Standardization of the first-trimester fetal cardiac examination using spatiotemporal image correlation with tomographic ultrasound and color Doppler imaging

S. Turan, O. M. Turan, K. Ty-Torredes, C. R. Harman, A. A. Baschat

Research output: Contribution to journalArticle

Abstract

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/m2) 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.

Original languageEnglish (US)
Pages (from-to)652-656
Number of pages5
JournalUltrasound in Obstetrics and Gynecology
Volume33
Issue number6
DOIs
StatePublished - Jun 1 2009
Externally publishedYes

Keywords

  • 3-dimensional ultrasound
  • 4-dimensional ultrasound
  • Fetal echocardiography
  • First trimester
  • Spatiotemporal image correlation
  • Tomographic ultrasound imaging

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

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