Real-time three-dimensional foetal echocardiography using a new transabdominal xMATRIX array transducer

Arch Cardiovasc Dis. 2014 Jan;107(1):4-9. doi: 10.1016/j.acvd.2013.10.003. Epub 2013 Dec 22.

Abstract

Background: Foetal echocardiography has been used to diagnose congenital heart disease. However, conventional echocardiography can only display two-dimensional (2D) structural images of the intricate three-dimensional (3D) foetal heart.

Aim: The purpose of this study was to report the first use of a new transabdominal xMATRIX array transducer and to describe its ability to perform all 3D modalities: intelligent spatiotemporal image correlation (iSTIC) acquisition, xPlane imaging and 3D surface imaging.

Methods: Eighty foetuses without congenital heart disease were included consecutively, with a gestational age between 20 and 37 weeks. 2D and 3D scans were performed with a transabdominal xMATRIX array transducer. Cardiac-STIC volume datasets were acquired and postprocessed with new automatic software (the 'Fetal Heart Navigator').

Results: A total of 224 iSTIC acquisitions were performed (mean time for each, 2 seconds). Only 78 iSTIC acquisitions (35%) were able to detect the ductal arch automatically. 'Fetal Heart Navigator' feasibility varied according to foetal position, including the descending aorta. Live xPlane imaging had excellent feasibility regardless of foetal position; using rotation, lateral and vertical tilts, all cardiac structures were identified from a unique reference plane. Live 3D surface imaging had variable feasibility depending on the target structure. Only 10% of the volume dataset offered comprehensive imaging of intracardiac views.

Conclusion: The new xMATRIX transabdominal transducer allows a multimodality approach to the foetal heart. Further studies that include foetuses with cardiac malformations are required.

Keywords: 2D echocardiography; 3D echocardiography; Cardiopathie congénitale; Congenital heart defect; Fetal echocardiography; STIC; Échocardiographie 2D; Échocardiographie 3D; Échocardiographie fœtale.

MeSH terms

  • Echocardiography, Three-Dimensional / instrumentation*
  • Equipment Design
  • Feasibility Studies
  • Female
  • Fetal Heart / diagnostic imaging*
  • Gestational Age
  • Humans
  • Predictive Value of Tests
  • Pregnancy
  • Radiographic Image Interpretation, Computer-Assisted
  • Software
  • Ultrasonography, Prenatal / instrumentation*