Document Detail

Fetal cardiac ventricle volumetry in the second half of gestation assessed by 4D ultrasound using STIC combined with inversion mode.
MedLine Citation:
PMID:  17566143     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Quantification of fetal heart ventricle volume can aid in the evaluation of functional and anatomical aspects of congenital heart disease. The aim of this study was to establish nomograms for ventricular volume using three-dimensional (3D) inversion mode ultrasonography with the spatio-temporal image correlation (STIC) modality and to calculate ejection fraction and stroke volume. METHODS: The fetal heart was scanned using the STIC modality, during fetal quiescence with abdomen uppermost, at an angle of 30-50 degrees , without color Doppler flow mapping. In post-processing, starting with the classic four-chamber view plane in the A-frame, the reference point was moved to the center of the ventricle. The operator used the edit volume followed by Virtual Organ Computer-aided AnaLysis (VOCAL) mode options; in manual trace the VOCAL settings were set to 15 degrees . The trace was drawn and included the myocardium; inversion mode thresholding provided the volume of the intraventricular (anechoic) voxels within the region of interest. The total volume and the intraventricular volume were displayed. The process was repeated for right (R) and left (L) ventricles at end diastole (EDV) and end systole (ESV). The stroke volume (SV = EDV - ESV) and ejection fraction (EF = SV/EDV) were calculated from these measurements. Intraclass correlation was used to evaluate intra- and interobserver agreement. RESULTS: One hundred fetuses ranging from 20 + 5 to 40 + 0 gestational weeks were included in the study. In addition, six fetuses diagnosed during the study period with a cardiac anomaly were examined and their ventricular volumes compared with those of the main study group. LEDV ranged from a mean of 0.53 cm(3) at midgestation to a mean of 3.96 cm(3) at term. LESV ranged from a mean of 0.17 cm(3) at midgestation to 1.56 cm(3) at term. REDV ranged from a mean of 0.68 cm(3) at midgestation to a mean of 5.44 cm(3) at term. RESV ranged from a mean of 0.26 cm(3) at midgestation to 2.29 cm(3) at term. Total stroke volume ranged from a mean of 0.78 cm(3) at midgestation to a mean of 5.5 cm(3) at term. The mean right : left ventricle ratio was 1.4, and left ejection fraction ranged from 42.5 to 86% in these fetuses. Nomograms were created for RESV, LESV, REDV, LEDV and total stroke volumes vs. estimated fetal weight and gestational age. Intra- and interobserver agreement reached 96%. CONCLUSIONS: 3D inversion mode sonography combined with STIC represents a simple and reproducible method for estimating fetal cardiac ventricle volume. This innovative methodology may add to overall evaluation of cardiac volume and function, and improve our understanding of normal and abnormal cardiac structure, as well as the severity and prognosis of cardiac lesions.
B Messing; S M Cohen; D V Valsky; D Rosenak; D Hochner-Celnikier; S Savchev; S Yagel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  30     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-31     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  142-51     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt. Scopus, Jerusalem, Israel.
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MeSH Terms
Cardiac Volume / physiology
Echocardiography, Doppler, Color
Echocardiography, Four-Dimensional*
Echocardiography, Three-Dimensional
Fetal Heart / embryology*,  ultrasonography*
Gestational Age
Heart Defects, Congenital / physiopathology,  ultrasonography
Heart Ventricles / embryology*,  ultrasonography*
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Regression Analysis
Ultrasonography, Prenatal / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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