Detailed three-dimensional fetal echocardiography facilitated by an Internet link.
ABSTRACT To assess whether a complete virtual cardiological examination can be achieved in stored three-dimensional volumes of the fetal heart, transmitted to a tertiary fetal cardiology center via the Internet.
Thirty sequential normal singleton pregnancies were included in the study. Four cardiac volumes were acquired using a three-dimensional ultrasound system. The volumes were sent via the Internet to a tertiary fetal cardiology center, where a detailed fetal cardiac examination was attempted using the three-dimensional volumetric dataset.
The median gestational age was 24 (range, 22-28) weeks. A complete heart examination was accomplished in 23 of 30 cases (76.7%; 95% confidence interval, 58-90%). The four-chamber view and the cardiac situs were seen in all cases. The right ventricular outflow tract was seen in 29 (96.7%) cases and the left ventricular outflow tract in 25 (83.3%) cases. The long-axis view of the aortic arch, superior vena cava, inferior vena cava and pulmonary veins were visualized in more than 80% of cases. The mean time of volume acquisition was 9.5 (standard deviation, 2.3) min and the mean examination time by the fetal cardiologist was 17 (standard deviation, 4.8) min.
These preliminary results demonstrate that a three-dimensional virtual examination of the fetal heart is possible. There are limitations such as the lack of flow and functional information but complete ascertainment of the main cardiac connections was possible in the majority of cases. The use of an Internet link has major implications, particularly for situations in which the scanning center is geographically remote from the tertiary referral center.
- SourceAvailable from: ncbi.nlm.nih.gov[show abstract] [hide abstract]
ABSTRACT: In the last decade 3D and live 3D ultrasound or the so called 4D (3D/4D) in examination of the fetal heart evolved very rapidly with the development of the new technique called Spatiotemporal Image Corelation - STIC, which enables the aquisition of a volume data concomitent with the beating heart. It appears that 3D/4D ultrasound in fetal echocardiography may make an important contribution to the diagnosis of congenital heart disease, to interdisciplinary management, to parental counseling and to medical personal training.Mædica. 01/2010; 5(1):45-50.
Article: Advances in fetal cardiac imaging.[show abstract] [hide abstract]
ABSTRACT: During the past 25 years, two-dimensional imaging of the fetal heart has evolved into a sophisticated and widely practiced clinical tool, but most heart disease still goes undetected until sometime after birth, despite routine fetal ultrasound evaluations. Over the next 25 years, tremendous advances in fetal cardiac imaging, including three-dimensional imaging, promise to revolutionize both the prenatal detection and diagnosis of congenital heart disease. Image resolution continues to improve year after year, allowing earlier (10-15 week) visualization of the fetal heart, as well as the detection of subtle valvar abnormalities that may progress to serious forms of ventricular hypoplasia at term. However, fetal cardiac imaging remains constrained by limited sonographic windows. To improve the prenatal detection of congenital heart disease, outflow tracts are increasingly included along with the routine screening four-chamber view. However, while the four-chamber view resides within a single plane, lending itself to tomographic evaluation with two-dimensional ultrasound, the outflow tracts (and most forms of congenital heart disease) do not reside within a single plane. For these and other reasons, three-dimensional imaging of the fetal heart ultimately may improve the detection of outflow tract abnormalities, and facilitate comprehension of complex forms of congenital heart disease. Finally, other imaging modalities, including but not limited to Doppler tissue imaging and magnetic resonance imaging, continue to evolve and to complement two- and three-dimensional sonographic imaging of the fetal heart. As a result of these ongoing advances in the prenatal detection and assessment of congenital heart disease, these are exciting and glorious times for the field of fetal cardiac imaging.Pediatric Cardiology 01/2011; 25(3):307-21. · 1.20 Impact Factor
- Gynécologie Obstétrique & Fertilité 04/2009; 37(3):269-74. · 0.55 Impact Factor