Detailed three-dimensional fetal echocardiography facilitated by Internet link

Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK.
Ultrasound in Obstetrics and Gynecology (Impact Factor: 3.85). 11/2001; 18(4):325-8. DOI: 10.1046/j.0960-7692.2001.00520.x
Source: PubMed


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.

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    • "acquiring data from the fetal heart (a single, automatic volume sweep) and produces a 4D cine sequence.(Michailidis et al., 2001) A group from Chile conducted a similar study STIC transmitted across an ADSL connection with bandwidths of 300 and 600 kbps. In total fifty scans were transmitted from two peripheral hospitals to the regional centre. On average complete fetal echocardiograms could be interpreted in 92%.(Vinals et al., 2005)"

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