title: Factors controlling fetal echocardiography determine the diagnostic accuracy of isolated ventricular septal defect.
abstract: BACKGROUND
  Fetal echocardiography (FECG) is a key screening tool for prenatal cardiac abnormalities. Herein, we examined the ultrasonic factors determining prenatal ultrasonic diagnosis of isolated ventricular septal defect (IVSD).
  
  
  METHODS
  The diagnostic role of ultrasonic factors was investigated in patients in middle or late pregnancy, diagnosed with IVSD by FECG and confirmed using postnatal echocardiography.
  
  
  RESULTS
  One hundred and six patients with IVSD were enrolled; the majority had perimembranous VSD. The combined imaging mode of 2 dimentional-echocardiography (2DE) and color doppler flow imaging (CDFI) showed the highest rate (56.6%) of IVSD detection, while CDFIwas more efficient than 2DE (32.1% vs. 11.3%). The single-view mode was more efficient than multiple-view mode (75.5% vs. 24.5%). The highest efficient mode to detect IVSD was achieved using combined imaging mode on the single view of the left ventricular outflow tract view (LVOTV) (28.3%). FECG correctly classified 71.7% of fetal IVSD. There was a significant difference of accuracy rate in classifying IVSD among the three different imaging modes (χ2=7.141, P<0.05). The single imaging mode of CDFIand the mode of CDFIcombined with 2DE correctly classified 75.9% and 75.0% of fetal IVSD, respectively. LVOTV was the most accurate view of fetal IVSD classification (85.2%; χ2=15.782, P<0.05). There was no difference in accuracies of IVSD classification among multiple-view modes (χ2=2.343, P>0.05) or between single-view mode and multiple-view mode (χ2=0.32, P>0.05).
  
  
  CONCLUSIONS
  Single LVOTV in CDFIor CDFIcombined with 2DE of FECG were the most effective diagnostic modes for fetal IVSD diagnosis.
authors.affiliation: Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Chen
authors.affiliation: The Vascular Remodeling and Developmental Defects Research Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xie
authors.affiliation: The Vascular Remodeling and Developmental Defects Research Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, China. hanmin@vip.163.com.|Department of Pediatric Pneumology, West China Second University Hospital, Sichuan University, Chengdu, China. hanmin@vip.163.com.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China. hanmin@vip.163.com.
authors.forename: Han-Min
authors.initials: HM
authors.lastname: Liu
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: congenital heart diseases/defects; echocardiography; fetal-ultrasound; isolated ventricular septal defect