5. Conclusions
Between both operators, our data indicated that 2D-STE analysis showed
excellent agreement for cardiac morphometry parameters (ED (ventricular
size) and SI (ventricular shape)), and good agreement for cardiac
function parameters (EndoGLS and FS (ventricular contractility)). For
less experienced operators to benefit from this state-of-the-art
technology, a number of obstacles obviously still need to be overcome.
With knowledge of these pitfalls, the 2D-STE analysis method can be
learned efficiently and performed with a high level of expertise.
However, as long as the performance of a 2D-STE analysis will not be
completely standardized and automated, we cannot recommend its use in
clinical routine for comprehensive fetal cardiac functional analysis by
less experienced operators ‘on-the-fly’, despite good to excellent
agreement of global and segmental deformation parameters between both
operators. AI will facilitate the implementation of 2D-STE analysis in
daily clinical practice. At present, from our perspective, due to its
complexity, the application of fetal 2D-STE remains the domain of
scientific-academic ultrasound perinatal diagnostics and should be
placed preferably in the hands of skilled operators.