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. 2023 Dec 7;31(4):298-304.
doi: 10.4103/jmu.jmu_102_22. eCollection 2023 Oct-Dec.

Area of the Fetal Ascending and Descending Aorta by Spatiotemporal Image Correlation in the Rendering Mode: Reproducibility and Comparison with Pregestational Diabetic Mothers

João Pedro Cassin Scappa  1 , Alberto Borges Peixoto  2   3 , Nathalie Jeanne Bravo-Valenzuela  4 , Gabriele Tonni  5 , Rosiane Mattar  1 , Edward Araujo Júnior  1
Affiliations

Area of the Fetal Ascending and Descending Aorta by Spatiotemporal Image Correlation in the Rendering Mode: Reproducibility and Comparison with Pregestational Diabetic Mothers

João Pedro Cassin Scappa et al. J Med Ultrasound. .

Abstract

Background: The objective of this study was to assess the ascending and descending aorta area measurements by three-dimensional (3D) ultrasound using spatiotemporal image correlation (STIC) in the rendering mode comparing these measurements with pregestational diabetic mothers and assessing the reproducibility of the method.

Methods: We carried out a retrospective cross-sectional study with 58 normal and nine fetuses from pregestational diabetic mothers between 20 and 33 + 6 weeks of gestation. Fetal heart volumes were acquired at the level of four-chamber view to obtain the reconstructed planes for the ascending and descending aorta areas in the rendering mode. Linear regression was performed to assess the correlation between the fetal aorta areas and gestational age (GA). To assess the intra- and interobserver reproducibility, we used the concordance correlation coefficient (CCC).

Results: The mean ascending and descending aorta areas were 0.12 (0.02-0.48) and 0.11 (0.04-0.39) cm2 in normal fetuses, respectively. There was a moderate positive correlation between GA and ascending aorta area measurements (0.005676*GA - 0.01283; r = 0.53, P < 0.0001) and strong positive correlation between GA and descending aorta area (0.01095*GA - 0.1581; r = 0.68, P < 0.0001). We observed a weak intra- and interobserver reproducibility with CCC ranging from 0.05 to 0.91. The mean difference in the ascending and descending aorta area measurements of normal and fetuses of pregestational diabetic mothers was -0.03 cm2 (P = 0.276) and -0.03 cm2 (P = 0.231), respectively.

Conclusion: The fetal ascending and descending aorta area measurements obtained by 3D ultrasound using STIC in the rendering mode increased with GA in normal fetuses. The method showed weak intra- and interobserver reproducibility.

Keywords: Aorta; area; fetal heart; pregestational diabetes; rendering mode; three-dimensional ultrasound.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Positioning of the green line (ROI) after the aortic valve, with automatic acquisition of the rendering image of the ascending aorta area (red arrow), (b) Rendering image of the fetal heart with delimitation of the internal area of the ascending aorta. ROI: Region of interest
Figure 2
Figure 2
(a) Positioning of the green line (ROI) after emergence of the ductus arteriosus, with automatic acquisition of the rendering image of the descending aorta area (red arrow), (b) Rendering image of the fetal heart with delimitation of the internal area of the descending aorta. ROI: Region of interest
Figure 3
Figure 3
(a) Correlation between the fetal area measurement of the ascending aorta (cm2) of normal pregnancies and GA (weeks), (b) Correlation between the fetal area measurement of the descending aorta (cm2) of normal pregnancies and GA (weeks) Spearman’s test P < 0.05. GA: Gestational age
Figure 4
Figure 4
The Bland–Altman plots for the intra- (a) and interobserver (b) reproducibility of the fetal ascending aorta area measurement
Figure 5
Figure 5
The Bland–Altman plots for the intra- (a) and interobserver (b) reproducibility of the fetal descending aorta area measurement
Figure 6
Figure 6
Scatter plot of the ascending (a) and descending (b) aorta area measurements of fetuses of normal (black circles) and pregestational diabetic mothers (red circles) according to GA. GA: Gestational age
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