3D/4D ultrasound in the diagnosis of significant hypoplasia of the left ventricle in hypoplastic left heart syndrome
https://doi.org/10.24835/1607-0771-2022-1-9-18
Abstract
Objective: to evaluate the value of 4D fetal heart ultrasound assessment of diastolic right : left ventricle volume ratio in diagnosis of significant hypoplasia of the left ventricle in hypoplastic left heart syndrome. Material and methods: the main group consisted of 21 fetuses with hypoplastic left heart syndrome, in which left ventricle length and end-diastolic dimension were equal or below the 5th percentile for gestational age. The control group consisted of 50 healthy fetuses. Prenatal ultrasound examination was performed at 18-21 weeks of gestation with the use of Voluson 730 Expert (GE Healthcare, USA) with Virtual Organ Computer-aided AnaLysis (VOCAL) and Spatio-Temporal Image Correlation (STIC) software with 4D convex transabdominal transducer (4-8.5 MHz). 4D volumes of the left and right ventricle in diastole and right : left ventricle volume ratio have been assessed. Results: at the gestational age of 18-21 weeks in fetuses of the control group the median of diastolic right : left ventricle volume ratio was 1.17 ml, the 5 and 95 percentile range - 1.00-1.23 ml, the minimum and maximum range - 1.00-1.23 ml; in the main group - 3.35 ml, 1.24-17.20 ml, 1.24-11.84 ml, respectively (P = 0.001). The sensitivity of diastolic right : left ventricle volume ratio > 1.23 in the in diagnosis of significant hypoplasia of the left ventricle in hypoplastic left heart syndrome - 100.0% (taking into account the inclusion to the main group the fetuses with left ventricle linear dimensions equal or below to lower limit of normal values with background of normal right ventricle dimensions). Conclusion: the use of right : left ventricle volume ratio allows to minimize 2D and 3D/4D measurement errors of absolute parameters, and reduce intraobserver and interobserver variability in ultrasound measurements.
About the Author
A. N. Chukanov
Belarusian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
References
1. Бокерия Л.А., Шаталов К.В. (ред.) Детская кардиохирургия: руководство для врачей. М.:ГБУ “НМИЦ ССХ им. А.Н. Бакулева” Минздрава России, 2016. 864 с.
2. Schwedler G., Lindinger A., Lange P.E., Sax U., Olchvary J., Peters B., Bauer U., Hense H.W. Frequency and spectrum of congenital heart defects among live births in Germany: a study of the Competence Network for Congenital Heart Defects. Clin. Res. Cardiol. 2011; 100 (12): 1111-1117. https://doi.org/10.1007/s00392-011-0355-7
3. Yagel S., Silverman N.H., Gembruch U. (eds.) Fetal cardiology: embryology, genetics, physiology, echocardiographic evaluation, diagnosis, and perinatal management of cardiac diseases. 3rd ed. CRC Press, 2019, 860 p.
4. Simpson J., Zidere V., Miller O.I. (eds.) Fetal cardiology. A practical approach to diagnosis and management. Springer Cham, 2018, 308 p. https://doi.org/10.1007/978-3-319-77461-9
5. Feinstein J.A., Benson D.W., Dubin A.M., Cohen M.S., Maxey D.M., Mahle W.T., Pahl E., Villafane J., Bhatt A.B., Peng L.F., Johnson B.A., Marsden A.L., Daniels C.J., Rudd N.A., Caldarone C.A., Mussatto K.A., Morales D.L., Ivy D.D., Gaynor J.W., Tweddell J.S., Deal B.J., Furck A.K., Rosenthal G.L., Ohye R.G., Ghanayem N.S., Cheatham J.P., Tworetzky W., Martin G.R. Hypoplastic left heart syndrome: current considerations and expectations. J. Am. Coll. Cardiol. 2012; 59 (1 Suppl.): S1-S42. https://doi.org/10.1016/j.jacc.2011.09.022
6. Allan L.D., Cook A.C., Huggon I.C. Fetal echocardiographiy. A practical guide. London: Cambridge University Press, 2009, 272 p.
7. Alphonso N., Angelini A., Barron D.J., Bellsham-Revell H., Blom N.A., Brown K., Davis D., Duncan D., Fedrigo M., Galletti L., Hehir D., Herberg U., Jacobs J.P., Januszewska K., Karl T.R.; (Chaiman HLHS Guidelines Task Force), Malec E., Maruszewski B., Montgomerie J., Pizzaro C., Schranz D., Shillingford A.J., Simpson J.M. Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: The European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Paediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force. Eur. J. Cardiothorac. Surg. 2020; 58 (3): 416-499. https://doi.org/10.1093/ejcts/ezaa188
8. Allan L.D. The normal fetal heart. In: Allan L.D., Hornberger L., Sharland G.K. (eds.): Textbook of fetal cardiology. London: Greenwich Medical Media, 2000, pp. 55-102.
