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Objective To explore the feasibility of smart-planes fetal heart ( S-planes FH ) in the display of the fetal ventricular outflow views ,and to compare diameters of fetal aorta ( AO) and pulmonary artery (PA) measured using two-dimensional echocardiography(2DE) and S-planes FH . Methods One hundred and eighty-five fetuses with gestational age of 17 - 36 weeks were enrolled . Each fetus had undergone conventional 2DE examination and the three-dimensional fetal cardiac volume datasets were obtained . The volume datasets were analyzed offline using S-planes FH . The diameters of AO and PA were measured by 2DE and S-planes FH ,respectively . Pearson correlation analysis was used to evaluate the correlation between the two methods for measuring the diameters of AO and PA . The consistency of the two methods was verified by Bland-Altman analysis . Results Fetal ventricular outflow views were successfully obtained using S-planes FH in 173 ( 93 .5％ ) cases of 185 fetuses whose ventricular outflow views were satisfactorily obtained by fetal 2DE . There were close correlations between the two methods in measuring the diameters of AO and PA ( r = 0 .84 , P = 0 .04; r = 0 .81 , P = 0 .00 ) . Bland-Altman analysis showed a close consistency between the two methods ,and their 95％ confidence intervals were ( -1 .17 ,1 .00) and ( -1 .79 ,1 .02) ,respectively . Conclusions There is a close consistency between S-planes FH and 2DE in measuring fetal AO and PA . S-planes FH may have potential for the evaluation of fetal ventricular outflow .
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Objective To investigate the application of fetal intelligent navigation echocardiography ( FINE ,5D Heart) in the diagnosis of conotruncal anomalies ( CTD ) . Methods For prospective study , volume transducer was used to collect the three-dimensional data of fetal heart at 20th - 30th week of gestation . The STIC volume images were processed by three independent physicians of different hierarchies via 5D Heart software afterwards ,and the quality of the STIC diagnosis as well as the consistence among the physicians were analyzed according to the gold standard of postpartum ultrasonic follow-up or surgery results . Results Twelve out of 16 CTD cases were finally included in the study ,and the volume data were analyzed . Senior physicians A could apply 5D Heart diagnosis to achieve 2D-US diagnosis efficiency and gold standard consistently( P = 0 .157 ,0 .083) ,medium and low seniority physician B and C got roughly equal score using 5D Heart diagnosis( P = 0 .705) ,but the diagnostic performance could not reach 2D-US ( P =0 .000 ,0 .000) and gold standard( P = 0 .000 ,0 .000) . Conclusions Fetal cardiac anomalies of CTD can be diagnosed correctly by an expert using 5D Heart ,which has important application prospects in remote consultation , training and scientific research and teaching of congenital heart disease of fetus .
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Objective To evaluate the clinical value of fetal intelligent navigation echocardiography (5D Heart) in the display of key diagnostic elements in basic fetal echocardiographic views.Methods Using volume probe,3D volume datasets of the 209 normal singleton fetuses in the second and third trimesters were acquired from a four-chamber view.After processing the datasets by using 5D Heart,9 cardiac diagnostic planes were acquired and then the image qualities of key diagnosis elements of the heart and great vessels were graded by 3 doctors with different experiences of performing fetal echocardiography.Results Two hundred and sixty-two volume datasets were acquired from 209 normal fetuses,including 53 volume datasets collected when cardiac apex was in different directions,satisfactory datasets failed to be acquired in 27 fetuses because of the maternal obesity,the artifacts of fetal movement,or other influencing factors.Two hundred and thirty-one volume datasets of 182 fetuses could be used for 5D Heart analyzing and displaying,and the displaying rate of 9 standard diagnostic views was up to 88.2％.No significant difference was found when comparing the grading results of one observer in different periods of time,the grading results between two experienced doctors and the grading results among the experienced doctor and one relatively inexperienced doctor (P ＞ 0.05).Conclusions 5D Heart has high reliability and repeatability in obtaining fetal echocardiographic diagnosis views and displaying fetal elemental diagnostic information.
