Dodaro Maria Gaia, Montaguti Elisa, Balducci Anna, Perolo Antonella, Angeli Emanuela, Lenzi Jacopo, Lombardo Lorenzo, Donti Andrea, Gargiulo Gaetano, Pilu Gianluigi
Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy.
Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6090-6096. doi: 10.1080/14767058.2021.1906855. Epub 2021 Apr 6.
Speckle tracking technology has been applied to assess ventricular deformation throughout the cardiac cycle. An electronic four dimensional probe that allows rapid acquisition of electronic spatio-temporal image correlation volumes (eSTIC) has been recently introduced.
The aim of our study was to investigate whether e-STIC acquisition improves deformation analyses reproducibility.
We recruited fetuses between 20 and 40 weeks of gestation. We obtained a 2D video clip and an e-STIC volume of a four-chamber view. We focused on left ventricular global strain (LV-GS) and left ventricular ejection fraction (LV-FE). Intraobserver, interobserver and intermethod agreement were assessed by means of intraclass correlation coefficient (ICC) and illustrated by Bland-Altman plots. Systematic differences between measurements were assessed using a paired t-test.
The mean difference between LV-GS values obtained with e-STIC and 2D analysis was -0.10 (95% CI -2.28, 2.08). No systematic differences were found between the two techniques for LV-GS values (-value = .927). The mean difference between LV-FE values obtained with e-STIC and 2D analysis was 7.55 (95% CI 4.16, 10.95; -value <.001). The inter-rater reliability of LV-GS was moderate-to-substantial for both e-STIC and 2D. The inter-rater reliability of LV-FE obtained via e-STIC was superior to that obtained via 2D analysis. The intra-rater reliability of LV-GS obtained with e-STIC was superior to that obtained with 2D analysis (ICC 0.857; 95% IC 0.761-0.917). The intra-rater reliability of LV-FE obtained via e-STIC was superior to that obtained via 2D analysis (ICC 0.647; IC 0.51-0.783).
e-STIC seems to be a better technique than 2D analysis for intra-rater reliability of LV-GS. 4D acquisition might improve intrinsic limitations of speckle tracking echocardiography.
斑点追踪技术已被应用于评估整个心动周期的心室变形。最近引入了一种电子四维探头，可快速采集电子时空图像相关容积（eSTIC）。
本研究旨在探讨e-STIC采集是否能提高变形分析的可重复性。
我们招募了妊娠20至40周的胎儿。我们获取了四腔心切面的二维视频片段和e-STIC容积。我们重点关注左心室整体应变（LV-GS）和左心室射血分数（LV-FE）。通过组内相关系数（ICC）评估观察者内、观察者间和方法间的一致性，并通过Bland-Altman图进行说明。使用配对t检验评估测量值之间的系统差异。
e-STIC与二维分析获得的LV-GS值的平均差异为-0.10（95%CI -2.28，2.08）。两种技术在LV-GS值方面未发现系统差异（P值 = 0.927）。e-STIC与二维分析获得的LV-FE值的平均差异为7.55（95%CI 4.16，10.95；P值 <0.001）。对于e-STIC和二维分析，LV-GS的观察者间可靠性为中度至高度。通过e-STIC获得的LV-FE的观察者间可靠性优于通过二维分析获得的可靠性。通过e-STIC获得的LV-GS的观察者内可靠性优于通过二维分析获得的可靠性（ICC 0.857；95%IC 0.761 - 0.917）。通过e-STIC获得的LV-FE的观察者内可靠性优于通过二维分析获得的可靠性（ICC 0.647；IC 0.51 - 0.783）。
对于LV-GS的观察者内可靠性，e-STIC似乎是比二维分析更好的技术。四维采集可能改善斑点追踪超声心动图的固有局限性。
