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Advances in Fetal Cardiac Imaging

机译：胎儿心脏成像的进展

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During the past 25 years, two-dimensional imaging of the fetal heart has evolved into a sophisticated and widely practiced clinical tool, but most heart disease still goes undetected until sometime after birth, despite routine fetal ultrasound evaluations. Over the next 25 years, tremendous advances in fetal cardiac imaging, including three-dimensional imaging, promise to revolutionize both the prenatal detection and diagnosis of congenital heart disease. Image resolution continues to improve year after year, allowing earlier (10-15 week) visualization of the fetal heart, as well as the detection of subtle valvar abnormalities that may progress to serious forms of ventricular hypoplasia at term. However, fetal cardiac imaging remains constrained by limited sonographic windows. To improve the prenatal detection of congenital heart disease, outflow tracts are increasingly included along with the routine screening four-chamber view. However, while the four-chamber view resides within a single plane, lending itself to tomographic evaluation with two-dimensional ultrasound, the outflow tracts (and most forms of congenital heart disease) do not reside within a single plane. For these and other reasons, three-dimensional imaging of the fetal heart ultimately may improve the detection of outflow tract abnormalities, and facilitate comprehension of complex forms of congenital heart disease. Finally, other imaging modalities, including but not limited to Doppler tissue imaging and magnetic resonance imaging, continue to evolve and to complement two- and three-dimensional sonographic imaging of the fetal heart. As a result of these ongoing advances in the prenatal detection and assessment of congenital heart disease, these are exciting and glorious times for the field of fetal cardiac imaging.
机译：在过去的25年中，胎儿心脏的二维成像已发展成为一种复杂且广泛使用的临床工具，但是尽管常规进行了胎儿超声评估，但大多数心脏病直到出生后仍未被发现。在接下来的25年中，胎儿心脏成像（包括三维成像）的巨大进步有望彻底改变先天性心脏病的产前检测和诊断。图像分辨率逐年提高，可以使胎儿心脏更早（10-15周）可视化，并检测到细微的瓣膜异常，这些异常在足月可发展为严重的心室发育不全。然而，胎儿心脏成像仍然受到超声窗口的限制。为了改善对先天性心脏病的产前检测，越来越多地包括流出道以及常规筛查四腔镜检查。但是，尽管四腔视图位于单个平面内，但有助于二维超声进行断层扫描评估，但流出道（以及大多数形式的先天性心脏病）并不位于单个平面内。由于这些和其他原因，胎儿心脏的三维成像最终可以改善流出道异常的检测，并有助于理解先天性心脏病的复杂形式。最后，其他成像方式，包括但不限于多普勒组织成像和磁共振成像，继续发展并补充胎儿心脏的二维和三维超声成像。由于先天性心脏病的产前检测和评估的这些不断发展的结果，对于胎儿心脏成像领域来说，这是激动人心且光荣的时代。

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