title: Role of four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation in detecting fetal pulmonary veins.
abstract: BACKGROUND
  Prenatal diagnosis of fetal total anomalous pulmonary vein connection (TAPVC) remains challenging for most screening sonographers. The purpose of this study was to evaluate the use of four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation (4D-HDFI) in identifying pulmonary veins in normal and TAPVC fetuses.
  
  
  METHODS
  We retrospectively reviewed and performed 4D-HDFI in 204 normal and 12 fetuses with confirmed diagnosis of TAPVC. Cardiac volumes were available for postanalysis to obtain 4D-rendered images of the pulmonary veins. For the normal fetuses, two other traditional modalities including color Doppler and HDFI were used to detect the number of pulmonary veins and comparisons were made between each of these traditional methods and 4D-HDFI.
  
  
  RESULTS
  For conventional echocardiography, HDFI modality was superior to color Doppler in detecting more pulmonary veins in normal fetuses throughout the gestational period. 4D-HDFI was the best method during the second trimester of pregnancy in identifying normal fetal pulmonary veins. 4D-HDFI images vividly depicted the figure, course, and drainage of pulmonary veins in both normal and TAPVC fetuses.
  
  
  CONCLUSIONS
  HDFI and the advanced 4D-HDFI technique could facilitate identification of the anatomical features of pulmonary veins in both normal and TAPVC fetuses; 4D-HDFI therefore provides additional and more precise information than conventional echocardiography techniques.
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Xue
authors.identifier: http://orcid.org/0000-0003-4772-4842
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ying
authors.identifier: http://orcid.org/0000-0002-5166-534X
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 Sonography, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
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, PA, USA.
authors.forename: Meilian
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Entomology, The Pennsylvania State University, University Park, PA, USA.
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: 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: Guyue
authors.initials: G
authors.lastname: Hu
mesh_terms: D000328:Adult; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D019561:Echocardiography, Four-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D011247:Pregnancy; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000196:embryology*; D012189:Retrospective Studies; D012587:Scimitar Syndrome / Q000000981:diagnostic imaging* / Q000196:embryology; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult
keywords: 
  STIC
  ; 4D; echocardiography; high-definition flow imaging; prenatal diagnosis; spatiotemporal image correlation