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Journal of Ultrasound in Medicine, Vol 20, Issue 4 317-327, Copyright © 2001 by American Institute of Ultrasound in Medicine
Three-dimensional quantitative echocardiographic assessment of ventricular volume in healthy human fetuses and in fetuses with congenital heart disease
M. Meyer-Wittkopf, A. Cole, S. G. Cooper, S. Schmidt and G. F. Sholler
Department of Obstetrics and Perinatal Medicine, Philipps-University of Marburg, Germany.
The purpose of this study was to evaluate the feasibility of
three-dimensional freehand echocardiographic assessment of ventricular
volumetry in healthy fetuses and in fetuses with congenital heart disease.
The study was approved by the hospital institutional review board. After
echocardiographic examination by conventional ultrasonographic equipment
interfaced with a magnetic tracking system, three-dimensional cardiac data
were collected prospectively in 57 fetuses. Ventricular volumes were
determined from three-dimensional data sets, and 22 fetuses with congenital
heart disease were compared with 29 healthy fetuses. A multiple regression
analysis of covariance was performed to assess between-group differences.
Gated three-dimensional volume data sets enabled assessment of ventricular
volumes in 51 of the 57 fetuses. Both fetuses with and without congenital
heart disease had exponential increases in cardiac volumes during
gestation. In fetuses with congenital heart disease and a marked inequality
of ventricular size but no heart failure, the combined end-diastolic and
stroke volumes of both ventricles were found to be significantly reduced
compared with controls with no disease and fetuses with other types of
congenital heart disease. Three-dimensional imaging can provide estimates
of ventricular volume changes in fetal hearts with abnormal ventricular
morphology that cannot easily be performed by two-dimensional
echocardiography, and it may provide insight into evolving congenital heart
disease.
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