title: Utility of a Single 3-Vessel View in the Evaluation of the Ventricular Outflow Tracts.
abstract: OBJECTIVE
  Prenatal diagnosis of congenital heart disease can improve neonatal outcomes. The purpose of this study was to evaluate the utility of an isolated 3-vessel view image in evaluating the ventricular outflow tracts.
  
  
  METHODS
  Three-vessel view images were prospectively collected from consecutive patients referred to a regional fetal heart center for fetal echocardiography between gestational ages of 18 weeks and 23 weeks 6 days. Cardiac malformations were categorized as anomalies of the outflow tracts, the 4-chamber view, or combined lesions. A single representative still-frame 3-vessel view image was reviewed by 2 independent and blinded observers who were asked to label each image as "normal" or "abnormal." Test characteristics of the isolated 3-vessel view were calculated.
  
  
  RESULTS
  During the study period, 122 consecutive patients (139 fetuses) underwent fetal echocardiography. Eight fetuses with fetal chest anomalies and 12 fetuses with oblique images were excluded. Thirty-four of 119 fetuses (28.6%) had abnormal echocardiograms, including 11 outflow tract anomalies and 16 combined anomalies. Using the 3-vessel view alone, both reviewers achieved 91% sensitivity for the detection of isolated outflow tract anomalies and mean sensitivity of 88% for combined anomalies. All cases of tetralogy of Fallot and transposition of the great arteries were identified in the 3-vessel view.
  
  
  CONCLUSIONS
  A single 3-vessel view image can serve as a representative view of the outflow tracts and can show ventricular outflow tract anomalies with high sensitivity. Given that the conventional outflow tract views can be difficult to obtain, the 3-vessel view may serve as an effective first-line view when evaluating the ventricular outflow tracts for congenital heart disease.
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA (J.S.B., E.W., N.S.); and Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA (J.R., D.S., M.L.M.). justin.brandt@uphs.upenn.edu.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Brandt
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA (J.S.B., E.W., N.S.); and Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA (J.R., D.S., M.L.M.).
authors.forename: Eileen
authors.initials: E
authors.lastname: Wang
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA (J.S.B., E.W., N.S.); and Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA (J.R., D.S., M.L.M.).
authors.forename: Jack
authors.initials: J
authors.lastname: Rychik
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA (J.S.B., E.W., N.S.); and Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA (J.R., D.S., M.L.M.).
authors.forename: Debbra
authors.initials: D
authors.lastname: Soffer
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA (J.S.B., E.W., N.S.); and Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA (J.R., D.S., M.L.M.).
authors.forename: Margaret L
authors.initials: ML
authors.lastname: McCann
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA (J.S.B., E.W., N.S.); and Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA (J.R., D.S., M.L.M.).
authors.forename: Nadav
authors.initials: N
authors.lastname: Schwartz
mesh_terms: D001011:Aorta / Q000002:abnormalities / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*; D054079:Vascular Malformations / Q000000981:diagnostic imaging*; D014683:Vena Cava, Superior / Q000002:abnormalities / Q000000981:diagnostic imaging
keywords: 3-vessel view; congenital heart disease; obstetric ultrasound; prenatal diagnosis; screening