Weichert Alexander, Gembicki Michael, Weichert Jan, Weber Sven Christian, Koenigbauer Josefine
Center for Prenatal Diagnosis and Women's Health, 10961 Berlin, Germany.
Departments of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany.
J Clin Med. 2023 Oct 5;12(19):6371. doi: 10.3390/jcm12196371.
Congenital heart disease (CHD) is one of the most common organ-specific birth defects and a major cause of infant morbidity and mortality. Despite ultrasound screening guidelines, the detection rate of CHD is limited. Fetal intelligent navigation echocardiography (FINE) has been introduced to extract reference planes and cardiac axis from cardiac spatiotemporal image correlation (STIC) volume datasets. This study analyses the cardiac axis in fetuses affected by CHD/thoracic masses ( = 545) compared to healthy fetuses ( = 1543) generated by FINE. After marking seven anatomical structures, the FINE software generated semi-automatically nine echocardiography standard planes and calculated the cardiac axis. Our study reveals that depending on the type of CHD, the cardiac axis varies. In approximately 86% (471 of 542 volumes) of our pathological cases, an abnormal cardiac axis (normal median = 40-45°) was detectable. Significant differences between the fetal axis of the normal heart versus CHD were detected in HLHS, pulmonary atresia, TOF (-value < 0.0001), RAA, situs ambiguus (-value = 0.0001-0.001) and absent pulmonary valve syndrome, DORV, thoracic masses (-value = 0.001-0.01). This analysis confirms that in fetuses with CHD, the cardiac axis can significantly deviate from the normal range. FINE appears to be a valuable tool to identify cardiac defects.
先天性心脏病（CHD）是最常见的器官特异性出生缺陷之一，也是婴儿发病和死亡的主要原因。尽管有超声筛查指南，但CHD的检出率仍然有限。胎儿智能导航超声心动图（FINE）已被用于从心脏时空图像相关（STIC）容积数据集中提取参考平面和心脏轴。本研究分析了FINE生成的患有CHD/胸部肿块的胎儿（n = 545）与健康胎儿（n = 1543）的心脏轴。在标记七个解剖结构后，FINE软件半自动生成九个超声心动图标准平面并计算心脏轴。我们的研究表明，根据CHD的类型，心脏轴会有所不同。在我们大约86%（542个容积中的471个）的病理病例中，可以检测到异常的心脏轴（正常中位数= 40 - 45°）。在左心发育不全综合征、肺动脉闭锁、法洛四联症（p值< 0.0001）、右位心、内脏反位（p值= 0.0001 - 0.001）以及肺动脉瓣缺如综合征、双心室流出道异常、胸部肿块（p值= 0.001 - 0.01）中，检测到正常心脏与CHD胎儿轴之间存在显著差异。该分析证实，患有CHD的胎儿，其心脏轴可能会显著偏离正常范围。FINE似乎是识别心脏缺陷的一个有价值的工具。
