Chaoui R, Hoffmann J, Heling K S
Unit of Prenatal Diagnosis and Therapy, Charité University Hospital, Berlin, Germany.
Ultrasound Obstet Gynecol. 2004 Jun;23(6):535-45. doi: 10.1002/uog.1075.
OBJECTIVE: Color Doppler echocardiography is used to visualize three transverse planes: the four-chamber, five-chamber, and three vessels and trachea views. Color Doppler spatio-temporal image correlation (STIC) is a new three-dimensional (3D) technique allowing the acquisition of a volume of data from the fetal heart that is displayed as a cineloop of a single cardiac cycle. The aim of the study was to examine the potential of color Doppler STIC to evaluate normal and abnormal fetal hearts. METHODS: This prospective study included 35 normal fetuses and 27 fetuses with congenital heart defects (CHD) examined between 18 and 35 weeks of gestation. Volume acquisition was achieved by initiating the image capture sequence from the transverse four-chamber view. Volumes were stored for later offline evaluation using a personal computer-based workstation in a multiplanar mode and as spatial volume rendering. RESULTS: Successful acquisition was possible in all 62 cases. The three planes could be demonstrated in 31/35 healthy fetuses and in 24/27 fetuses with CHD. Spatial volume rendering was attempted in 18 fetuses with CHD. In the four normal fetuses with inadequate visualization using color Doppler STIC, the region of interest was perpendicular to the ultrasound beam. In two fetuses with CHD inadequate visualization was related to an enlarged heart in late gestation, in which the entire cardiac volume could not be acquired. The third case was an 18-week fetus with complex CHD and transposed great vessels in which artifacts were related to confluent color signals as a result of low resolution in the reconstructed plane. CONCLUSIONS: STIC in combination with color Doppler ultrasound is a promising new tool for multiplanar and 3D/4D rendering of the fetal heart. Limitations may be found later in gestation in fetuses with large hearts and early in gestation as a result of low discrimination of signals. In addition, insonation perpendicular to the structure of interest does not image color Doppler signals and should be avoided during acquisition.
目的：彩色多普勒超声心动图用于显示三个横断面：四腔心、五腔心以及三血管和气管切面。彩色多普勒时空图像相关技术（STIC）是一种新的三维（3D）技术，可从胎儿心脏采集一系列数据，并显示为单个心动周期的动态环。本研究的目的是探讨彩色多普勒STIC评估正常及异常胎儿心脏的潜力。 方法：这项前瞻性研究纳入了35例正常胎儿和27例先天性心脏病（CHD）胎儿，检查孕周为18至35周。通过从四腔心横断面开始图像采集序列来获取容积数据。将容积数据存储起来，随后使用基于个人计算机的工作站以多平面模式和空间容积再现方式进行离线评估。 结果：62例均成功采集到数据。35例健康胎儿中的31例以及27例CHD胎儿中的24例能够显示出三个切面。对18例CHD胎儿尝试进行了空间容积再现。在4例使用彩色多普勒STIC显示不佳的正常胎儿中，感兴趣区域与超声束垂直。在2例CHD胎儿中，显示不佳与孕晚期心脏增大有关，无法采集到整个心脏容积。第三例是一名18周的胎儿，患有复杂CHD及大血管转位，重建平面分辨率低导致伪像与融合的彩色信号有关。 结论：STIC联合彩色多普勒超声是一种用于胎儿心脏多平面及三维/四维成像的有前景的新工具。在孕晚期，对于心脏较大的胎儿以及孕早期，由于信号分辨力低，可能会发现局限性。此外，与感兴趣结构垂直的超声探测无法显示彩色多普勒信号，采集过程中应避免。
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