Three-dimensional (3D) speckle tracking in fetal echocardiography: A new technology in assessment of fetal heart function

Objective: To demonstrate the possible application of 3D speckle tracking enabling to do real 3D based analysis of fetal heart function on raw data volumes acquired.

Methods: Preliminary results of myocardial deformation measurement in individual fetuses assessed for the first time by 3D Wall Motion Tracking technology.

For fetal echocardiography a Toshiba Artida ultrasound machine (Toshiba Medical Systems Corporation, Otawa, Tochigi, Japan) equipped with a PST-25SX (2 – 4 MHz) matrix array transducer and an additional ECG dummy (phantom 320, Mueller & Sebastiani Elektronik GmbH, Ottobrunn, Germany) was used. Based on an apical 4-chamber view of the fetal heart raw data volumes with a high temporal resolution of at least 30 volumes per second and including up to three fetal heart cycles were acquired and digitally stored.

Results: Within an offline analysis in individual healthy fetuses basic parameters as longitudinal and circumferential strain as well as advanced three-dimensional myocardial motion patterns such as area strain, rotation, twist and torsion were assessed. The temporal resolution was between 30 – 38 volumes per second.

Conclusions: In adult echocardiography three-dimensional speckle tracking is becoming more and more important in the evaluation of cardiac function. At the moment its application in fetal echocardiography seems to be technically feasible only in individual cases.

Myocardial deformation parameter for the assessment of fetal heart function can be obtained. For the future further development of this technique is necessary to improve its application in fetal echocardiography. Furthermore clinical value of prenatal assessment of these parameters must be investigated in the future. Reliability, accuracy, creation of normal values and detection of gestational age dependent changes are objects of own current studies.