Sharma Shreyasi, Bennasar Mar, Yadav Manisha
Fetal Medicine and Genetics Centre, Gurgaon, India.
BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clinicl and Hospital Sant Joan de Deu, Barcelona, Spain.
J Clin Ultrasound. 2025 Feb;53(2):271-285. doi: 10.1002/jcu.23859. Epub 2024 Oct 11.
To evaluate the intra- and interobserver reproducibility of parameters used to determine cardiac morphometry and deformation using FetalHQ in Indian population.
Two operators blinded to each other performed FetalHQ analysis independently on 35 normal fetuses of gestational age between 18 + 0 and 37 + 0 weeks and days. Intra- and interobserver correlation coefficient and limits of agreement were ascertained for parameters obtained from HQ analysis.
Excellent reproducibility (ICC > 0.9) was observed for global morphometric parameters. Ejection fraction, stroke volume, stroke volume/kg demonstrated excellent reliability (ICC > 0.9), cardiac output, fractional area change showed a lower correlation (ICC < 0.8), and right and left ventricular global strain showed no correlation. Twenty-four segment sphericity index of left ventricle (LV) and right ventricle (RV) showed low to moderate correlation (LV-ICC 0.48-0.79; RV-ICC 0.43-0.82). Fractional shortening (FS) showed poor intraobserver reliability in RV.
FetalHQ provides reliable estimates of the global cardiac morphometry but not for global cardiac strain. Regional transverse contractility represented by FS has poor correlation in right ventricle, especially in the apical region, possibly due to moderator band. Nevertheless, it is a promising tool which requires technical advancements and validation to improve its accuracy and reliability.
评估在印度人群中使用FetalHQ测定心脏形态学和变形参数时观察者内和观察者间的可重复性。
两名彼此不知情的操作者对35例孕龄在18 + 0至37 + 0周及天数的正常胎儿独立进行FetalHQ分析。确定从HQ分析获得的参数的观察者内和观察者间相关系数及一致性界限。
整体形态学参数显示出极好的可重复性（ICC > 0.9）。射血分数、每搏输出量、每搏输出量/体重显示出极好的可靠性（ICC > 0.9），心输出量、面积变化分数显示出较低的相关性（ICC < 0.8），左右心室整体应变无相关性。左心室（LV）和右心室（RV）的24节段球形指数显示出低至中度的相关性（LV-ICC 0.48 - 0.79；RV-ICC 0.43 - 0.82）。右心室的缩短分数（FS）显示出较差的观察者内可靠性。
FetalHQ能提供可靠的整体心脏形态学估计，但不能用于整体心脏应变。由FS代表 的局部横向收缩性在右心室中相关性较差，尤其是在心尖区域，可能是由于节制索。尽管如此，它仍是一个有前景的工具，需要技术进步和验证以提高其准确性和可靠性。
