Quality of 2- and 3-dimensional fast acquisition fetal cardiac imaging at 18 to 22 weeks: ramifications for screening

Cohen, L.; Mangers, K.; Platt, L.; Julien, S.; Gotteiner, N.; Dungan, J.; Grobman, W.

J Ultrasound Med. 2009 Apr 25; 28(5):595-601

Abstract

OBJECTIVE: The purpose of this study was to evaluate the frequency with which 6 different fetal cardiac views taken during a fetal ultrasound examination at 18 to 22 weeks' gestation can be obtained satisfactorily for cardiac anomaly screening using either a 2-dimensional (2D) static or 3-dimensional (3D) fast acquisition technique. METHODS: A prospective study of 100 low-risk women undergoing an anatomic survey was performed. Standard static 2D and 3D fast acquisition volumes were obtained on all patients. The 2D and 3D images were assigned, in a random order, to be independently graded by 3 reviewers. The degree of inter-reviewer agreement was assessed through the use of the Cohen kappa statistic. The factors contributing to satisfactory imaging were evaluated by random effects logistic regression. RESULTS: A significant proportion of both 2D and 3D images were judged unsatisfactory for screening purposes. However, 2D images were significantly more likely, for all cardiac views, to be judged satisfactory (P < .05). The odds ratios for the 2D technique's being more likely than the 3D technique to provide images satisfactory for screening were 2.6 for the 4-chamber view, 2.4 for the right ventricular outflow tract, 4 for the left ventricular outflow tract, 3.2 for the 3-vessel view, 8.6 for the aortic arch, and 2.2 for the ductal arch. CONCLUSIONS: In this prospective study, static 2D imaging was significantly more likely than fast acquisition 2D imaging to yield cardiac views of high enough quality to satisfactorily screen for anomalies.

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