A ‘holistic’ sonographic view on congenital heart disease – how
semiautomatic reconstruction eases the unveiling of abnormal cardiac
anatomy part I: right heart anomalies
Abstract
Attempting a comprehensive examination of the fetal heart remains
challenging for unexperienced operators as it emphasizes the acquisition
and documentation of sequential cross-sectional and sagittal views and
inevitably results in diminished detection rates of fetuses affected by
congenital heart disease. The introduction of three-/four-dimensional
spatial-temporal image correlation 3D/4D STIC technology facilitated a
volumetric approach for thorough cardiac anatomic evaluation by the
acquisition of cardiac 4D datasets by analyzing and correlating numerous
images from different heart cycles obtained during an automated sweep
and subsequently displaying them in an endless cine loop sequence.
However, postanalysis with manipulation and repeated slicing of the
volume usually requires experience and in-depth anatomic knowledge,
which limits the widespread application of this advanced technique in
clinical care and unfortunately leads to the underestimation of its
diagnostic value to date. Fetal intelligent navigation echocardiography
(FINE), a novel method that automatically generates and displays 9
standard fetal echocardiographic views in normal hearts, has shown to be
able to overcome these limitations. Very recent data on the detection of
congenital heart defects (CHDs) revealed a sensitivity and specificity
of 98 % and 93 %, respectively. In this two-part manuscript, we
focused on the performance of FINE in delineating abnormal anatomy of
typical right and left heart lesions and thereby emphasized the
educational potential of this technology for more than just teaching
purposes. We further discussed recent findings regarding these
morphological changes seen in a pathophysiological and/or functional
context.