title: Two-dimensional sonographic cine imaging improves confidence in the initial evaluation of the fetal heart.
abstract: OBJECTIVE
  Initial screening sonography of the fetal heart with static images is often inadequate, resulting in repeated imaging or failure to detect abnormalities. We hypothesized that the addition of short cine clips would reduce the need for repeated imaging.
  
  
  METHODS
  Two-dimensional (2D) static sonograms and short 2D cine clips of the 4-chamber view and left and right ventricular outflow tracts were obtained from 342 patients with gestational ages of greater than 16 weeks. A diagnostic radiologist and a perinatologist retrospectively reviewed the static and cine images independently and graded them as normal, abnormal, or suboptimal.
  
  
  RESULTS
  A statistically significant increase in the number of structures called normal was seen when 2D cine clips were added to static imaging for both observers (P < .05); the radiologist called 86.5% normal with combined static and cine images versus 61.9% with static images alone, whereas the perinatologist recorded 68.1% as normal versus 58.8%, respectively. The radiologist called 77.8% of structures normal with cine images only versus 61.9% with static images only (P < .001), whereas the perinatologist called fewer structures normal with cine images alone (38.9%) versus static images alone (58.8%). The use of cine loops alone resulted in no significant increase in the ability to clear the heart as normal. The maternal body mass index was inversely associated with the ability to clear structures when 2D cine images were added to static images (P < .05).
  
  
  CONCLUSIONS
  The addition of 2D cine clips to standard 2D static imaging of the fetal heart significantly improves the number of structures cleared as normal. Two-dimensional cine clips are easily obtained, add little time to a study, and require minimal archival space.
authors.affiliation: Departments of Radiology, University of California, San Diego, California USA.
authors.forename: Patricia Sims
authors.initials: PS
authors.lastname: Poole
authors.forename: Romy
authors.initials: R
authors.lastname: Chung
authors.forename: Yvette
authors.initials: Y
authors.lastname: Lacoursiere
authors.forename: Carolina Rossi
authors.initials: CR
authors.lastname: Palmieri
authors.forename: Andrew
authors.initials: A
authors.lastname: Hull
authors.forename: Dawn
authors.initials: D
authors.lastname: Engelkemier
authors.forename: Michele
authors.initials: M
authors.lastname: Rochelle
authors.forename: Neha
authors.initials: N
authors.lastname: Trivedi
authors.forename: Dolores H
authors.initials: DH
authors.lastname: Pretorius
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014741:Video Recording / Q000379:methods*
keywords: 2-dimensional sonography; cardiac; cine; fetal