986: The utility of Fetal Intelligent Navigation Echocardiography in obtaining fetal echocardiography views

Abstract

Prenatal identification of congenital heart defects can be difficult due to the complex anatomy, size and motion of the fetal heart. Newer evidence suggests that 3D and 4D sonographic imaging using a dynamic volume dataset may improve identification of fetal heart anomalies. We aimed to evaluate the performance of Fetal Intelligent Navigation Echocardiography (FINE) when applied to volume datasets of the normal fetal heart. Prospective cohort study from a single academic institution of low risk women presenting for fetal anatomic evaluation between 18 and 23 weeks gestation. During sonographic evaluation, one or more dynamic volume acquisitions were obtained by a qualified, trained sonographer of the apical 4 chamber view of the heart. Each dynamic volume dataset was assessed for quality of anatomical views and the presence of motion or shadow artifact by a trained sonographer and physician prior to application of FINE (5D) software. The rates (95% CI) for visualization of the various heart views using diagnostic 2D planes and the 5D heart method were calculated using the Wald method, and compared between the two groups using χ2 test. One or more dynamic volumes (160 in total) were obtained from 60 women. Non-manipulated 2D view rates of visualization for individual fetal echocardiographic views ranged from 50-95%. Applying the FINE method resulted in rates of visualization of individual fetal echocardiographic views ranging between 80-98% (Table 1). The completeness of cardiac views for basic, detailed, and fetal echocardiography surveys was improved with additional manipulations obtained through diagnostic planes or FINE-Assistance for each normal dynamic volume dataset (Table 2). The FINE (5D) method is superior to traditional 2D diagnostic plane in generating all nine standard fetal echocardiography views in cases studied. Utilization of the 5D heart (FINE) method may enhance fetal cardiac survey during second trimester anatomic ultrasounds.View Large Image Figure ViewerDownload Hi-res image Download (PPT)