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Objective To evaluate the value of fetal intelligent navigation echocardiography with color flow imaging ( 5D Heart Color) in the display of key diagnostic elements in basic fetal echocardiographic views . Methods The heart volumes datasets of 220 fetuses were collected and the offline analysis was conducted . Pearson correlations was used to compare the detection rate of blood flow element between 5D Heart Color software and color Doppler flow imaging(CDFI) in basic fetal echocardiographic views ,and the detection rate of blood flow between normal fetuses ( control group ) and fetuses with cardiovascular abnormalities( case group) . Bland-Altman analysis was used to prove consistency and reliability of the results . Results Totally 384 fetal heart volume datasets were collected from 220 fetuses ,and 317 volume datasets of 200 cases could be used for the analysis ,with the acquiring success rate of 82 .6％ . 5D Heart Color software and CDFI showed a close correlation in displaying key cardiovascular blood flow information in key fetal echocardiographic diagnosis sections ( r =0 .88 , P <0 .05) ;The detection rates of blood flow elements in control group and case group were 91 .9％ and 87 .3％ ,respectively , with an average of 89 .6％( r = 0 .9 , P < 0 .05 ) . Bland-Altman analysis showed close consistency between inter- and intra-observations in the detection rates of blood flow elements ,and their 95％ confidence intervals were ( -0 .1/+0 .09) and ( -0 .09/+0 .1) ,respectively ,and the points outside the 95％ confidence interval were 5 .4％(17/231) and 5 .7％ (18/231) ,respectively . Conclusions 5D Heart Color software shows similar usefulness in the displaying key blood flow elements ,comparing with CDFI , demonstrating higher reliability and repeatability in displaying fetal echocardiographic diagnosis views and diagnostic blood flow elements .
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Objective To investigate the value of fetal intelligent navigation echocardiography (FINE,5D Heart)in displaying the normal fetal heart structure during 20 to 38 weeks'gestation.Methods Three-dimensional data of fetal heart during 20 to 38 weeks'gestation were acquired using volume transducer prospectively.The STIC volume images were post-processed with 5D heart software by three physicians with different levels of echocardiographic examination and the quality of the section images were analyzed.The intra-and interobserver repeatability was analyzed for the qualification of section images.The correlation between the quality of image and gestational age,body mass index,the placenta position,fetal initial plane position were evaluated using univariate and multivariable logistic regression analysis.Results Two hundreds and five cases of pregnant women were included,and 9 cases were excluded.Volume data acquisition was completed in 180 pregnant women,and the image acquisition rate was 91.8%.The data were assessed twice by three observers and qualified 9 section images were gotten in 156-180 cases(degree of qualification 86.7%-100%).The screening images were satisfied in 152 cases(84.4%),dissatisfied with 28 cases(15.6%).The intra-observer agreement by three observers was absolute concord in four chamber view and abdomen、stomach view;excellent in three vessel trachea view(3VT),five chamber view, left ventricular outflow tract view and superior and inferior vena cava view;good in right ventricular outflow tract view,ductal arch view and aortic arch view.The inter-observer agreement by each of three observers was absolute concord in four chamber view and abdomen、stomach view;excellent in superior and inferior vena cava view;excellent to good in five chamber view,left ventricular outflow tract view,right ventricular outflow tract view;good in 3VT,ductal arch view and aortic arch view.In a univariate analysis,the quality of the image was associated with obesity(χ2=15.338,P =0.000),gestational age(χ2=23.356,P =0.000).Multivariable analysis showed that the obesity(OR=5.587,P =0.001)and gestational age (OR=8.843,P=0.000)were factors affecting the quality of the image.The average time spent in post-processing the images for first time by three observers was(2.77±1.39)min,and there was no significant difference among observers(P > 0.05).Conclusions Fetal intelligent navigation echocardiography (FINE,5D Heart)based on STIC volumes can successfully generate 9 standard fetal echocardiography views in 86.7%-100% of fetuses in the 2nd and 3rd trimesters.This method can simplify examination of the fetal heart and reduce operator dependency.