24-SEGMENT Sphericity Index: A New Technique to Evaluate Fetal Cardiac Diastolic Shape (original) (raw)
Related papers
Ultrasound in Obstetrics & Gynecology, 2017
Objective Fetuses with growth restriction have been reported to have an abnormal sphericity index (SI), which is indicative of the shape of the ventricular chambers of the heart. Our aim was to evaluate the SI for 24 transverse segments distributed from base to apex of the right (RV) and left (LV) ventricles to determine whether, in small-for-gestational-age (SGA) fetuses, the SI is abnormal at locations other than the basal segment. Methods We evaluated 30 SGA fetuses between 25 and 37 weeks of gestation. SI was computed for both ventricles by dividing the end-diastolic mid-basal-apical length by each of 24 end-diastolic transverse segmental widths, from base (Segment 1) to apex (Segment 24). For each ventricle, the Z-score and centile for the SI from each of the 24 segments were computed using the mean and SD from published equations. The 24-segment method, defining abnormal SI as values < 10 th centile or > 90 th centile, was compared with that of using only the basal segment by chi-square analysis to determine the number of fetuses identified with an abnormal SI. Results In 23 of the 30 (77%) SGA fetuses, at least one of the 24 transverse segments in one or both ventricles had an abnormal SI; in 17% of cases, both ventricles were affected, in 23% of cases only the RV was involved and in 37% of cases only the LV was involved. Compared with the 24-segment model, significantly fewer fetuses with an abnormal SI were identified using only basal
Prenatal Diagnosis, 2017
Introduction: The purpose of this study was to simultaneously measure with speckle tracking software (STS) the end-diastolic ventricular area (A), basal transverse width (BW), mid-chamber transverse width, (MW) and the basal-apical length (BAL) in normal fetuses and those with pathology. Methods: The 4-chamber view of the fetal heart was obtained in 200 control fetuses between 20 and 40 weeks of gestation and in nine 3rd trimester fetuses with heart malformations. The mean and standard deviation for the A, BW, MW, and BAL were computed from the control fetuses and Zscores computed in 9 fetuses with cardiac malformations. Results: The A, BAL, BW, and MW were correlated with 7 somatic and age independent variables (R 2 = 0.63-0.85). The highest R 2 values occurred for the head circumference, estimated fetal weight and ultrasound mean gestational age (0.82-0.85). Z-score values and centiles from the 9 fetuses with cardiac malformations suggested that the A, BW, MW, and BAL were below or above the 5 th and 95 th centiles as expected for the corresponding ventricular pathology. Conclusions: This study reports an integrated approach to evaluate the end-diastolic size of the right and left ventricular chambers and demonstrated clinical utility in fetuses with cardiac malformations.
The 24-Segment Sphericity Index: A New Technique to Evaluate Fetal Cardiac Diastolic Shape
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2017
Because of parallel circulation in the fetus and the differential effect various disease states may have on the shape of the right and left ventricles, this study was conducted to evaluate the Sphericity Index (SI) of 24 transverse segments distributed from the base to the apex of the ventricular chambers. Two hundred control fetuses were examined between 20 and 40 weeks of gestation. The displacement of the ventricular endocardium during the cardiac cycle was computed using offline software. From the ASCII output of the analysis, 24 end-diastolic segments were computed from the base to the apex for the right and left ventricles as well as the end-diastolic mid basal-apical length. The SI was computed for each of the 24 segments by dividing the mid basal-apical length by the transverse length for each segment. Examples of fetal cardiovascular abnormalities were selected to demonstrate the utility of this technology. The SI for each segment was independent of gestational age and feta...
Fetal & Pediatric Pathology, 2009
Our objective was to determine the normal dimensions of the ventricular segment of the human fetal heart between 13 and 20 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; gestation. 103 hearts obtained by necropsy were dissected and measurements of different portions of ventricles were determined under stereoscopic magnification. In each ventricle were measured anteroposterior and lateral diameters, inlet and outlet length, and thickness of walls at different levels. Our results showed the cardiac apex was constituted by the left ventricle in 68.9% of the hearts. Both ventricles showed linear growth during this period of fetal development. Ranges in median values of external and internal ventricular measurements were determined. The left ventricular wall was thicker than the right, and the right ventricular cavity was larger. This study provides morphometric reference information concerning the dimensions and growth of both ventricles of the fetal heart, which may be useful in pediatric cardiac surgery and echocardiography.
Journal of Ultrasound in Medicine, 2018
Introduction-This study was conducted to evaluate the 24-segment transverse widths of the right and left ventricles distributed from the base to the apex of the ventricular chambers and compute the right ventricular (RV)/left ventricular (LV) ratios for each segment. Methods-Two hundred control fetuses were examined between 20 and 40 weeks' gestation. Using offline speckle-tracking software, the 24 end-diastolic transverse widths were computed and the RV/LV ratios were regressed against 7 independent variables related to the size, weight, and age of the fetuses. Five fetuses with coarctation of the aorta and 5 fetuses with pulmonary stenosis were examined to exemplify the utility of these measurements. Findings-The 24-segment transverse widths were associated with changes in fetal size, weight, and age. Regression equations were developed to describe these changes with R 2 values between .5 and .82. The measurements were normally distributed (Shapiro-Wilk > 0.5). The RV/LV ratio for the 24 segments did not strongly correlate (R 2 = .001 to-.2) with fetal size, weight, or gestational age. Fetuses with coarctation of the aorta and pulmonary stenosis demonstrated characteristic changes in the 24-segment transverse widths and the RV/LV ratios in the basal (segments 1-8), mid (segments 9-16) and apical (segments 17-24) sections of the ventricles. Conclusions-The 24-segment transverse widths of the right and left ventricles and the RV/LV ratios provide a comprehensive method to examine the width of the ventricular chambers.
