Three-Dimensional Ultrasound Imaging With Multi-Planar Reconstruction(mpr) In Fetal Cardiac Screening

Objective:To evaluate the efficiency of three-dimensional ultrasound(3DU) volume datasets acquired with different initial planes for the second-trimester fetal cardiac screening,applying in multi-planar reconstruction(MPR) mode. Method:Subjects This prospective study was conducted in the Second People`s Hospital of Liaocheng from Oct.2011 to Dce.2013.Fifty-two gravidas with single normal fetus underwent routine prenatal examination were included.Equipment Using the system of SIMENS SC2000 with 3DU and MPR technology and software of 4D view.Acquisition of 3DU volume datasets 3DU volumes were obtained with three different initial planes according to the fetal positions.The volume datasets were stored and divided into three individual groups:group A(Four chamber view, 4CV),group B(Short axis view of great artery, SAV)and group C(Long axis view of aortic arch, LAV-Ao A).Acquisition and analysis of 3DU volumes datasets were performed by two experienced investigators.Analysis of 3DU volumes datasets The operators demonstrated seven standardized planes of fetal heart subsequently with the stored volume datasets on an offline personal computer with 4D view software,and standardized A plane was displayed with MPR modality. Then 4CV,3VVT, LOVT, ROVT, SVC-IVC, LAV-DA, LAV-Ao A view were visualized consecutively by adjusting slice distance, referent plane or XYZ axis.Investigators evaluated whether these images included necessary anatomical details or not.Then all the results were recorded.Statistics The times of examination were compared with t test. Visualization ratios of seven standardized fetal cardiac planes in three groups of 3DU volumes datasets were compared with R×C Chi—square test.A P-value of <0.05(<0.017 when comparison of interclass in three groups) was considered statistically significant. Results:General information of subjects The median gestational age was 22.6 weeks(range 20~24 weeks), 113 volume datasets were acquired during studying period, including 42 volumes of Group A, 39 volumes of Group B, 32 volumes of Group C. Displaying beginning planes of fetal heart was affected by the fetal position.Visualization of seven standardized fetal cardiac planes in three groups The total visualization ratio of fetal heart planes was 87.8%(258/294) in Group A, 93.0%(254/273) in Group B and 73.7%(165/224) in Group C. There was significant interclass difference between Group A and Group C,Group B and Group C(P<0.05). Visualization ratio of LAV-Ao A and LAV-DA was 100%, 96.9% in Group C, 64.3%, 59.5% in Group A, 87.2% in Group B.And there was significant difference between Group A, Group B and Group C(PA-B-C <0.017). Conclusion:The capability of 3DU volume datasets in demonstrating fetal standardized cardiac planes were influenced by the different initial planes. Acquisition of 3DU volumes from different initial planes may complement each other in fetal cardiac scanning. The technology of visualization multiple planes simultaneously by 3D ultrasound with MPR may improve efficiency of analysis the volume datasets in screening fetal heart.