2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods
Background The diagnosis of congenital heart defects is challenging, especially for what concerns conotruncal anomalies. Indeed, although the screening techniques of fetal cardiac anomalies have greatly improved, the detection rate of conotruncal anomalies still remains low due to the fact that they...
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| Format: | Article |
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PeerJ Inc.
2018-04-01
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| Series: | PeerJ |
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| Online Access: | https://peerj.com/articles/4561.pdf |
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| author | Stefania Dell’Oro Maria Verderio Maddalena Incerti Salvatore Andrea Mastrolia Sabrina Cozzolino Patrizia Vergani |
| author_facet | Stefania Dell’Oro Maria Verderio Maddalena Incerti Salvatore Andrea Mastrolia Sabrina Cozzolino Patrizia Vergani |
| author_sort | Stefania Dell’Oro |
| collection | DOAJ |
| description | Background The diagnosis of congenital heart defects is challenging, especially for what concerns conotruncal anomalies. Indeed, although the screening techniques of fetal cardiac anomalies have greatly improved, the detection rate of conotruncal anomalies still remains low due to the fact that they are associated with a normal four-chamber view. Therefore, the study aimed to compare real-time three-dimensional echocardiography with live xPlane imaging with two-dimensional (2D) traditional imaging in visualizing ductal and aortic arches during routine echocardiography of the second trimester of gestation. Methods This was an observational prospective study including 114 women with uncomplicated, singleton pregnancies. All sonographic studies were performed by two different operators, of them 60 by a first level operator, while 54 by a second level operator. A subanalysis was run in order to evaluate the feasibility and the time needed for the two procedures according to fetal spine position and operator’s experience. Results The measurements with 2D ultrasound were performed in all 114 echocardiographies, while live xPlane imaging was feasible in the 78% of the cases, and this was mainly due to fetal position. The time lapse needed to visualize aortic and ductal arches was significantly lower when using 2D ultrasound compared to live xPlane imaging (29.56 ± 28.5 s vs. 42.5 ± 38.1 s, P = 0.006 for aortic arch; 22.14 ± 17.8 s vs. 37.1 ± 33.8 s, P = 0.001 for ductal arch), also when performing a subanalysis according to operators’ experience (P < 0.05 for all comparisons). Feasibility of live xPlane proved to be correlated with the position of the fetal spine and the operator’s experience. Discussion To find a reproducible and standardized method to detect fetal heart defects may bring a great benefit for both patients and operators. In this scenario live xPlane imaging is a novel method to visualize ductal and aortic arches. We found that the position of the fetal spine may affect the feasibility of the method since, when the fetal back is anterior or transverse, the visualization of the correct view of three-vessels and trachea in order to set the reference line properly becomes more challenging. In addition, the fetal spine position influences the duration of the ultrasound examination. Regarding operator’s skills and experience, in our study a first level operator was able to perform the complete 2D and xPlane examination in a lower number of cases compared to second level operators. In addition, the time required for the complete examination was higher for first level operators. This means that this technique is based on an adequate operators’ expertise. |
| first_indexed | 2024-03-09T06:45:12Z |
| format | Article |
| id | doaj.art-52d39af918c846f489fea8d8995ea3d3 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:45:12Z |
| publishDate | 2018-04-01 |
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| spelling | doaj.art-52d39af918c846f489fea8d8995ea3d32023-12-03T10:36:25ZengPeerJ Inc.PeerJ2167-83592018-04-016e456110.7717/peerj.45612D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methodsStefania Dell’OroMaria VerderioMaddalena IncertiSalvatore Andrea MastroliaSabrina CozzolinoPatrizia VerganiBackground The diagnosis of congenital heart defects is challenging, especially for what concerns conotruncal anomalies. Indeed, although the screening techniques of fetal cardiac anomalies have greatly improved, the detection rate of conotruncal anomalies still remains low due to the fact that they are associated with a normal four-chamber view. Therefore, the study aimed to compare real-time three-dimensional echocardiography with live xPlane imaging with two-dimensional (2D) traditional imaging in visualizing ductal and aortic arches during routine echocardiography of the second trimester of gestation. Methods This was an observational prospective study including 114 women with uncomplicated, singleton pregnancies. All sonographic studies were performed by two different operators, of them 60 by a first level operator, while 54 by a second level operator. A subanalysis was run in order to evaluate the feasibility and the time needed for the two procedures according to fetal spine position and operator’s experience. Results The measurements with 2D ultrasound were performed in all 114 echocardiographies, while live xPlane imaging was feasible in the 78% of the cases, and this was mainly due to fetal position. The time lapse needed to visualize aortic and ductal arches was significantly lower when using 2D ultrasound compared to live xPlane imaging (29.56 ± 28.5 s vs. 42.5 ± 38.1 s, P = 0.006 for aortic arch; 22.14 ± 17.8 s vs. 37.1 ± 33.8 s, P = 0.001 for ductal arch), also when performing a subanalysis according to operators’ experience (P < 0.05 for all comparisons). Feasibility of live xPlane proved to be correlated with the position of the fetal spine and the operator’s experience. Discussion To find a reproducible and standardized method to detect fetal heart defects may bring a great benefit for both patients and operators. In this scenario live xPlane imaging is a novel method to visualize ductal and aortic arches. We found that the position of the fetal spine may affect the feasibility of the method since, when the fetal back is anterior or transverse, the visualization of the correct view of three-vessels and trachea in order to set the reference line properly becomes more challenging. In addition, the fetal spine position influences the duration of the ultrasound examination. Regarding operator’s skills and experience, in our study a first level operator was able to perform the complete 2D and xPlane examination in a lower number of cases compared to second level operators. In addition, the time required for the complete examination was higher for first level operators. This means that this technique is based on an adequate operators’ expertise.https://peerj.com/articles/4561.pdfReal-time three-dimensional echocardiographyCongenital heart diseaseMatrix probeSecond trimester screeningPrenatal diagnosisConotruncal anomalies |
| spellingShingle | Stefania Dell’Oro Maria Verderio Maddalena Incerti Salvatore Andrea Mastrolia Sabrina Cozzolino Patrizia Vergani 2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods PeerJ Real-time three-dimensional echocardiography Congenital heart disease Matrix probe Second trimester screening Prenatal diagnosis Conotruncal anomalies |
| title | 2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods |
| title_full | 2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods |
| title_fullStr | 2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods |
| title_full_unstemmed | 2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods |
| title_short | 2D versus 3D real time ultrasound with live xPlane imaging to visualize aortic and ductal arches: comparison between methods |
| title_sort | 2d versus 3d real time ultrasound with live xplane imaging to visualize aortic and ductal arches comparison between methods |
| topic | Real-time three-dimensional echocardiography Congenital heart disease Matrix probe Second trimester screening Prenatal diagnosis Conotruncal anomalies |
| url | https://peerj.com/articles/4561.pdf |
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