title: Increasing the detection rate of congenital heart disease during routine obstetric screening using cine loop sweeps.
abstract: OBJECTIVE
  The purpose of this study was to demonstrate an increase in the detection rate of fetal cardiac defects using 2 cine loop sweeps.
  
  
  METHODS
  Image reviewers examined a series of 93 cases randomly sorted, including 79 studies with normal findings and 14 studies with abnormal findings. All of the images were assessed by 5 standard criteria. Cases were classified as normal, abnormal, or indeterminate. Reviewers using the conventional approach reviewed 3 still images: the 4-chamber, left ventricular outflow tract, and right ventricular outflow tract views. Reviewers using the cine loop sweeps viewed 2 grayscale sweeps through the fetal heart in real time. The image sequences were reviewed independently by 2 experts, 3 nonexperts, and 2 sonographers blinded to each others' results.
  
  
  RESULTS
  The cine loop sweeps had an increased detection rate of 38% for the nonexperts and 36% for the experts compared with the conventional approach. The cine loop sweeps allowed identification of all cardiac defects by at least 2 of the 7 reviewers; the percentage of cases with false-positive findings was 3.9%. With the conventional approach, 2 defects went undetected by all reviewers, and 4 defects were found by only 1 reviewer; the percentage of cases with false-positive findings was 5.4%.
  
  
  CONCLUSIONS
  The use of cine loop sweeps has the potential to increase the detection of fetal cardiac defects without increasing the rate of false-positive findings or increasing the interpretation and decision-making times.
authors.affiliation: Department of Medical Radiation Sciences, Mohawk College, Hamilton, Ontario, Canada. ted.scott@mohawkcollege.ca
authors.forename: Ted E
authors.initials: TE
authors.lastname: Scott
authors.forename: Judy
authors.initials: J
authors.lastname: Jones
authors.forename: Herschel
authors.initials: H
authors.lastname: Rosenberg
authors.forename: Andrea
authors.initials: A
authors.lastname: Thomson
authors.forename: Hournaz
authors.initials: H
authors.lastname: Ghandehari
authors.forename: Neil
authors.initials: N
authors.lastname: Rosta
authors.forename: Kim
authors.initials: K
authors.lastname: Jozkow
authors.forename: Malka
authors.initials: M
authors.lastname: Stromer
authors.forename: Hans
authors.initials: H
authors.lastname: Swan
mesh_terms: D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology / Q000453:epidemiology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods / Q000706:statistics & numerical data*; D014741:Video Recording / Q000379:methods / Q000706:statistics & numerical data*
keywords: cine loop; congenital heart disease; prenatal; real time; screening; sonography; sweeps