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2.
Front Pediatr ; 11: 1159342, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37138576

RESUMO

Patients with single left ventricle (SLV) and tricuspid atresia (TA) have impaired systolic and diastolic function. However, there are few comparative studies among patients with SLV, TA and children without heart disease. The current study includes 15 children in each group. The parameters measured by two-dimensional echocardiography, three-dimensional speckle tracking echocardiography (3DSTE), and vortexes calculated by computational fluid dynamics were compared among these three groups. Twist is best correlated with ejection fraction measured by 3DSTE. Twist, torsion, apical rotation, average radial strain, peak velocity of systolic wave in left lateral wall by tissue Doppler imaging (sL), and myocardial performance index are better in the TA group than those in the SLV group. sL by tissue Doppler imaging in the TA group are even higher than those in the Control group. In patients with SLV, blood flow spreads out in a fan-shaped manner and forms two small vortices. In the TA group, the main vortex is similar to the one in a normal LV chamber, but smaller. The vortex rings during diastolic phase are incomplete in the SLV and TA groups. In summary, patients with SLV or TA have impaired systolic and diastolic function. Patients with SLV had poorer cardiac function than those with TA due to less compensation and more disordered streamline. Twist may be good indicator for LV function.

3.
Front Cardiovasc Med ; 9: 834285, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35463790

RESUMO

Secundum atrial septal defect (ASD) is one of the most common congenital heart diseases (CHDs). This study aims to evaluate the feasibility and accuracy of automatic detection of ASD in children based on color Doppler echocardiographic images using convolutional neural networks. In this study, we propose a fully automatic detection system for ASD, which includes three stages. The first stage is used to identify four target echocardiographic views (that is, the subcostal view focusing on the atrium septum, the apical four-chamber view, the low parasternal four-chamber view, and the parasternal short-axis view). These four echocardiographic views are most useful for the diagnosis of ASD clinically. The second stage aims to segment the target cardiac structure and detect candidates for ASD. The third stage is to infer the final detection by utilizing the segmentation and detection results of the second stage. The proposed ASD detection system was developed and validated using a training set of 4,031 cases containing 370,057 echocardiographic images and an independent test set of 229 cases containing 203,619 images, of which 105 cases with ASD and 124 cases with intact atrial septum. Experimental results showed that the proposed ASD detection system achieved accuracy, recall, precision, specificity, and F1 score of 0.8833, 0.8545, 0.8577, 0.9136, and 0.8546, respectively on the image-level averages of the four most clinically useful echocardiographic views. The proposed system can automatically and accurately identify ASD, laying a good foundation for the subsequent artificial intelligence diagnosis of CHDs.

4.
BMC Med Imaging ; 20(1): 76, 2020 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631249

RESUMO

BACKGROUND: Fetal right atrium (RA) dilation is frequently detected in routine screenings while it remains a challenge to clarify the reasons. This study aimed to analyze the cardiac anatomy and hemodynamics of fetal RA dilation and the changes of hemodynamic indexes. METHODS: In the retrospective study, 420 fetuses with RA dilation were included, which were classified into the physiological group (n = 202), volume overload group (n = 142), and the pressure overload group (n = 76). The ratio of right atrium to left atrium (RA/LA) were measured at four-chamber view. Peak velocity of tricuspid regurgitation (VTR) was recorded in each case, if existed. RESULTS: The RA/LA ratio in the volume overload group is significantly higher than both the pressure overload group and the physiological group (both P = 0.000) throughout the pregnancy while no difference presents between the pressure overload group and the physiological group (P = 0.694 for 19-31 GW, and P = 0.974 for 32-36 GW, respectively). The VTR in the pressure overload group (3.29 ± 0.58 m/s) is significantly higher than both the volume overload group (1.85 ± 0.45 m/s, P = 0.000) and the physiological group (0.88 ± 0.45 m/s, P = 0.000). The volume overload group shows a significantly higher VTR than the physiological group (P = 0.000). In the volume overload group, the ductal contraction/closure shows a significantly higher VTR than that in the pulmonary valve stenosis/atresia (3.98 ± 0.41 m/s vs. 3.03 ± 0.38 m/s, P = 0.000). CONCLUSIONS: A strategy proposed herein is useful to clarify the reasons for RA dilatation by systematically assessing fetal hemodynamics, which may facilitate the sonographers to make an accurate diagnosis of congenital heart disease.


Assuntos
Coração Fetal/fisiopatologia , Cardiopatias Congênitas/diagnóstico por imagem , Ecocardiografia Doppler em Cores , Ecocardiografia Doppler de Pulso , Feminino , Coração Fetal/diagnóstico por imagem , Cardiopatias Congênitas/patologia , Cardiopatias Congênitas/fisiopatologia , Hemodinâmica , Humanos , Gravidez , Diagnóstico Pré-Natal , Estudos Retrospectivos
5.
J Clin Ultrasound ; 48(7): 423-427, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32324908

RESUMO

In utero diagnosis of anomalous origin of one pulmonary artery from the ascending aorta (AOPA) has been rarely reported, although this malformation has a high mortality rate due to the rapid development of pulmonary hypertension. We report two cases of AOPA, in which either the left or the right pulmonary artery originated from the distal part of the ascending aorta. Scanning around the three-vessel view to search for the origin of the left and right pulmonary arteries is essential for the diagnosis. In addition, recognition of an abnormal vessel at the three-vessel tracheal view is also useful. Three-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation technique facilitates the identification of the anomalous origin of the pulmonary artery and should be considered a complementary modality in fetal cardiac examinations.


Assuntos
Aorta/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos , Coração Fetal/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Malformações Vasculares/diagnóstico , Adulto , Aorta/embriologia , Feminino , Humanos , Gravidez , Diagnóstico Pré-Natal , Artéria Pulmonar/anormalidades , Artéria Pulmonar/embriologia , Malformações Vasculares/embriologia
6.
Echocardiography ; 36(5): 1009-1013, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31002180

RESUMO

Coronary artery fistula (CAF) is a rare malformation and is seldom reported during pregnancy. Right coronary artery fistula commonly drains into the right ventricle, right atrium, or pulmonary artery. We describe here a rare case of fetal CAF draining into the left ventricle using cross-sectional and color Doppler echocardiography. We also summarized our experience in the diagnosis of this uncommon malformation, in which tracing the origin, course, and outlet of the abnormal intra-cardiac flow played a key role.


Assuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Ecocardiografia Doppler em Cores/métodos , Fístula/diagnóstico por imagem , Fístula/embriologia , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Coração Fetal/anormalidades , Coração Fetal/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Recém-Nascido , Masculino , Gravidez
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