Assessment of the quality of fetal heart standard views using the FAST, STAR, and FINE four-dimensional ultrasound techniques in the screening of congenital heart diseases.

Abstract

To compare the quality of standard fetal echocardiographic views obtained by four-dimensional ultrasound with those obtained by the simple targeted arterial rendering (STAR) technique, four-chamber view swing technique (FAST), and fetal intelligent navigation echocardiography (FINE/5D Heart® ) technique. This was a cross-sectional prospective study that included pregnant women between 22 and 34weeks of gestation, with normal fetuses. Fetal heart volumes were acquired using spatio-temporal image correlation (STIC) with the fetal spine between 2 and 9 o'clock. The FAST/STAR techniques consist of the manipulation of STIC volumes by drawing OmniView™ lines to obtain echocardiographic views. The FINE/5D Heart® technique uses intelligent navigation to automatically generate echocardiographic views. The quality of the images was classified as excellent, good, acceptable, and unacceptable. The analysis was performed using the Bonferroni multiple comparisons test. The study included 101 pregnant women aged between 16 and 44years. There was no mean difference in image quality between the techniques regarding fetal spine position in all echocardiographic views (P>.05). However, in the five-chamber, left ventricular outflow tract, right ventricular outflow tract, ductal arch, superior vena cava/inferior vena cava, and abdomen/stomach views, there was a statistically significant mean difference quality between the techniques, regardless of the spine position (P<.05). The best mean image quality was obtained by the FINE technique (P≤.016 for all fetal echocardiographic views). The quality of the echocardiographic views obtained using the FINE technique was superior to that of those generated by the FAST/STAR techniques in normal fetuses.