Fetal ventricular mass determination on three-dimensional echocardiography: studies in normal fetuses and validation experiments.
BACKGROUND
Estimation of ventricular volume and mass is important for baseline and serial evaluation of fetuses with normal or abnormal hearts. Direct measurement of chamber wall volumes and mass can be made without geometric assumptions by 3D fetal echocardiography. Our goals were to determine the feasibility of using fast nongated 3D echocardiography for fetal volumetric and mass assessments, to validate the accuracy of the ultrasound system and the measurement technique, and if satisfactory, to develop normal values for fetal ventricular mass during the second and third trimesters.


RESULTS
This was a prospective outpatient study of 90 consecutive normal pregnancies during routine obstetric services at Oregon Health & Science University (Portland). Optimized 3D volumes of the fetal thorax and cardiac chambers were rapidly acquired and later analyzed for right and left ventricular mass by radial summation technique from manual epicardial and endocardial traces. Experiments to validate the ultrasound system and measurement technique were performed with modified small balloon models and in vivo and ex vivo small animal experiments. Our study established the feasibility of fetal ventricular mass measurements with 3D ultrasound technology and developed normal values for right and left ventricular mass from 15 weeks' gestation to term.


CONCLUSIONS
Nongated fast 3D fetal echocardiography is an acceptable modality for determination of cardiac chamber wall volume and mass with good accuracy and acceptable interobserver variability. The method should be especially valuable as an objective serial measurement in clinical fetal studies with structurally or functionally abnormal hearts.
Clinical Care Center for Congenital Heart Disease, Oregon Health & Science University, Portland 97239-3098, USA.
Aarti Hejmadi
AH
Bhat
Virginia
V
Corbett
Nathan
N
Carpenter
Nick
N
Liu
Ruolan
R
Liu
Anna
A
Wu
Graham
G
Hopkins
Roya
R
Sohaey
Carey
C
Winkler
Christine S
CS
Sahn
Valerie
V
Sovinsky
Xiaokui
X
Li
David J
DJ
Sahn
D000818:Animals; D005240:Feasibility Studies; D005260:Female; D005318:Fetal Heart / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000254:growth & development; D005865:Gestational Age; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000196:embryology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D049451:Nomograms; D015588:Observer Variation; D009922:Oregon; D009929:Organ Size; D019047:Phantoms, Imaging; D011247:Pregnancy; D011446:Prospective Studies; D011817:Rabbits; D051381:Rats; D012016:Reference Values; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal / Q000379:methods*