Journal of Medical Sciences and Health, 2019
Introduction: The difference in the size of the two ventricles in adult is well known due to the difference in the resistance of systemic and pulmonary circulation. However, the difference between the two during fetal life is rarely studied in India. Material and methods: In the present study, the normal fetal hearts were selected from 21 to 40 weeks of gestation. The measurement of the right and left ventricular thickness was done using a graduated scale. They were compared with each other and were also compared with body weight, crown-rump length, and head circumference. Total heart weight in these cases were compared with body weight, crown-rump length, head circumference, and gestation age. Results: The right ventricle showed similar or slightly more dimension than the left ventricle from 22nd week up to 30th week gestation, while there was similar thickness of both the ventricles from 32nd week and beyond. Conclusion: Linear correlation was obtained between the right ventricular and the left ventricular thickness without much difference in their thickness throughout the gestation.
Evaluation of fetal heart dimensions from 12 weeks to term
The American Journal of Cardiology, 2001
To evaluate whether fetal cardiac measurements can be made in the second trimester, we examined a cohort of normal pregnancies between 12 and 18 weeks' gestation using state-of-the-art ultrasound equipment. We examined this population longitudinally at intervals of 2 weeks, as well as at 32 weeks' gestation. From the 4-chamber view we measured the ventricular and atrial cavity dimensions, the thickness of the ventricular walls and septum at end-diastole, and the annulus dimensions of the mitral and tricuspid valves. Using a variety of views we also measured the long and cross-sectional diameters of the atria, the aorta, the pulmonary artery and its main left and right branches, the ductus arteriosus, and the superior and inferior vena cavae. To test the frequency with which measurements could be made, we divided them into measurements that were clear and easy to define (statistically good), to those that were unclear (statistically bad), or those that were not measured at all (none). Data were then analyzed by regres-sion analysis, analysis of variance, and covariance. The frequency of reliable measurements varied inversely with gestational age. The inflection point for measurements was approximately at 16 weeks. Data from this longitudinal study were evaluated against those obtained from our previous study. Because no statistical differences were found in measurements between these studies where they overlapped, the data were pooled into 1 large group and the mean and SEEs calculated for all variables. Our study demonstrates that with current transabdominal imaging, fetal cardiac measurements can be made reliably in normal fetuses from 16 weeks' gestation onward. The frequency of obtaining data in younger normal fetuses suggests it is unlikely that reliable observations can be made routinely in abnormal fetuses <16 weeks old, although this might be possible in individual fetuses. ᮊ2001 by Excerpta Medica, Inc.
Evaluation of Fetal Left Ventricular Size and Function Using Speckle‐Tracking and the Simpson Rule
Journal of Ultrasound in Medicine, 2018
Objectives-This study was conducted to evaluate left ventricular (LV) size and function in healthy fetuses and to test a cohort of fetuses at risk for abnormal function using speckle-tracking software. Methods-Two hundred control fetuses were examined between 20 and 40 weeks' gestation. With the use of offline speckle-tracking software, the enddiastolic and end-systolic volumes were measured and the following computed: stroke volume (SV), SV per kilogram, cardiac output (CO), CO per kilogram, and ejection fraction. These were regressed against 7 independent variables related to the size, weight, and age of the fetuses. Five fetuses with risk factors for LV dysfunction were examined to sample the validity of the data from the control group. Results-The R 2 values for measurements of the end-diastolic volume, SV, and CO correlated with the 7 independent variables of fetal size and age (0.7-0.78), whereas the SV/kg, CO/kg, and ejection fraction had lower R 2 values (0.02-0.1). The measurements were normally distributed (Shapiro-Wilke > 0.5). The 5 fetuses at risk for abnormal LV function had measurements of LV size and function that were consistent with the expected pathologic condition. Conclusions-Speckle tracking can provide a comprehensive evaluation of the size and function of the fetal LV.
Ultrasound in Obstetrics & Gynecology, 2019
Objectives To measure, using speckle-tracking technology, the fractional area change (FAC) of the right and left ventricles in normal fetal hearts between 20 and 40 weeks of gestation. Methods The four-chamber view of the fetal heart was obtained in 200 normal fetuses between 20 and 40 weeks of gestation. FAC was computed from the ventricular areas (((end-diastolic area − end-systolic area)/end-diastolic area) × 100) for the right and left ventricles, and regressed against seven independent biometric and age variables. FAC was correlated with longitudinal fractional shortening (LFS) (((end-diastolic longitudinal length − end-systolic longitudinal length)/enddiastolic longitudinal length) × 100) obtained from the mid-ventricular basal-apical lengths of the right and left ventricular chambers and with transverse fractional shortening (TFS) (((end-diastolic transverse length − end-systolic transverse length)/end-diastolic transverse length) × 100) from three transverse positions (base, mid, apical) located within each ventricular chamber. To evaluate potential clinical utility, FAC, LFS and TFS results were examined in nine fetuses with a congenital heart defect (CHD). Results Regression analysis demonstrated significant associations between FAC and the independent biometric and age variables (R 2 = 0.13-0.15). FAC was significantly correlated with LFS (R 2 = 0.18-0.28) and TFS (R 2 = 0.13-0.33). Examination of the fetuses with CHD revealed that six of the nine had abnormal FAC Z-score values for the index pathological ventricle. When abnormal LFS and TFS values were compared to the FAC in these fetuses, the FAC was either abnormally low or normal.