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Case Reports
. 2023 Jan 26;13(3):456.
doi: 10.3390/diagnostics13030456.

Prenatal Diagnosis and Fetopsy Validation of Complete Atrioventricular Septal Defects Using the Fetal Intelligent Navigation Echocardiography Method

Paola Veronese  1 , Alvise Guariento  2 , Claudia Cattapan  2 , Marny Fedrigo  3 , Maria Teresa Gervasi  1 , Annalisa Angelini  3 , Arianna Riva  1 , Vladimiro Vida  2
Affiliations
Case Reports

Prenatal Diagnosis and Fetopsy Validation of Complete Atrioventricular Septal Defects Using the Fetal Intelligent Navigation Echocardiography Method

Paola Veronese et al. Diagnostics (Basel). .

Abstract

(1) Background: Artificial Intelligence (AI) is a modern tool with numerous applications in the medical field. The case series reported here aimed to investigate the diagnostic performance of the fetal intelligent navigation echocardiography (FINE) method applied for the first time in the prenatal identification of atrioventricular septal defects (AVSD). This congenital heart disease (CHD) is associated with extracardiac anomalies and chromosomal abnormalities. Therefore, an early diagnosis is essential to advise parents and make adequate treatment decisions. (2) Methods: Four fetuses diagnosed with AVSD via two-dimensional (2D) ultrasound examination in the second trimester were enrolled. In all cases, the parents chose to terminate the pregnancy. Since the diagnosis of AVSD with 2D ultrasound may be missed, one or more four-dimensional (4D) spatiotemporal image correlation (STIC) volume datasets were obtained from a four-chamber view. The manual navigation enabled by the software is time-consuming and highly operator-dependent. (3) Results: FINE was applied to these volumes and nine standard fetal echocardiographic views were generated and optimized automatically, using the assistance of the virtual intelligent sonographer (VIS). Here, 100% of the four-chamber views, and after the VISA System application the five-chamber views, of the diagnostic plane showed the atrioventricular septal defect and a common AV valve. The autopsies of the fetuses confirmed the ultrasound results. (4) Conclusions: By applying intelligent navigation technology to the STIC volume datasets, 100% of the AVSD diagnoses were detected.

Keywords: atrioventricular septal defects; congenital heart disease; fetal intelligent navigation echocardiography; spatiotemporal image correlation; virtual intelligent sonographer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Diagnostic planes with FINE in the systolic cardiac phase; 9 planes were used for the analysis. (b) Diagnostic planes with FINE in the diastolic cardiac phase; 9 planes were used for the analysis.
Figure 2
Figure 2
Female fetus heart at 20 weeks of gestation, affected by trisomy 21 and volunteer pregnancy interruption. (A) Macroscopic view of the left cavities mimicking the lateral long axis two-chamber echo view; note the patent oval fossa and complete atrioventricular septal defect with a common orifice of the valve with the posterior bridging leaflet (PBL, arrow) and anterior bridging leaflet (head arrow) and the gap between the two (*). Four-chamber section at the level of the gap at the interventricular septum between the anterior and posterior bridging leaflets. Posterior view (B) showing the posterior bridging leaflet attached to the interventricular septum (arrow), with the intact free margin of the posterior leaflet confirming the absence of the fusion with the anterior leaflet. Anterior view of the four-chamber section with the anterior leaflet attached to the interventricular septum (type A of Rastelli) (C).
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