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Article: Simultaneous real-time imaging of four-chamber and left ventricular outflow tract views using xPlane imaging capability of a matrix array probe

TitleSimultaneous real-time imaging of four-chamber and left ventricular outflow tract views using xPlane imaging capability of a matrix array probe
Authors
KeywordsCongenital heart defect
Fetal echocardiography
Outflow tract
Issue Date2011
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0960-7692/
Citation
Ultrasound In Obstetrics And Gynecology, 2011, v. 37 n. 3, p. 302-309 How to Cite?
AbstractObjectives: To determine the feasibility and reliability of using xPlane imaging to examine simultaneously the four-chamber and left ventricular outflow tract (LVOT) views in real time, to assess rotation angles from the four-chamber view to the LVOT view, and to investigate factors affecting the angles. Methods: In 145 fetuses at 11-37 weeks' gestation, we visualized the four-chamber view in one of three cardiac positions: a subcostal view with the apex at the 3 or 9 o'clock position; an apical view with the apex at the 12 or 6 o'clock position; or a view with the fetal heart apex midway between these two positions. We then used the rotation function of xPlane imaging, using the four-chamber view as the reference plane, to visualize the LVOT view simultaneously in real time on the secondary image plane, on the right side of the split screen, by rotating a reference line from 0° with a rotation step of 5°. The rotation angle necessary for the first appearance of LVOT was recorded as the first rotation angle. The reference line was then rotated until the LVOT was just out of view, and this last rotation angle was recorded as the second rotation angle. The difference between these two angles was recorded as the angle span of the LVOT display. Reliability was assessed by intraclass correlation coefficient (ICC). Results: Of the 145 fetuses examined, 29 had cardiac defects. Using xPlane imaging, the LVOT was visualized successfully after 14 weeks in 95.1% of cases. The first and second rotation angles varied significantly with cardiac position (P < 0.001); when the fetal heart was examined using a subcostal approach with the apex at the 3 or 9 o'clock position, the first rotation angle was smaller than that at the apical view for normal hearts (20° vs. 50°, P < 0.001). There was also a significant difference for the second rotation angle and for the angle span, between fetuses with and without normal LVOT (P = 0.038 and 0.006, respectively). Regarding intra- and interobserver reliability for measurement of first and second rotation angles, the ICCs were high (range, 0.847-0.980). Conclusion: Using xPlane imaging, it is feasible to examine simultaneously the four-chamber and LVOT views in real time, and measurement of the rotation angles between these two views is reproducible. The rotation angles depend on the position of the fetal heart, and the normality of the LVOT. Proposed algorithms for examination of the fetal heart with three-/four-dimensional ultrasonography may need to be adapted to optimize visualization of the standard planes. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/164819
ISSN
2015 Impact Factor: 4.197
2015 SCImago Journal Rankings: 1.766
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuan, Yen_HK
dc.contributor.authorLeung, KYen_HK
dc.contributor.authorOuyang, YSen_HK
dc.contributor.authorYang, Fen_HK
dc.contributor.authorTang, MHYen_HK
dc.contributor.authorChau, AKTen_HK
dc.contributor.authorDai, Qen_HK
dc.date.accessioned2012-09-20T08:10:11Z-
dc.date.available2012-09-20T08:10:11Z-
dc.date.issued2011en_HK
dc.identifier.citationUltrasound In Obstetrics And Gynecology, 2011, v. 37 n. 3, p. 302-309en_HK
dc.identifier.issn0960-7692en_HK
dc.identifier.urihttp://hdl.handle.net/10722/164819-
