(1021) Are standard video sweeps during fetal ultrasound examination more effective for cardiac screening?

To compare workflow properties of standardized ultrasound video clips performed as sweeps from the four-chamber [4C] view to the three-vessel-trachea [3VT] view, to the still images and videos acquired during the routine fetal cardiac screening (FCS).

Study Design:

An observational study was conducted at the John Radcliffe Hospital, Oxford. Singleton fetuses with normal cardiac anatomy at the routine 18⁺⁰ to 23⁺⁰ weeks anomaly scan were included. The available stored grey-scale images, videos and sweeps were extracted from scans performed by seven sonographers. We evaluated the number of records collected per fetus, time spent for data acquisition and the computer memory needed for storing these, comparing FCS and standardized sweeps. For the former, the order of view acquisition and the prevalence of cardiac workflow interrupted by extra-cardiac planes was also assessed.

Results:

A total of 100 studies were included. FCS included solely still images in 17% of cases, but in 83% videos were used to complete cardiac assessment, mostly cine-4C alone or 4C and left ventricular outflow tract (LVOT) views. The mean number of images or videos in the FCS group were 10 ± 3, compared to 2 ± 1 in standardized sweeps. In 47% of cases, FCS data-acquisition was interrupted by extra-cardiac records, with a median amount of time spent in heart examination of 285 seconds (interquartile range (IQR) 94-726), compared to 4 seconds (IQR 3-8) needed to perform sweeps. Median memory required to store FCS data and sweeps were 167 MB (IQR 60-257) and 123 MB (IQR 76-165), respectively.

Conclusion:

Standardized cardiac sweeps represented a more effective way to acquire and store data compared to the FCS; less time was spent on image acquisition, which was not interrupted by extra-cardiac views, and lower storage memory was required. Further studies are needed to assess the two methods, especially in the presence of fetal congenital heart defects.