4D fetal echocardiography—An update

DeVore, Greggory R.; Satou, Gary; Sklansky, Mark

doi:10.1111/echo.13708

Cited by 32 publications

(28 citation statements)

References 165 publications

(157 reference statements)

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“…3D/4D ultrasound provided important advancement in fetal echocardiography, which allowed for enhanced image acquisition and display and for the application of post-processing tools to help with spatial display of cardiac structures. The advent of the matrix probe promises an improvement in imaging as it enables an almost live 4D examination of the fetal heart, a rapid STIC acquisition (eSTIC) with reduced artifacts [20], as well as new tools as biplane or x-plane with a new perspective of the cardiac examination. The ability to semi-automate the fetal heart examination will ultimately result in simplification of the fetal echocardiography examination, with the ultimate goal of improving detection of congenital heart disease.…”

Section: Discussionmentioning

confidence: 99%

Recent Development in Three and Four Dimension Fetal Echocardiography

Chaoui¹,

Abuhamad

Martins

2019

Fetal Diagn Ther

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Since its introduction > 15 years ago, the use of spatial and temporal image correlation (STIC) technology has contributed substantially to fetal echocardiography. Moreover, significant advances have occurred in 3-and 4-dimensional (3D/4D) echocardiography over the past several years including the matrix probe along with advances in gray scale and color Doppler post processing, resulting in improved display of ultrasound images. In this article, we provide examples to show these recent developments including the use of color Doppler with STIC in the glass-body mode and the matrix probe thus enabling the demonstration of cardiac anomalies of the 4-chamber-view and great arteries. The use of the matrix probe allows the examination of cardiac structures in 2 orthogonal planes simultaneously, which can help in display of anatomy side by side (Biplane mode). In addition, the rapid image reconstruction of the matrix probe allows for the display of live 4D and the rapid acquisition of a STIC volume. The display of multiplanar images of the heart in 3D/4D has also been used to automate the display of ultrasound images, resulting in standardiza-tion of the image display and thus minimizing the operation dependency of the ultrasound examination. Future addition of image recognition software can also provide assistance in image review.

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Section: Discussionmentioning

confidence: 99%

Recent Development in Three and Four Dimension Fetal Echocardiography

Chaoui¹,

Abuhamad

Martins

2019

Fetal Diagn Ther

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“…The main limitations of the STIC technique are the artifacts introduced as a result of fetal movement and breathing, which compromise the usefulness of this technique for examining cardiovascular structures. 13 This imaging technology can facilitate a sophisticated evaluation of fetal vascular rings, but a learning curve is required. Due to the small patient population in this series, the long postprocessing time (>2 hours to produce a 3D image) could be further shortened with experience from more cases.…”

Section: Discussionmentioning

confidence: 99%

An In‐depth Perspective of Aortic Arch Branching in Fetal Vascular Rings Using Spatiotemporal Image Correlation Combined With High‐definition Flow Imaging: Report of 4 Cases

Tseng

Peng

Jan

2018

J of Ultrasound Medicine

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On the basis of 2‐dimensional fetal echocardiographic findings, we investigated 4 different fetal vascular ring cases using spatiotemporal image correlation (STIC) combined with high‐definition (HD) flow imaging. An in‐depth 3‐dimensional perspective of aortic arch branching (ie, the brachiocephalic arteries) was created by application of glass body and HDlive flow rendering algorithms (GE Healthcare, Zipf, Austria). Additionally, complete (U‐ or O‐shaped) or incomplete (C‐shaped) vascular rings were clearly differentiated in utero, and articulations around the trachea and esophagus were more easily imaged. In conclusion, spatiotemporal image correlation combined with HD flow imaging could classify fetal vascular rings with accuracy and facilitate decision making during postnatal management.

