title: Evaluation of fetal cardiac valve anomalies by four-dimensional echocardiography with spatiotemporal image correlation (4DSTIC).
abstract: BACKGROUND
  Prenatal diagnosis of cardiac valve anomalies challenged most screening sonographers. The purpose of the study was to evaluate the use of four-dimensional echocardiography with spatiotemporal image correlation (4DSTIC) in detecting normal and abnormal fetal cardiac valves.
  
  
  METHODS
  Forty-three cases of confirmed cardiac valve anomalies identified by two-dimensional echocardiography (2DE) were retrospectively reviewed in this study. Additional 121 confirmed normal fetuses were included as controls. Four-dimensional volumes were acquired from each fetus using a transverse sweep. Four-dimensional rendered images were retrieved from the volumes for each of the cardiac valves for the normal fetuses and for the intended valves for fetuses with valve malformations.
  
  
  RESULTS
  The visualization rates of cardiac valves retrieved from 4D volumes in the normal fetuses ranged from 72.5% to 97.5% before 33 gestational weeks and from 46.3% to 80.5% in late pregnancy. Furthermore, 4D rendered images were successfully obtained in 38 of 43 (88.4%) fetuses with cardiac valve lesions.
  
  
  CONCLUSIONS
  The 4D images and cine loops displayed the valves anatomy vividly in both normal and abnormal fetuses, including some subtle malformations which were not identified by traditional 2DE. The standardized protocol we propose herein was important in obtaining the 4D images from the volumes. The 4D modality allows a better visualization of fetal cardiac valves and should be considered a valuable addition to traditional 2DE imaging.
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Guyue
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Fan
authors.affiliation: Department of Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Shenyang, China.|Department of Entomology, The Pennsylvania State University, University Park, Pennsylvania.
authors.forename: Meilian
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Entomology, The Pennsylvania State University, University Park, Pennsylvania.
authors.forename: Faiza Amber
authors.initials: FA
authors.lastname: Siddiqui
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Sun
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Dongyu
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Wenjia
authors.initials: W
authors.lastname: Lei
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Sun
mesh_terms: D019561:Echocardiography, Four-Dimensional / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006349:Heart Valve Diseases / Q000151:congenital / Q000175:diagnosis* / Q000196:embryology; D006351:Heart Valves / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: 
  STIC
  ; 4D; echocardiography; prenatal diagnosis; spatiotemporal image correlation; valve lesion