dc.description.abstractObjectives: To determine the feasibility and reliability of using xPlane imaging to examine simultaneously the four-chamber and left ventricular outflow tract (LVOT) views in real time, to assess rotation angles from the four-chamber view to the LVOT view, and to investigate factors affecting the angles. Methods: In 145 fetuses at 11-37 weeks' gestation, we visualized the four-chamber view in one of three cardiac positions: a subcostal view with the apex at the 3 or 9 o'clock position; an apical view with the apex at the 12 or 6 o'clock position; or a view with the fetal heart apex midway between these two positions. We then used the rotation function of xPlane imaging, using the four-chamber view as the reference plane, to visualize the LVOT view simultaneously in real time on the secondary image plane, on the right side of the split screen, by rotating a reference line from 0° with a rotation step of 5°. The rotation angle necessary for the first appearance of LVOT was recorded as the first rotation angle. The reference line was then rotated until the LVOT was just out of view, and this last rotation angle was recorded as the second rotation angle. The difference between these two angles was recorded as the angle span of the LVOT display. Reliability was assessed by intraclass correlation coefficient (ICC). Results: Of the 145 fetuses examined, 29 had cardiac defects. Using xPlane imaging, the LVOT was visualized successfully after 14 weeks in 95.1% of cases. The first and second rotation angles varied significantly with cardiac position (P < 0.001); when the fetal heart was examined using a subcostal approach with the apex at the 3 or 9 o'clock position, the first rotation angle was smaller than that at the apical view for normal hearts (20° vs. 50°, P < 0.001). There was also a significant difference for the second rotation angle and for the angle span, between fetuses with and without normal LVOT (P = 0.038 and 0.006, respectively). Regarding intra- and interobserver reliability for measurement of first and second rotation angles, the ICCs were high (range, 0.847-0.980). Conclusion: Using xPlane imaging, it is feasible to examine simultaneously the four-chamber and LVOT views in real time, and measurement of the rotation angles between these two views is reproducible. The rotation angles depend on the position of the fetal heart, and the normality of the LVOT. Proposed algorithms for examination of the fetal heart with three-/four-dimensional ultrasonography may need to be adapted to optimize visualization of the standard planes. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.interscience.wiley.com/jpages/0960-7692/en_HK
dc.relation.ispartofUltrasound in Obstetrics and Gynecologyen_HK
dc.rightsUltrasound in Obstetrics & Gynecology. Copyright © John Wiley & Sons Ltd.-
dc.subjectCongenital heart defecten_HK
dc.subjectFetal echocardiographyen_HK
dc.subjectOutflow tracten_HK
dc.subject.meshEchocardiography, Three-Dimensional - methods-
dc.subject.meshFetal Heart - embryology - physiopathology - ultrasonography-
dc.subject.meshHeart Defects, Congenital - embryology - physiopathology - ultrasonography-
dc.subject.meshHeart Ventricles - embryology - ultrasonography-
dc.subject.meshStroke Volume - physiology-
dc.titleSimultaneous real-time imaging of four-chamber and left ventricular outflow tract views using xPlane imaging capability of a matrix array probeen_HK
dc.typeArticleen_HK
dc.identifier.emailTang, MHY: mhytang@hkucc.hku.hken_HK
dc.identifier.authorityTang, MHY=rp01701en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/uog.8883en_HK
dc.identifier.pmid21077157-
dc.identifier.scopuseid_2-s2.0-79951879430en_HK
dc.identifier.hkuros209018en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79951879430&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume37en_HK
dc.identifier.issue3en_HK
dc.identifier.spage302en_HK
dc.identifier.epage309en_HK
dc.identifier.isiWOS:000287606600009-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYuan, Y=55204646200en_HK
dc.identifier.scopusauthoridLeung, KY=8247106900en_HK
dc.identifier.scopusauthoridOuyang, YS=35990331700en_HK
dc.identifier.scopusauthoridYang, F=35363141900en_HK
dc.identifier.scopusauthoridTang, MHY=8943401300en_HK
dc.identifier.scopusauthoridChau, AKT=35787094400en_HK
dc.identifier.scopusauthoridDai, Q=35285610700en_HK
dc.identifier.citeulike8895911-

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