Fetal Cardiac Structures, Shape, and Aortic Tortuosity at 15–17 + 6 Weeks of Gestation: HDlive Flow Study

JOURNAL TITLE: Donald School Journal of Ultrasound in Obstetrics and Gynecology

1. Toshiyuki Hata
Publishing Year
Author Affiliations
    1. Department of Obstetrics and Gynecology, Miyake Clinic, Minami-ku, Okayama, Japan; Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Ikenobe, Miki, Kagawa, Japan
  • Article keywords
    Aortic tortuosity index, Early second trimester, Fetal aortic tortuosity, Fetal heart shape, HDlive Flow with spatio-temporal image correlation, Spatial global sphericity index


    Objective: To examine fetal cardiac structures at 15–17 + 6 weeks of gestation using HDlive Flow with spatio-temporal image correlation (STIC). Assessments of the fetal cardiac shape and tortuosity of the descending aorta (DAo) were also conducted. Methods: Transabdominal HDlive Flow with STIC was performed on 101 normal fetuses at 15–17 + 6 weeks of gestation to evaluate the feasibility of the spatial three-vessel and panoramic views (PaVs). Target structures were examined in both views. The following ratings were used: “good” when all structures were identified, “fair” when only one structure was missing, and “poor” when two or more structures were missing. The fetal cardiac circumference (FCC) was obtained with ellipse measurements in the spatial four-chamber view. The spatial global sphericity index (GSI) to assess the fetal cardiac shape and the aortic tortuosity index (ATI) to evaluate fetal aortic tortuosity were also calculated. Results: The rates of “good,” “fair,” and “poor” were 81.8, 16.2, and 2%, respectively, in the spatial three-vessel view (3VV) and 27.3, 64.6, and 8.1%, respectively, in the PaV. FCC was 3.59 (mean) ± 1.16 mm [standard deviation (SD)]. Spatial GSI was 1.15 (mean) ± 0.34 (SD). Posterior ATI was 0.97 (mean) ± 0.07 (SD). Lateral ATI was 0.988 (mean) ± 0.458 (SD). Conclusion: HDlive Flow with STIC has the potential as a useful diagnostic modality to assess fetal cardiac structures and aortic tortuosity in the early stages of the second trimester. Furthermore, spatial GSI and ATI may be applied to evaluations of the fetal cardiac shape and aortic tortuosity.

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