RESUMO
OBJECTIVE: To evaluate the feasibility of the use of spatiotemporal image correlation (STIC) as a screening program for congenital heart disease and the influence of professional experience in those examinations. METHODS: This prospective cross-sectional study included 64 pregnant women at gestational age between 20 and 34 weeks, and 12 physician participants who were divided into two groups: group 1-"STIC specialist"; and group 2-"STIC nonspecialist." Volumes were analyzed to obtain the five axial views for optimal fetal heart screening: abdominal situs, four-chamber view (4CV), outflow tract views (OTV), and three vessels and trachea view (3VT). The chi-square test (χ(2) ) was used to compare the group's results and kappa coefficient to evaluate inter- and intra-observer reproducibility. RESULTS: Spatiotemporal image correlation volume acquisition was successful in 97.3% of cases in which it was attempted (group 1: 100%; group 2:95%). A total of 197 STIC volumes were used in this study. In 71%, it was possible to demonstrate 4CV and OTV (group 1:88.9%; group 2:58.6%). 4CV, OTV, and 3VT were visualized in 55.3% of the volume dataset (group 1:74.1% and group 2:42.2%). In 49% of volumes, all five views for optimal fetal heart screening were seen (group 1:67%; group 2: 36%). A good inter-observer agreement was found in all cardiac views and a good intra-observer agreement in most of views except in OTV. CONCLUSION: We believe that STIC can be used as a tool to improve the cardiac screening examination of the fetus. Professional experience was the most important influence in the image quality of the STIC volume.
Assuntos
Competência Clínica , Ecocardiografia Tridimensional/métodos , Coração Fetal/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Ultrassonografia Pré-Natal/métodos , Adulto , Estudos Transversais , Estudos de Viabilidade , Feminino , Humanos , Gravidez , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: The aim of this study was to evaluate feasibility of fetal lateral ventricle (LV) volumetry in fetuses with ventriculomegaly and to compare measurements performed by 3D sonographic method virtual organ computer-aided analysis (VOCAL) with those obtained by magnetic resonance imaging (MRI). METHODS: This cross-sectional study evaluated 30 fetuses with atrial width (AW) between 10 and 30 mm, from 20 to 36 gestational weeks. Fifty-nine ventricles were measured by two observers. Sonographic volumetric measurements using VOCAL 30° were performed with an ACCUVIX XQ machine (Medison, Korea) and MRI assessments with a Sonata system using ARGUS software (Siemens, Germany). Agreement between both techniques was assessed by intraclass correlation coefficient (ICC) calculation, and proportionate Bland-Altman plots were constructed. RESULTS: A high degree of reliability was observed between VOCAL and MRI measurements (ICC 0.928, 95%CI [0.876;0.958]). Bland-Altman plots confirmed the high correlation (mean of differences: 1.62 cm(3) and standard deviation: ± 8.41 cm(3)). CONCLUSION: Three-dimensional volumetry of fetal LVs by VOCAL method has good agreement with fetal MRI in fetuses with ventriculomegaly and may be used as an additional tool in patient counseling and prognosis prediction.
Assuntos
Ventrículos Cerebrais/embriologia , Hidrocefalia/embriologia , Imageamento por Ressonância Magnética , Ultrassonografia Pré-Natal , Adolescente , Adulto , Ventrículos Cerebrais/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/patologia , Masculino , Gravidez , Prognóstico , Ultrassonografia Pré-Natal/métodosRESUMO
BACKGROUND: To assess the reliability of fetal heart volume measurement by three-dimensional sonography (3DUS) using the eXtended Imaging Virtual Organ Computer-aided AnaLysis (XI VOCAL) method. METHODS: This reliability study enrolled 30 pregnant women with singleton healthy pregnancies between 19 and 34 weeks of gestation. All volume acquirements were performed with a convex volumetric transducer (C3-7ED) coupled to an Accuvix XQ sonography device (Medison, Korea). The XI VOCAL 10 planes was the method of choice for volumetric measurement. 3D datasets were analyzed by two observers (EQSB and HJFM); fetal heart volume was measured twice by the first and once by the second observer to calculate intra and interobserver reproducibility. Statistical analysis used pareated Student's t test (p) and calculated Intraclass correlation coefficients (ICC). Bland-Altman plots were also constructed. RESULTS: We observed an excellent intra- and interobserver reliability for fetal cardiac volume assessed by XI VOCAL. For the intraobserver the ICC was 0.998 (95% CI: 0.997; 0.999), with mean of differences of 0.12 cm3 (95% limits of agreement: -0.84; +0.84; p = 0.130). For interobserver the ICC was 0.899 (95%CI: 0.996; 0.998), mean of differences 0.05 cm3 (95% limits of agreement: -0.84; +0.84; p = 0.175). CONCLUSION: Fetal cardiac volume assessed by 3DUS using XI VOCAL method is highly reproducible between 19 to 34 gestational weeks.