Current Opinion in Obstetrics and Gynecology

Fetal kardiyak görüntüleme teknolojisinde güncel uygulamalar
Fetal kardiyak görüntüleme teknolojisinde güncel uygulamalar
Jing Denga,b ve Charles H. Rodecka
aDepartment of Medical Physics and Bioengineering, University College London, London, UK and bDepartment of Obstetrics and Gynaecology, University College London, London, UK
Article Language: TR
ÖZET
Derlemenin amacı
Son birkaç yılda, görüntüleme teknolojisinde oluşan büyük ilerleme, tanı ve tedavi amaçlı olarak fetus kalbinin prenatal görüntülenmesinde değişik yaklaşımları da beraberinde getirmektedir.

Son bulgular

Bu yayında, söz konusu bu yeni teknikler, başlıca dinamik üç boyutlu (4D) ekokardiyografi, myokardın Doppler ile görüntülenmesi, B-flow ultrasonografi, endoskopik ultrason ve manyetik rezonans görüntüleme teknikleri kullanılarak yapılan güncel klinik araştırmalar gözden geçirilmiştir. Bunların içinde en önemli ve anlamlı gelişme olan dinamik üç boyutlu (4D) ekokardiyografi, daha ayrıntılı olarak tartışılmıştır. Bu yöntemde, matriks-array transducer teknolojisinden yararlanarak gerçek zamanlı volümetrik veri alabilmek, alansal ve zamansal görüntü korelasyonu kullanarak hareket artefaktını elimine edebilmek ve çeşitli görüntü seçenekleri mümkündür. Derlemede, ayrıca, her yeni teknolojinin avantajları ve kısıtlılıklarına da değinilmektedir.
Özet
Bu tekniklerin yardımıyla (1) tam bir 4D veri seti kullanarak tüm kalp ardışık olarak incelenebilir, (2) ventrikül duvarlarındaki trabeküller 4D olarak belirlenebilir, ventriküler septal defektler ve alansal olarak karmaşık malformasyonların, en-face dinamik şekilleri görüntülenebilir, (3) Doppler doku görüntüleme ile myokardın kontraktilitesi ve gerilme oranı ile ilişkili kardiyak indeksler oluşturulabilir, (4) transözofageal ultrason kılavuzluğunda in utero kardiyak girişimler yapılabilir. Tüm bu teknikler, in utero fetus kalbinin morfolojisini ve işlevlerini değerlendirme olanağımızı arttırmaktadır.

Anahtar Kelimeler: B-flow ultrasonografi, Doppler doku görüntüleme, dinamik üç boyutlu (4D-dört boyutlu) görüntüleme, fetal kalp, manyetik rezonans görüntüleme, transözofageal ekokardiyografi
ABSTRACT
Purpose of review
Over the last few years, great progress has been made in imaging technology, which is changing the way prenatal visualization of the fetal heart is used for diagnosis and therapy.
Recent findings
This paper reviews recent clinical research using these new techniques, namely dynamic three-dimensional (4D) echocardiography, myocardial Doppler imaging, B-flow ultrasonography, endoscopic ultrasound, and magnetic resonance imaging. Of them, 4D echocardiography is the most significant development and is discussed in greater detail. This includes real-time volumetric data acquisition using matrix-array transducer technology, motion artefact elimination using spatio-temporal image correlation, and various display options. The advantages and limitations of each are also addressed.
Summary
These techniques can provide (1) sequential assessment of the entire heart using a full 4D dataset, (2) 4D delineation of trabeculation patterns on the ventricular walls, en-face dynamic shapes of ventricular septal defects and spatially complex malformations, (3) derivation of cardiac indices to myocardial contractility and strain rate by Doppler tissue imaging, and/or (4) the use of transoesophageal ultrasound to guide in-utero cardiac intervention. All of these techniques expand our ability to evaluate the morphology and function of the in-utero heart.

Keywords: B-flow ultrasonography, Doppler tissue imaging, dynamic three-dimensional (four-dimensional) imaging, fetal heart, magnetic resonance imaging, transoesophageal echocardiography

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