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Circulation. 2004;110:1054-1060
Published online before print August 23, 2004, doi: 10.1161/01.CIR.0000139848.33468.22
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(Circulation. 2004;110:1054-1060.)
© 2004 American Heart Association, Inc.

Original Articles

Fetal Ventricular Mass Determination on Three-Dimensional Echocardiography

Studies in Normal Fetuses and Validation Experiments

Aarti Hejmadi Bhat, MD; Virginia Corbett; Nathan Carpenter; Nick Liu; Ruolan Liu; Anna Wu; Graham Hopkins; Roya Sohaey, MD; Carey Winkler, MD; Christine S. Sahn, RDMS RDCS, RVT; Valerie Sovinsky, RDMS RDCS; Xiaokui Li, MD; David J. Sahn, MD

From the Clinical Care Center for Congenital Heart Disease, Oregon Health & Science University, Portland.

Correspondence to David J. Sahn, MD, Clinical Care Center for Congenital Heart Disease, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L608, Portland, OR 97239-3098. E-mail sahnd{at}ohsu.edu

Received December 19, 2003; revision received April 6, 2004; accepted April 8, 2004.

Background— Estimation of ventricular volume and mass is important for baseline and serial evaluation of fetuses with normal or abnormal hearts. Direct measurement of chamber wall volumes and mass can be made without geometric assumptions by 3D fetal echocardiography. Our goals were to determine the feasibility of using fast nongated 3D echocardiography for fetal volumetric and mass assessments, to validate the accuracy of the ultrasound system and the measurement technique, and if satisfactory, to develop normal values for fetal ventricular mass during the second and third trimesters.

Methods and Results— This was a prospective outpatient study of 90 consecutive normal pregnancies during routine obstetric services at Oregon Health & Science University (Portland). Optimized 3D volumes of the fetal thorax and cardiac chambers were rapidly acquired and later analyzed for right and left ventricular mass by radial summation technique from manual epicardial and endocardial traces. Experiments to validate the ultrasound system and measurement technique were performed with modified small balloon models and in vivo and ex vivo small animal experiments. Our study established the feasibility of fetal ventricular mass measurements with 3D ultrasound technology and developed normal values for right and left ventricular mass from 15 weeks’ gestation to term.

Conclusions— Nongated fast 3D fetal echocardiography is an acceptable modality for determination of cardiac chamber wall volume and mass with good accuracy and acceptable interobserver variability. The method should be especially valuable as an objective serial measurement in clinical fetal studies with structurally or functionally abnormal hearts.


Key Words: echocardiography, fetal • imaging • fetus • heart defects, congenital




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