Volumetry of Fetal Hearts using 3D Real-Time Matrix Echocardiography – In Vitro Validation Experiments and 3D Echocardiographic Studies in Fetuses

Herberg, Ulrike; Luck, Susan R.; Steinweg, B.; Brand, M.; Knies, Ralf; Geipel, A.; Trier, H. G.; Breuer, Johannes

doi:10.1055/s-0029-1245428

Cited by 6 publications

(24 citation statements)

References 15 publications

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“…3,4,10,15,16 In accordance with these studies, our results show that real-time 3D echocardiography-derived volumes and areas are significantly smaller than actual measurements. confidence interval.…”

Section: Discussionsupporting

confidence: 89%

“…Customized tissuemimicking test objects with volumes between 0.5 and 50 mL were used to confirm the results obtained by the eggshaped phantom and to assess volume measurements with various sizes. 10 The ultrasound system used for 2D and 3D studies was a Sonos 7500 unit (Philips Healthcare, Andover, MA) with conventional phased array transducers (sector scanner: S8, 3-8 MHz; curved array: C3540, 6-8 MHz) and a matrix transducer (X4-1, 4 MHz, used in 2D and real-time 3D modes).…”

Section: Test Objects and Equipmentmentioning

confidence: 99%

“…For 3D analysis, two different workstations were compared (QLab 5.0; Philips Healthcare; and InViVo-ScanNT; Medcom, Darmstadt, Germany). 10 For each measurement, operators were blinded to previous results. Twodimensional data were analyzed by the first reviewer, and 3D data were analyzed independently by the second reviewer.…”

Section: Data Processing and Analysismentioning

confidence: 99%

“…These data were verified by 3D volume calculations performed on calibrated customized phantoms (mean Δ, -5.49% ± 5.05%; 95% limits of agreement, 4.40% to -15.37% [ScanNT]; -24.15% ± 6.89%; 95% limits of agreement, -10.65% to -37.65% [QLab]). 10 Herberg For further evaluation of the significant underestimation of 3D volumes on semiautomatic border detection, 3D data sets were evaluated by calculating the basic measurements 3D distance and area. Three-dimensional distances were within the expected values on both workstations.…”

Section: Area and Volume Measurementsmentioning

confidence: 99%

“…[3][4][5][6][7] Unfortunately, there are little data regarding the validity, accuracy, and reproducibility of real-time 3D echocardiography for small cardiac structures in the neonatal and infant heart. [8][9][10] From a clinical aspect, measurements within this age group are the most important with respect to the need for far-reaching decisions. Small distances, areas, and volumes are basic parameters for the calculation of prognostic relevant cardiac indices; their systematic assessment can be ideally performed by the use of phantoms.…”

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confidence: 99%

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Variables Influencing the Accuracy of 2‐Dimensional and Real‐time 3‐Dimensional Echocardiography for Assessment of Small Volumes, Areas, and Distances

Herberg

Brand

Bernhardt

et al. 2011

J of Ultrasound Medicine

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Objectives The aim of this study was to assess the validity, accuracy, and reproducibility of real‐time 3‐dimensional (3D) echocardiography for small distances, areas, and volumes. Methods Real‐time 3D echocardiography using matrix technology was performed in small calibrated tissue‐mimicking phantoms and compared with 2‐dimensional (2D) echocardiography. In a systematic variation of variables on data acquisition and analysis including different 3D workstations (manual disk summation versus semiautomatic border detection), the relative contributions of sources of errors were determined. The clinical relevance of the in vitro findings was assessed in 5 neonates and infants. Results Distance calculation was valid (mean relative error ± SD, −0.15% ± 1.2%). Underestimation of areas and volumes was significant for both 2D and 3D echocardiography (area: 2D, −7.0% ± 2.9%; 3D, −6.0% ± 2.8%; volume: 2D, −13.1% ± 4.5%; 3D, −6.7% ± 2.5%; P < .05). Adjustment of compression and gain on data acquisition (difference of the means: 2D, 11.6%; 3D, 17.9%), gain on postprocessing (3D, 3.4%), and the border detection algorithm on analysis (2D, 4.8%; 3D, 16.6%) had a highly significant effect on volume and area calculations (P < .001). In vivo, compression and gain on acquisition (3D, 19.1%) and the 3D workstation on analysis (3D, 22.2%) had a highly significant impact on left ventricular volumetry (P < .001). Conclusions Real‐time 3D echocardiography is a reliable method for calculation of small distances, areas, and volumes comparable with the size of the neonatal and infant heart. Variables influencing boundary identification during image acquisition and analysis have a significant impact on 2D and 3D area and volume calculations. Standardized protocols are mandatory to avoid these sources of error in both clinical practice and research.

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Section: Discussionsupporting

confidence: 89%

Section: Test Objects and Equipmentmentioning

confidence: 99%

Section: Data Processing and Analysismentioning

confidence: 99%

Section: Area and Volume Measurementsmentioning

confidence: 99%

mentioning

confidence: 99%

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Variables Influencing the Accuracy of 2‐Dimensional and Real‐time 3‐Dimensional Echocardiography for Assessment of Small Volumes, Areas, and Distances

Herberg

Brand

Bernhardt

et al. 2011

J of Ultrasound Medicine

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4D imaging of fetal right ventricle—feasibility study and a review of the literature

Pasieczna

Duliban

Grzyb

et al. 2021

Int J Cardiovasc Imaging

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Functional analysis of the fetal cardiovascular system is crucial for the assessment of fetal condition. Evaluation of the right ventricle with standard 2D echocardiography is challenging due to its complex geometry and irregular muscle fibers arrangement. Software package TOMTEC 4D RV-Function is an analysis tool which allows assessment of right ventricular function based on volumetric measurements and myocardial deformation. The aim of this study was to determine the feasibility of this method in fetal echocardiography. The retrospective study was conducted in the high-flow Referral Center for Fetal Cardiology. We recorded 4D echocardiographic sequences of 46 fetuses with normal hearts. Following parameters were calculated: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF), right ventricle longitudinal free-wall (RVLS free-wall) and septal strain (RVLS septum). Tei index was calculated as a standard measure or RV function for comparison. 4D assessment was feasible in 38 out of 46 fetuses (83%). RV volumetric parameters—EDV, ESV and SV—increased exponentially with gestational age. Functional parameters—RV Tei index, EF and strains—were independent of gestational age. Mean EF was 45.2% (± 6%), RV free-wall strain was − 21.2% and RV septal strain was − 21.5%. There was a statistically significant correlation between septal and free-wall strains (r = 0.51, p = 0.001) as well as between EF and RV free-wall strain (r = − 0.41, p = 0.011). 4D RV assessment is feasible in most fetuses. Its clinical application should be further investigated in larger prospective studies.

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Role of 3-D Ultrasound in Clinical Obstetric Practice: Evolution Over 20 Years

Tonni

Martins

Filho³

et al. 2015

Ultrasound in Medicine & Biology

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Volumetry of Fetal Hearts using 3D Real-Time Matrix Echocardiography – In Vitro Validation Experiments and 3D Echocardiographic Studies in Fetuses

Cited by 6 publications

References 15 publications

Variables Influencing the Accuracy of 2‐Dimensional and Real‐time 3‐Dimensional Echocardiography for Assessment of Small Volumes, Areas, and Distances

Variables Influencing the Accuracy of 2‐Dimensional and Real‐time 3‐Dimensional Echocardiography for Assessment of Small Volumes, Areas, and Distances

4D imaging of fetal right ventricle—feasibility study and a review of the literature

Role of 3-D Ultrasound in Clinical Obstetric Practice: Evolution Over 20 Years

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