This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Winn, V. D. Articles by Filly, R. A. Search for Related Content PubMed PubMed Citation Articles by Winn, V. D. Articles by Filly, R. A.

Echogenic Intracardiac Focus

Potential for Misdiagnosis

Departments of Obstetrics, Gynecology, and Reproductive Sciences (V.D.W., R.A.F.) and Radiology (R.A.F.), University of California, San Francisco, San Francisco, California USA; and School of Medicine University of Hawaii, Honolulu, Hawaii USA (J.S.).

Address correspondence and reprint requests to Roy A. Filly, MD, Department of Radiology, University of California, San Francisco, 505 Parnassus Ave, L-374, San Francisco, CA 94143-0628 USA. E-mail: roy.filly{at}radiology.ucsf.edu.

Objective. To assess the potential rate of specular reflectors within the fetal heart producing reflections of sufficient amplitude to be mistaken for echogenic intracardiac foci. Methods. Between July 1999 and December 2000, 200 patients were randomly selected from the University of California, San Francisco, perinatal database who met the following criteria: (1) had singleton pregnancy, (2) delivered at University of California, San Francisco, and (3) had obstetric sonography at University of California, San Francisco, between 18 and 22 weeks’ gestation. Bright focal reflections within the heart were judged to be either "true" or "false" echogenic intracardiac foci. Results. In this population of patients who underwent routine obstetric sonography at a tertiary care hospital, the rate of true echogenic intracardiac focus cases was 11 per 200 (5.5%). The rate of false echogenic intracardiac focus cases was 34 per 200 (17%). The most common locations for identification of a spurious echogenic intracardiac focus were the endocardial cushion, the moderator band, and the tricuspid valve annulus. Conclusions. A specular reflection from the moderator band was judged the false echogenic intracardiac focus most likely to fool examiners. The rate of specular reflection from the moderator band was 11 per 200 (5.5%). Because it is possible to generate a specular reflection from an interface in the fetal heart in virtually any patient, it is important to exercise caution before diagnosing an echogenic intracardiac focus.

Key Words: echogenic intracardiac focus • false-positive prenatal diagnosis • obstetric sonography

Abbreviations: EIF, echogenic intracardiac focus • FPR, false-positive rate • T21, trisomy 21 • UCSF, University of California, San Francisco

This article has been cited by other articles:

				Z. Szigeti, A. Csaba, B. Pete, J. Hajdu, Z. Papp, and C. Papp Correlation of Prenatal Sonographic Diagnosis and Morphologic Findings of Fetal Autopsy in Fetuses With Trisomy 21 J. Ultrasound Med., January 1, 2007; 26(1): 61 - 68. [Abstract] [Full Text] [PDF]

				R. L. Fischer and G. L. Sveinbjornsson Influence of Fetal Heart Orientation on the Sonographic Identification of an Echogenic Intracardiac Focus in the Left Ventricle Journal of Diagnostic Medical Sonography, January 1, 2006; 22(1): 48 - 52. [Abstract] [PDF]