A preliminary study of fetal intelligent navigation echocardiography in the display of 9 views in the normal fetuses by a new sonographer

Abstract

Objective To explore the applicability of fetal intelligent navigation echocardiography (FINE, 5D Heart) in displaying the normal fetal heart structure by a new sonographer and assess the value of this technique in fetal cardiac ultrasonography. Methods Eighty cases of normal fetal heart at the second trimester were scanned by an echocardiographic expert. STIC volume datasets with satisfactory from apical four-chamber and common 2D modality with 9 standard views of fetal echocardiogram were achieved for each case. The STIC volume images were post-processed with 5D heart software by two physicians with different levels of echocardiographic examination. The quality of the section images of 9 standard views from 2D 5D heart and were analyzed. The intraobserver and interobserver with common 2D modality repeatability were analyzed for the qualification of section images. The time spent in post-processing the images was record and analyzed. Results The qualified 9 section images with 2D were 75~80 cases (degree of qualification 93.8%~100.0%). The data were assessed twice by two observers and qualified 9 section images were got in 73~80 cases (degree of qualification 91.3%~100.0%). The intra-observer agreement by two observers was absolute concord in four chamber view and abdomen/stomach view (Kappa=1); excellent in three vessel trachea view (3VT, Kappa=0.851~0.882); good to excellent in five chamber view (Kappa=0.787~0.882); good in aortic arch view (Kappa=0.738~0.787), left ventricular outflow tract view (Kappa=0.709~0.787), right ventricular outflow tract view (Kappa=0.655~0.794), superior and inferior vena cava view (Kappa=0.647~0.649) and ductal arch view (Kappa=0.640~0.707). The inter-observer agreement by each two observers and 2D was absolute concord in four chamber view and abdomen/stomach view (Kappa=1); excellent in five chamber view (Kappa=0.851~0.902); good to excellent in ductal arch view (Kappa=0.749~0.820), aortic arch view (Kappa=0.707~0.882), right ventricular outflow tract view (Kappa=0.661~0.851) and 3VT (Kappa=0.655~0.851); good in left ventricular outflow tract view (Kappa=0.737~0.749), superior and inferior vena cava view (Kappa=0.655~0.794). The average time spent in post-processing the images for first time by three observers was (2.64±1.35) min, and there was no significant difference during the each observers (P>0.05). Conclusions 5D Heart represents a single method in obtaining 9 fetal diagnosis planes, which can be used easily by a sonographer lack of skills, and has high reliability and repeatability. It is helpful for improving the application of fetal heart screening. Key words: Echocardiography; Fetal; Spatiotemporal image correlation