Initial Study Of Fetal Heart With Spatiotemporal Image Correlation

Three-dimensional fetal echocardiography is a developing new technique during several years, along with growth of color Doppler and perinatology, improvement of congenital cardiovascular anomaly interventional therapy. It plays a more important role in prenatal diagnosis of morphosis fetal cardiac morphosis and function. This study with spatiotemporal image correlation was designed to evalue fetal cardiac morphosis and function, comparing with two-dimensional fetal echocardiography.Study population and MethodsStudy populationFetal echocardiographic examinations were performed in26consecutive pregnant women, aged28±2.9years, range23-35years, gestational age31±7.4weeks, range16-41weeks). They fulfilled the following inclusion criteria:(1) no evidence of structural cardiovascular disease founded by fetal echocardiography,(2) no evidence of other organ system diseases detected prenatally by2-dimensional or Doppler ultrasonography.Methods The ultrasound system used in this study was a Voluson730Expert series (GE Medical System). The transducers are S32D probe (2.5-3.5MHz) and the real-time probe(3.5-5.0MHz). Fetal Echo and4D View were used for analysis.Each fetal heart was carried out a2D ultrasound sweep ranging20-40min and a3D ultrasound sweep ranging10-20min by the same operator. Data acquisition finished and was stored.To assess fetal cardiac morphosis, the cardiac apex fou-chamber view, left ventricle outflow tract long axis or the cardiac apex five-chamber view, ritht ventricle outflow tract long axis view, three-vessels view or aortic arch long axis view are required. The following items should be observed:the size of chambers, valves, thickness of ventricle wall, valve orifice blood flow, arterial duct, valve of foramen ovale, the soure, intermal diameterd and courser of aorta and pulmonary artery.Fetal left ventricle (LV) systole function assessment was carried by two ways: simplify Simpson and VOCAL II in STIC.LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were obtained by three-dimensional reconstruction of LV with VOCAL II and LV ejection fraction (LVEF) gaind on the basis of the formula LVEF=(LVEDV-LVESV)/LVEDV.Results262D-FE examinations and263D-FE examinations were performed in26fetuses, among them25with normal cardiac structures and normal rhythm, and one with isolated irregulary thythm, whose heart rate were in normal range (120-180beats/min).Volume data acquired by STIC was offline analyzed on4D View, including Tomographic Ultrasound Imaging, Niche, Render,VOCAL II. More information were procured than2D-FE.Fetal LV systole function assessment was carried in22fetuses. By simplify Simpson, LVEDV is (1.99±2.38)ml, LVESV is (0.62±0.48)ml, SV(stroke volume) is (1.37±2.00)ml, LVEF is (63.0±8.4)%; By VOCAL II, LVEDV is (1.90±1.21)ml, LVESV is (0.71±0.41)ml, SV is (1.20±0.87)ml, LVEF is (61.4±7.0)%. No significant changes of LVEDV,LVESV,SV,LVEF were observed in fetuses with two measurements. ConclusionSTIC is a multiple fast real-time skill with three-dimensional reconstruction, observing fetal heart more accutate, diminishing influence on examinations by checker and fetal position, reducing scanning time, assessing LV systolic function more exactly. It has an advantage than common2D-FE, conducing to prenatal diagnosis and curative effect evaluation.