Geburtshilfe Frauenheilkd 2006; 66 - FV_G_01_05
DOI: 10.1055/s-2006-952229

Fetal volumetry: validation of the method using 3-dimensional ultrasound of heart, brain and liver

B Schiessl 1, U Fakler 2, M Vogt 2, J Hess 2, K Friese 1, R Oberhoffer 3
  • 1Ludwig-Maximilians-Universität München, I. Frauenklinik-Innenstadt, München
  • 2German Heart Center, Munich, Munich, Germany
  • 3Childrens Hospital of the Technical University, Munich

Introduction:

Three- and 4-dimensional ultrasound have opened new aspects of fetal examination. Aim of the presented study was the validation of the method.

Methods:

One hundred and four fetuses between 14 and 38 weeks of gestation were prospectively studied. In 39 fetuses a structural cardiac defect was diagnosed, in 65 fetuses it was excluded. Sonographic examination was performed with a Voluson 730 Expert machine GE, Germany. Three- and 4D data sets were acquired of heart, brain and abdomen and were analysed offline. The 4D-view-software (GE, Germany) was used for calculation of the following parameters: epi- and endocardial area, myocardial thickness, ventricular length and myocardial mass of each ventricle, liver and brain volume. Descriptive statistics, coefficients of correlation and variation as well as Bland Altman analyses were performed.

Results:

Acquirement of volumetric datasets lasted approx. 10 minutes, offline analysis took up to 45 minutes per patient. The latter was possible in 75% of the stored volumetries. For the fetal liver and brain volumetries, coefficients of variation ranged between 2.57 and 3.48, respectively (r2=0.98). For the myocardial parameters, coefficients of variation were between 5.96 and 12 (r2 between 0.88 and 0.94) in the left heart, and between 6.59 and 16.4 (r2 between 0.74 and 0.9) in the right heart. Fetal liver and brain volumes were positively associated with gestational age; also fetal myocardial mass showed a significant increase with advancing gestational age. Neither fetal liver nor brain volumes were different in fetuses with or without congenital heart disease.

Conclusions:

Prenatal volumetry of organs and heart is time consuming, but reliable depending on the examined parameter. Based on our data, which present fetal reference values for liver and brain volume as well as for myocardial mass, clinical application becomes more realistic and further scientific programs can be performed.