Selection and identification of standard cardiac views from three-dimensional volume scans of the fetal thorax.

Zosmer, Nurit; Jurkovic, D.; Jauniaux, Eric; Gruboeck, K; Lees, C.; Campbell, Stuart

doi:10.7863/jum.1996.15.1.25

Cited by 46 publications

(27 citation statements)

References 4 publications

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“…Three-dimensional [45][46][47][48][49][50][51] and, more recently, four-dimensional ultrasonography of the fetal heart [52][53][54][55][56][57][58] have the potential for making the examination less operator-dependent. Once a volume dataset is acquired, the heart can be examined using multiple planes of section, some of which are unobtainable with two-dimensional ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Gonçalves

Espinoza

Romero

et al. 2005

The Journal of Maternal-Fetal & Neonatal Medicine

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Methods.A technique was developed to obtain dynamic multiplanar images of the left ventricular outflow tract (LVOT) and right ventricular outflow tract (RVOT) from volume datasets acquired with STIC. Volume datasets were acquired from fetuses with normal cardiac anatomy. Twenty volume datasets of satisfactory quality were pre-selected by one investigator. The data was randomly assigned for a blinded review by two independent observers with previous experience in fetal echocardiography. Only one volume dataset was used for each fetus. After a training session, the observers obtained standardized cardiac views of the LVOT and RVOT, which were scored on a scale of 1 to 5, based on diagnostic value and image quality (1 = unacceptable, 2 = marginal, 3 = acceptable, 4 = good, and 5 = excellent). Median scores and interquartile range, as well as inter-and intraobserver agreement were calculated for each view. Results. The mean menstrual age at the time of volume acquisition was 25.5 + 4.5 weeks. Median scores (interquartile range) for LVOT images, obtained by the first and second observers, were 3.5 (2.25-5.00) and 4 (3.00-5.00), respectively. The median scores (interquartile range) for RVOT images obtained by the first and second observers were 3 (3.00-5.00) and 3 (2.00-4.00), respectively. The interobserver intraclass correlation coefficient for the LVOT was 0.693 (95% CI 0.380-0.822), and 0.696 (95% CI 0.382-0.866) for the RVOT. For the intraobserver agreement analysis, observer 1 gave higher scores to the LVOT the second time the volumes were analyzed [LVOT: 3.50 (2.25-5.00) vs. 5.00 (4.00-5.00, p = 0.008)]. Conclusion. STIC can be reproducibly used to evaluate fetal cardiac outflow tracts by independent examiners. Slightly better image quality rating scores during the intraobserver variability trial suggests the presence of a learning curve for the manipulation and analysis of volume data obtained by STIC.

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Section: Introductionmentioning

confidence: 99%

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Gonçalves

Espinoza

Romero

et al. 2005

The Journal of Maternal-Fetal & Neonatal Medicine

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show abstract

“…21 rapid, is simple, and does not require specialized training to obtain echocardiographic views, (2) ability to slice the acquired three-dimensional volumetric data into an infinite number of planes and views, including views not visualized on two-dimensional imaging, (3) ability to move back and forth through an acquired volume, allowing for appreciation of the three-dimensionality of the visualized structures, (4) ability to store acquired data, which can be manipulated by multiple reviewers after the study has been completed, and finally (5) improved educational potential.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19][20] Preliminary 3DUS studies of the fetal heart have been performed both without and with cardiac gating and appear promising. 21,22 Whereas cardiac gating appears to have theoretical advantages, in view of the difficulty in obtaining acceptable fetal electrocardiographic tracings and the need for special equipment, the aim of this study is to assess the ability of non-cardiac-gated 3DUS of the fetus to improve the visualization of the fetal heart as opposed to routine 2DUS by displaying standard echocardiographic views from a threedimensional volume obtained by personnel without specialized echocardiographic training.…”

mentioning

confidence: 99%

Three-dimensional ultrasonography of normal fetal heart: comparison with two-dimensional imaging.