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“…Since its first description as an off-line 4 D fetal echocardiography technique [1], Spatial Temporal Image Correlation (STIC) analysis has been validated as a useful clinical tool [2], offering remote evaluation of digitally stored fetal heart volumes by experts [3], improved imaging of complex vascular malformations [4], unique views of the fetal heart valves and interventricular septum [2,5,6]. It also represents a promising research tool, allowing for fetal heart volumetry [7], biometry [8] and assessment of systolic ventricular function [9,10], while it enhances fetal echocardiography teaching [11] and morphological interpretation especially when assisted by designated software applications [12,13].…”

Section: Introductionmentioning

confidence: 99%

Electronic versus conventional spatiotemporal image correlation (STIC) fetal echocardiography: a direct comparison

Pepes

Parthenakis

Makrigiannakis

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

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Objectives: Recent advances in Spatial Temporal Image Correlation (STIC) 4 D fetal echocardiography include the application of eSTIC based on electronic probe image acquisition. We aimed to directly compare the performance of conventional STIC versus eSTIC technique (B-Mode and color Doppler imaging) during off-line reconstruction of STIC/eSTIC fetal heart volume pairs. Methods: Pairs of B-Mode and Color Doppler STIC volumes were acquired sequentially by firstly conventional (STIC) followed by electronic (eSTIC) probes during 33 consecutive obstetric scans at median 23 (range 13-31) gestational weeks. The resulting 66 fetal heart volume pairs were assessed blindly off-line by a fetal cardiologist who documented feasibility of reconstruction, presence of motion artifacts, subjective image quality on a 4-level scale: 1-best to 4-non-diagnostic and morphological diagnosis, to enable a paired comparison of STIC and eSTIC in the same fetus under similar scanning conditions. Results: eSTIC volumes had higher temporal resolution (37 vs. 24 frames per second, p < .001), less motion during acquisition (12 vs. 20 cases, O.R. 7.0, p ¼ .002) and better average image quality (1.9 vs. 2.2, p ¼ .006) compared to STIC volumes. More diagnostic reconstructions were achieved by eSTIC (n ¼ 55, 86%) than STIC (n ¼ 52, 78.8%), p ¼ .001), in a comparable analysis time (mean 4.96 vs. 4.94 min). During a comparison of image quality of the original acquisition (A) and reconstructed planes (B and C planes) e STIC was superior in 22 (33%), 39 (59%) and 21 (38%) volumes, respectively, with the remaining cases being of similar quality (<10% in each plane in favor of STIC). Imaging mode and gestational age had a similar impact on both eSTIC and STIC performance: diagnostically acceptable studies in 49 (75.8%) vs. 48 (72.2%) by B-Mode, 60 (90.9%) vs. 56 (84.8%) by Color Doppler Mode, 8 (62.5%) vs. 10 (50%) in early scans, 38 (95%) vs. 38 (95%) in mid-gestation scans, and 7 (70%) vs. 6 (60%) in third trimester scans. Eight obstetric scans identified a fetus with a cardiac variant or structural abnormality. Diagnostic concordance of the two STIC approaches was comparable (40/48 concordant interpretations, kappa 0.657) all confirmed by fetal and/or postnatal echocardiography. Conclusions: eSTIC was associated with more effective 4 D fetal heart reconstruction due to reduced motion artifacts and superior image quality in all planes, when compared to STIC. Early gestation reconstructions were not generally successful using either technology. Further study is needed to define the cost-effectiveness and diagnostic impact of eSTIC over conventional STIC and their role over, or in addition to, screening 2 D fetal echocardiography by appropriately trained sonographers.

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4D fetal echocardiography—An update

Cited by 32 publications

References 165 publications

Recent Development in Three and Four Dimension Fetal Echocardiography

Recent Development in Three and Four Dimension Fetal Echocardiography

An In‐depth Perspective of Aortic Arch Branching in Fetal Vascular Rings Using Spatiotemporal Image Correlation Combined With High‐definition Flow Imaging: Report of 4 Cases

Electronic versus conventional spatiotemporal image correlation (STIC) fetal echocardiography: a direct comparison

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