Feasibility Of Fetal Echocardiogaghy Applying Four-Dimensional Spatiotemporal Image Correlation Technology Prior To20Weeks’ Gestation

Objective: To explore the feasibility of applying Spatio-temporal Image Correlation（STIC）in fetuses prior to20weeks’ gestation，aiming to advance the timing forprenatal ultrasonography，provide important proof for earlier diagnosis of fetalcongenital heart disease (FCHD).Methods: Select90cases of fetus prior to20weeks’ gestation as normal group whoare checked under2D ultrasonography and proved to have normal cardiacconfiguration during June,2010till July,2011.These cases are divided into3groupsaccording to pregnant weeks:14+0~15+6weeks’ gestation;16+0~17+6weeks’ gestation;pregnant18+0~19+6weeks’ gestation,30cases for each group, and the routine prenatalultrasonography checking result during22+0~26+6weeks’ gestation of each groups areset as comparison groups accordingly. Based on STIC technology we take volumedata for each case at first, then get9cardiac views according to ASE under MP modeland TUI model, in the end we take Kappa test to check the image quality consistencybetween the3groups and that taken after22weeks’ gestation.Select110concecutive cases in the same period as high dangerous group, whichare all pregnant women prior to20weeks with high dangerous facts. Applying STICin the check of fetal cardiac and observe the checking result of FCHD.Result: Kappa consistency test indicates: in14+0~15+6weeks’ gestation group, only2views are satisfied(kappa value0.55~0.59)，1view is awful(kappa value0.18)andthe rest are not ideal(kappa value0.20~0.39); in16+0~17+6weeks’ gestation group3views are mean (kappa value0.40~0.55), and the rest views are satisfied or nearlyidentical(kappa value0.70~0.87); in18+0~19+6weeks’ gestation group all the viewsare nearly identical(kappa value0.86~0.94).Out of the110cases in high dangerous group:4fetal cardiac abnormality cases are found:1Hypoplastic left heart syndrome case(16+6W),1Transposition of great artery（TGA） case(16+4W)，1Single ventricle case(17+3W),1Ventricular Septal Defect（VSD） case（18+5W）and; while1case is omitted: TGA (14+4W)Conclusion: Usually, we take fetal echocardiogaghy during22+0~26+6weeks’gestation. We apply STIC technology for the fetus prior to22weeks’ gestation，innormal group， all views of the fetal cadiac image of16weeks are identical withthose of the fetus exceeding22weeks, while4cases of FCHD are found in the highdangerous group. So, by STIC we can advance the timing of prenatal ultrasonographyto16weeks in order to find fetal cardiac abnormality earlier then before.