Levental

Pretorius

Sklansky

et al. 1998

Journal of Ultrasound in Medicine

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Thirty‐one high‐risk patients (16 to 35 weeks' gestation) underwent two‐dimensional and three‐dimensional ultrasonography to compare two‐dimensional and non‐cardiac‐gated three‐dimensional ultrasonography of the normal fetal heart. After normal two‐dimensional studies, three‐dimensional sonographic volumes were acquired without cardiac gating in transverse and longitudinal planes. Standard cardiac views were derived from three‐dimensional data, analyzed, and rated as follows: (1) not identifiable, (2) identifiable but inadequate for diagnosis, (3) adequate, and (4) excellent. Two‐dimensional ultrasonography demonstrated better yields of diagnostically acceptable images of basic echocardiographic views (four‐chamber view, 100% for two‐dimensional sonography versus 10 to 71% for three‐dimensional sonography; right ventricular outflow tract, 42% for two‐dimensional versus 6 to 26% for three‐dimensional ultrasonography; left ventricular outflow tract, 71% for two‐dimensional versus 13 to 45% for three‐dimensional sonography). In one subject three‐dimensional ultrasonography was superior to two‐dimensional sonography in demonstrating an outflow tract. Aortic and ductal arches were not imaged with the two‐dimensional technique but were available from the acquired three‐dimensional volumes in 3 to 32% and 23%, respectively. False‐positive and false‐negative findings were observed on three‐dimensional ultrasonograms. Overall, compared to two‐dimensional ultrasonography, non‐cardiac‐gated three‐dimensional sonography yielded inadequate reconstructed image quality of basic echocardiographic views (four‐chamber view, right ventricular outflow tract, left ventricular outflow tract). Three‐dimensional ultrasonography, however, shows potential for allowing nonechocardiographers to acquire some diagnostically acceptable views of the aortic and ductal arches.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Rapid and facile, 3D imaging allows the acquisition of a volume data set in a matter of seconds, in comparison with the more prolonged interval typically required for conventional fetal cardiac imaging. Thus, whereas conventional fetal cardiac imaging requires a great deal of expertise, acquisition of volume data sets appears far less dependent on operator expertise.…”

Section: B Amentioning

confidence: 99%

“…Although the majority of work in fetal 3D sonographic cardiac imaging has focused on reconstructive techniques, [1][2][3][4][5][6][7][8][9][10][11]14 real-time 3D technology has recently emerged as a potentially superior approach to fetal car-diac imaging. 12,13,15 Although reconstructive techniques acquire a series of planar images over several seconds, real-time approaches acquire entire volumes (rather than single planes) instantaneously, using specialized 2D matrix, phased array transducers.…”

mentioning

confidence: 99%

Real-time 3-Dimensional Fetal Echocardiography With an Instantaneous Volume-Rendered Display

Sklansky

DeVore²,

Wong

2004

Journal of Ultrasound in Medicine

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Objective. Random fetal motion, rapid fetal heart rates, and cumbersome processing algorithms have limited reconstructive approaches to 3-dimensional fetal cardiac imaging. Given the recent development of real-time, instantaneous volume-rendered sonographic displays of volume data, we sought to apply this technology to fetal cardiac imaging. Methods. We obtained 1 to 6 volume data sets on each of 30 fetal hearts referred for formal fetal echocardiography. Each volume data set was acquired over 2 to 8 seconds and stored on the system's hard drive. Rendered images were subsequently processed to optimize translucency, smoothing, and orientation and cropped to reveal "surgeon's eye views" of clinically relevant anatomic structures. Qualitative comparison was made with conventional fetal echocardiography for each subject. Results. Volume-rendered displays identified all major abnormalities but failed to identify small ventricular septal defects in 2 patients. Important planes and views not visualized during the actual scans were generated with minimal processing of rendered image displays. Volume-rendered displays tended to have slightly inferior image quality compared with conventional 2-dimensional images. Conclusions. Real-time 3-dimensional echocardiography with instantaneous volume-rendered displays of the fetal heart represents a new approach to fetal cardiac imaging with tremendous clinical potential.

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Selection and identification of standard cardiac views from three-dimensional volume scans of the fetal thorax.

Cited by 46 publications

References 4 publications

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

Three-dimensional ultrasonography of normal fetal heart: comparison with two-dimensional imaging.

Real-time 3-Dimensional Fetal Echocardiography With an Instantaneous Volume-Rendered Display

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