92.6%(88/95)and 97.3%(72/74)respectively,the PPV was 97.8%(88/90)and the NPV was 91.1%(72/79).The area under the receiver operating characteristic(ROC)curve were 0.98 and 0.95 respectively.Conclusion: The results of display rates demonstrated the capability of STIC in the prenatal screening or diagnosis of CHDs.Optimal acquisition scheme is benefit to the application and promotion of the technology.STIC technology has a high diagnostic value in fetal CHDs.