The Research Of Fetal Cardiac Left Ventricular Stroke Volume And Ventricular Septal Defect Screening By Four-dimensional Ultrasound With Spatio-temporal Image Correlation

Objective To compare the reproducibility and agreement of two-dimensional (2D) ultrasonography with Doppler capability, 2D ultrasonography with M mode, four-dimensional (4D) with spatiotemporal image correlation (STIC) on the evaluation left ventricular stroke volume (LVSV) in normal fetuses.Methods 2D Doppler, 2D M mode, and 4D STIC were used to measure LSV of 30 normal fetuses at 26 to 30 weeks. Intraclass correlation coefficient (ICC) was used to evaluate the agreement by the three techniques, and proportionate Bland–Altman plots constructed.Results There was not significant difference in LSV value among the three methods within the same observer (P all >0.05). The ICC of the LVSV by the 4D STIC was the highest between the observers (2D Doppler ICC: 0.93 and 95%CI: 0.86-0.95, 2D M mode ICC: 0.89 and 95%CI: 0.82-0.91, 4D STIC ICC: 0.95 and 95%CI: 0.88-0.97). The 4D STIC was the best method demonstrated by Bland & Altman plot between the observers (2D Doppler Mean difference: -0.04ml and 95%CI: -0.22～0.14ml, 2D M mode Mean difference: -0.06ml and 95%CI: -0.20～0.08ml, 4D STIC Mean difference: -0.01ml and 95%CI: -0.11～0.09ml).Conclusions There is a good reproducibility among LVSV measured by 2D Doppler, 2D M mode, or by 4D STIC. But the 4D STIC represents best reproducibility and agreement to estimate fetal LVSV and promises to become the method of choice. Objective To determine the operation experience of four-dimensional ultrasound with spatio-temporal image correlation impacted on the detection condition of fetal ventricular septal defect (VSD).Methods 96 fetuses at high risk of CHD were examined by four-dimensional(4D) with spatio-temporal image correlation(STIC) were evaluated by two blinded independent examiners. One examiner had operated 4D STIC about two and a half years (examiner 1), and the other one was inexperienced (examiner 2). The detection condition of fetal VSD was calculated and compared.Results 42 cases of fetal VSD were detected by examiner 1, and 40 cases were detected by examiner 2. Furthermore, 3 cases were detected by examiner 1 alone, and 1 cases were detected by examiner 2 alone. Compared to the detection condition of fetal VSD by 4D STIC,inexperienced sonographers and experienced sonographer were not significantly different(χ2 =0.25,P>0.05).Conclusions 4D STIC shows less rely on the experience of sonographers, and represents a better technique to detect fetal VSD and promises to become the method of choice.