Electronic spatiotemporal image correlation improves four-dimensional fetal echocardiography.
OBJECTIVE
To compare the efficiency of electronic spatiotemporal image correlation (eSTIC) with that of conventional STIC to acquire four-dimensional (4D) fetal cardiac volumes of diagnostic quality.


METHODS
This was a randomized controlled trial of 100 patients in mid-gestation with normal sonograms. In half of the cases, STIC volumes of the fetal heart were obtained with a conventional mechanical 4D probe and in the remaining cases eSTIC volumes were obtained with an electronic 4D probe. Examinations were kept within the timeframe allotted for a standard examination of fetal anatomy, and a maximum of two attempts were made at obtaining a 4D cardiac volume. Datasets were stored on a computer and subsequently analyzed and categorized as being of optimal, satisfactory or inadequate quality, depending on whether or not it was possible to perform an extended basic cardiac examination, including obtaining a three vessels and trachea view, as well as a clear reconstruction of both the aortic and ductal arches in the sagittal plane.


RESULTS
The eSTIC volume datasets were more frequently of optimal or satisfactory diagnostic quality compared with conventional STIC (94% vs 76%, P < 0.0001). Failure to obtain an eSTIC volume of adequate quality was in all cases the consequence of an unfavorable position of the fetus.


CONCLUSIONS
Compared with a standard mechanical probe, the electronic 4D probe facilitates acquisition of sonographic cardiac volumes in mid-trimester fetuses. In our hands, eSTIC volumes of optimal or satisfactory diagnostic quality, allowing a detailed offline evaluation of the fetal heart, were obtained in more than 90% of cases within the time frame of a standard examination of fetal anatomy. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.|GynePro Medical Centers, Bologna, Italy.
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Guasina
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.|GynePro Medical Centers, Bologna, Italy.
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http://orcid.org/0000-0003-1080-366X
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Bellussi
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.
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Morganelli
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.
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Salsi
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.|GynePro Medical Centers, Bologna, Italy.
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Pilu
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.
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Simonazzi
D000328:Adult; D002306:Cardiac Volume; D019561:Echocardiography, Four-Dimensional; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal
STIC; congenital heart disease; fetal echocardiography; fetus; prenatal diagnosis; three-dimensional ultrasound; ultrasound