9. AIUM Practice Parameter for the Performance of Fetal Echocardiography. J. Ultrasound Med. 2020; 39 (1): E5-E16. https://doi.org/10.1002/jum.15188
10. Messing B., Cohen S.M., Valsky D.V., Rosenak D., Hochner-Celnikier D., Savchev S., Yagel S. Fetal cardiac ventricle volumetry in the second half of gestation assessed by 4D ultrasound using STIC combined with inversion mode. Ultrasound Obstet. Gynecol. 2007; 30 (2): 142-151. https://doi.org/10.1002/uog.4036
11. Schneider C., McCrindle B.W., Carvalho J.S., Hornberger L.K., McCarthy K.P., Daubeney P.E. Development of Z-scores for fetal cardiac dimensions from echocardiography. Ultrasound Obstet. Gynecol. 2005; 26 (6): 599-605. https://doi.org/10.1002/uog.2597
12. Rizzo G. 4D fetal echocardiography. Bentham Science Publishers, 2010. https://doi.org/10.2174/97816080504441100101
13. Bunduki V., Zugaib M. Atlas of fetal ultrasound. Normal imaging and malformations. Springer International Publishing AG, 2018. 261 p. https://doi.org/10.1007/978-3-319-54798-5
14. Pasieczna M., Duliban J., Grzyb A., Szymkiewicz-Dangel J. 4D imaging of fetal right ventricle-feasibility study and a review of the literature. Int. J. Cardiovasc. Imaging. 2022; 38 (2): 319-329. https://doi.org/10.1007/s10554-021-02407-9
15. Hamill N., Yeo L., Romero R., Hassan S.S., Myers S.A., Mittal P., Kusanovic J.P., Balas ubramaniam M., Chaiworapongsa T., Vaisbuch E., Espinoza J., Gotsch F., Goncalves L.F., Lee W. Fetal cardiac ventricular volume, cardiac output, and ejection fraction determined with 4-dimensional ultrasound using spatiotemporal image correlation and virtual organ computer-aided analysis. Am. J. Obstet. Gynecol. 2011; 205 (1): 76.e1-10. https://doi.org/10.1016/j.ajog.2011.02.028
16. Bravo-Valenzuela N.J., Peixoto A.B., Mattar R., Melo Junior J.F., da Silva Pares D.B., Araujo Junior E. Fetal cardiac function and ventricular volumes determined by three-dimensional ultrasound using STIC and VOCAL methods in fetuses from pre-gestational diabetic women. Pediatr. Cardiol. 2020; 41 (6): 1125-1134. https://doi.org/10.1007/s00246-020-02362-7
17. Bhat A.H., Corbett V., Carpenter N., Liu N., Liu R., Wu A., Hopkins G., Sohaey R., Winkler C., Sahn C.S., Sovinsky V., Li X., Sahn D.J. Fetal ventri cular mass determination on three-dimensional echocardiography: studies in normal fetuses and validation experiments. Circulation. 2004; 110 (9): 1054-1060. https://doi.org/10.1161/01.cir.0000139848.33468.22
18. Abuhamad A., Chaoui R. A practical guide to fetal echocardiography: normal and abnormal hearts. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, 2010, 379 p.
19. Tworetzky W., McElhinney D.B., Reddy V.M., Brook M.M., Hanley F.L., Silverman N.H. Improved surgical outcome after fetal diagnosis of hypoplastic left heart syndrome. Circulation. 2001; 103 (9): 1269-1273. https://doi.org/10.1161/01.cir.103.9.1269
20. Thakur V., Munk N., Mertens L., Nield L.E. Does prenatal diagnosis of hypoplastic left heart syndrome make a difference? A systematic review. Prenat. Diagn. 2016; 36 (9): 854-863. https://doi.org/10.1002/pd.4873
Review
For citations:
Chukanov A.N. 3D/4D ultrasound in the diagnosis of significant hypoplasia of the left ventricle in hypoplastic left heart syndrome. Ultrasound & Functional Diagnostics. 2022;(1):9-18. (In Russ.) https://doi.org/10.24835/1607-0771-2022-1-9-18
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