Clinical value of Fetal Intelligent Navigation Echocardiography (5D Heart) to display diagnostic views of fetal complete transposition of the great arteries

doi:10.3877/cma.j.issn.1672-6448.2020.09.009

Abstract

Abstract:

Objective

To evaluate the value of Fetal Intelligent Navigation Echocardiography (5D Heart) in displaying the diagnostic views of fetal complete transposition of the great arteries (cTGA).

Methods

The fetal heart volume datasets of 15 fetuses with cTGA were collected at Sir Run Run Shaw Hospital from January to July 2018, and an experienced sonographer in fetal echocardiography was responsible for the collection. Only the heart volume dataset with the best image quality per case was selected by two sonographers with relatively insufficient experiences in performing fetal echocardiography and analyzed using 5D Heart software and the built-in VIS-Assistance. The images were analyzed 2 weeks later by one of the two sonographers. All the images were stored. Then, the image qualities of diagnostic views and diagnostic elements of each view were graded and the visualization rates were calculated. The consistency of visualization rates of one sonographer in different periods of time and those between two sonographers were compared.

Results

The visualization rates of the four diagnostic views, namely, three-vessel view (3VT), four-chamber view (4CV), left ventricular outlet view (LVOT), and right ventricular outlet view (RVOT), by using 5D Heart software combining VIS-Assistance were 86.7%, 93.3%, 80.0%, and 86.7%, respectively. The visualization rates of the diagnostic elements in the diagnostic views were greater than 73.3%. No significant differences were found when comparing the visualization rates of one sonographer in different periods of time and the visualization rates between two relatively inexperienced sonographers (P>0.05).

Conclusion

5D Heart technology has a high visualization rate of the diagnostic views in fetus with cTGA, with high repeatability and consistency, and it can assist inexperienced sonographers to screen for fetal cTGA.

Key words: Congenital heart disease, Complete transposition of the great arteries, Fetal echocardiography, Fetal intelligent navigation echocardiography

Haisu Pang, Bowen Zhao, Chao Huang, Ran Chen, Mei Pan, Xiaohui Peng, Bei Wang. Clinical value of Fetal Intelligent Navigation Echocardiography (5D Heart) to display diagnostic views of fetal complete transposition of the great arteries[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(09): 866-873.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.09.009

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I09/866

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References 24

1	Villafane J, Lantin-Hermoso MR, Bhatt AB, et al. D-transposition of the great arteries: the current era of the arterial switch operation [J]. J Am Coll Cardiol, 2014, 64(5): 498-511.
2	Clark EB. Pathogenetic mechanisms of congenital cardiovascular malformations revisited [J]. Semin Perinatol, 1996, 20(6): 465-472.
3	Anderson RH, Becker AE, Losekoot TG, et al. Anatomically corrected malposition of great arteries [J]. Br Heart J, 1975, 37(10): 993-1013.
4	Raboisson MJ, Samson C, Ducreux C, et al. Impact of prenatal diagnosis of transposition of the great arteries on obstetric and early postnatal management [J]. Eur J Obstet Gynecol Reprod Biol, 2009, 142(1): 18-22.
5	Blyth M, Howe D, Gnanapragasam J, et al. The hidden mortality of transposition of the great arteries and survival advantage provided by prenatal diagnosis [J]. BJOG, 2008, 115(9): 1096-1100.
6	Bertagna F, Rakza T, Vaksmann G, et al. Transposition of the great arteries: factors influencing prenatal diagnosis [J]. Prenat Diagn, 2014, 34(6): 534-547.
7	Khoshnood B, De Vigan C, Vodovar V, et al. Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in France, 1983-2000: a population-based evaluation [J]. Pediatrics, 2005, 115(1): 95-101.
8	Lammer EJ, Chak JS, Iovannisci DM, et al. Chromosomal abnormalities among children born with conotruncal cardiac defects [J]. Birth Defects Res A Clin Mol Teratol, 2009, 85(1): 30-35.
9	Song MS, Hu A, Dyamenahalli U, et al. Extracardiac lesions and chromosomal abnormalities associated with major fetal heart defects: comparison of intrauterine, postnatal and postmortem diagnoses [J]. Ultrasound Obstet Gynecol, 2009, 33(5): 552-559.
10	Yagel S, Cohen SM, Rosenak D, et al. Added value of three-/four-dimensional ultrasound in offline analysis and diagnosis of congenital heart disease [J]. Ultrasound Obstet Gynecol, 2011, 37(4): 432-437.
11	Espinoza J, Lee W, Comstock C, et al. Collaborative study on 4-dimensional echocardiography for the diagnosis of fetal heart defects: the COFEHD study [J]. J Ultrasound Med, 2010, 29(11): 1573-1580.
12	Kusanovic JP, Nien JK, Goncalves LF, et al. The use of inversion mode and 3D manual segmentation in volume measurement of fetal fluid-filled structures: comparison with Virtual Organ Computer-aided AnaLysis (VOCAL) [J]. Ultrasound Obstet Gynecol, 2008, 31(2): 177-186.
13	Gonçalves LF, Espinoza J, Romero R, et al. Four-dimensional ultrasonography of the fetal heart using a novel Tomographic Ultrasound Imaging display [J]. J Perinat Med, 2006, 34(1): 39-55.
14	Jurgens J, Chaoui R. Three-dimensional multiplanar time-motion ultrasound or anatomical M-mode of the fetal heart: a new technique in fetal echocardiography [J]. Ultrasound Obstet Gynecol, 2003, 21(2): 119-123.
15	Bega G, Lev-Toaff A, Kuhlman K, et al. Three-dimensional ultrasonographic imaging in obstetrics: present and future applications [J]. J Ultrasound Med, 2001, 20(4): 391-408.
16	Tripodi E, Tripodi A, Sturlese E. Fetal echocardiography: a comparison of different techniques [J]. Clin Exp Obstet Gynecol, 2000, 27(3-4): 225-226.
17	Van Velzen C, Haak M, Reijnders G, et al. Prenatal detection of transposition of the great arteries reduces mortality and morbidity [J]. Ultrasound Obstet Gynecol, 2015, 45(3): 320-325.
18	Chaoui R. The four-chamber view: four reasons why it seems to fail in screening for cardiac abnormalities and suggestions to improve detection rate [J]. Ultrasound Obstet Gynecol, 2003, 22(1): 3-10.
19	American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of obstetric ultrasound examinations [J]. J Ultrasound Med, 2013, 32(6): 1083-1101.
20	Salomon L, Alfirevic Z, Berghella V, et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan [J]. Ultrasound Obstet Gynecol, 2011, 37(1): 116-126.
21	Yeo L, Romero R. Intelligent navigation to improve obstetrical sonography [J]. Ultrasound Obstet Gynecol, 2016, 47(4): 403-409.
22	Garcia M, Yeo L, Romero R, et al. Prospective evaluation of the fetal heart using fetal intelligent navigation echocardiography (FINE) [J]. Ultrasound Obstet Gynecol, 2016, 47(4): 450-459.
23	Ravi P, Mills L, Fruitman D, et al. Population trends in prenatal detection of transposition of great arteries: impact of obstetric screening ultrasound guidelines [J]. Ultrasound Obstet Gynecol, 2018, 51(5): 659-664.
24	Yeo L, Luewan S, Romero R. Fetal intelligent navigation echocardiography (FINE) detects 98% of congenital heart disease [J]. J Ultrasound Med, 2018, 37(11):2577-2593.

诊断切面	诊断要素	诊断要素显示率（%）
三血管气管切面	仅见一只大血管	86.7
三血管气管切面	上腔静脉	93.3
四腔心切面	四个房室腔	100.0
	卵圆孔瓣	60.0
	十字交叉	100.0
	室间隔	100.0
	调节束	100.0
	房室瓣	100.0
	房室瓣距离	100.0
左心室流出道切面	起自解剖右心室的大血管未见分支/　起自解剖左心室的大血管可见分支	73.3
左心室流出道切面	两条大血管平行走形	73.3
大动脉短轴切面	主动脉、肺动脉交叉环抱关系消失	80.0

诊断切面	诊断要素	诊断要素显示率（%）
三血管气管切面	仅见一只大血管	86.7
三血管气管切面	上腔静脉	93.3
四腔心切面	四个房室腔	100.0
	卵圆孔瓣	60.0
	十字交叉	100.0
	室间隔	100.0
	调节束	100.0
	房室瓣	100.0
	房室瓣距离	100.0
左心室流出道切面	起自解剖右心室的大血管未见分支/　起自解剖左心室的大血管可见分支	73.3
左心室流出道切面	两条大血管平行走形	73.3
大动脉短轴切面	主动脉、肺动脉交叉环抱关系消失	80.0

评分	3VT	Four chamber	LVOT	RVOT
第1次	2.000（2.000~3.000）	3.000（2.000~3.000）	2.000（2.000~2.000）	2.500（2.000~2.000）
第2次	2.000（2.000~3.000）	3.000（2.000~3.000）	2.000（2.000~3.000）	1.000（2.000~3.000）
Z值	-0.000	-0.447	-0.577	-0.447
P值	1.000	0.655	0.564	0.655

评分	3VT	Four chamber	LVOT	RVOT
第1次	2.000（2.000~3.000）	3.000（2.000~3.000）	2.000（2.000~2.000）	2.500（2.000~2.000）
第2次	2.000（2.000~3.000）	3.000（2.000~3.000）	2.000（2.000~3.000）	1.000（2.000~3.000）
Z值	-0.000	-0.447	-0.577	-0.447
P值	1.000	0.655	0.564	0.655

医师	3VT	Four chamber	LVOT	RVOT
医师A	2.000（2.000~3.000）	3.000（2.000~3.000）	2.000（2.000~3.000）	2.000（2.000~2.000）
医师B	2.000（2.000~3.000）	3.000（2.000~3.000）	2.000（2.000~3.000）	2.000（2.000~3.000）
Z值	-1.000	-1.000	-1.890	-0.816
P值	0.317	0.371	0.059	0.414

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