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Abstract

The objective of this study was to compare the ability to visualize an echogenic intracardiac focus (EIF) of the left ventricle in four different cardiac projections. One hundred seventeen fetuses at 15 to 24 weeks’ gestation with a known EIF were rescanned in at least one longitudinal cardiac plane (apical or basilar) and one lateral plane (left or right lateral). An EIF was recorded as present if an intensely bright focus was visualized within the left ventricle. An EIF was identified in 100% (111/111) of apical views, 49.2% (29/59) of left lateral views, 46.8% (29/62) of right lateral views, and 100% (12/12) of basilar views. An EIF was seen in 100% of longitudinal views compared with 48.7% of lateral views (P < .001). It was concluded that an EIF is more consistently seen from the apical and basilar views than from the right or left lateral views of the fetal heart. A longitudinal view of the heart is required to truly rule out an EIF.

Keywords

echogenic intracardiac focus heart orientation sonography fetal echocardiography prenatal diagnosis

References

Caughey AB , Lyell DJ , Filly RA , Washington AE , Norton ME : The impact of the use of the isolated echogenic intracardiac focus as a screen for Down syndrome in women under the age of 35 years. Am J Obstet Gynecol 2001;185:1021-1027.

Brown DL , Roberts DJ , Miller WA : Left ventricular echogenic focus in the fetal heart: pathologic correlation. J Ultrasound Med 1994;13:613-616.

Achiron R , Lipitz S , Gubbay U , Yagel S : Prenatal ultrasonographic diagnosis of fetal heart echogenic foci: no correlation with Down syndrome. Obstet Gynecol 1997;89:945-948.

Petrikovsky BM , Challenger M , Wyse LJ : Natural history of echogenic foci within ventricles of the fetal heart. Ultrasound Obstet Gynecol 1995;5:92-94.

Smith-Bindman R , Hosmer W , Feldstein VA , Deeks JJ , Goldberg JD : Second-trimester ultrasound to detect fetuses with Down syndrome: a meta-analysis. JAMA 2001;285:1044-1055.

Sotiriadis A , Makrydimas G , Ioannidis JPA : Diagnostic performance of intracardiac echogenic foci for Down syndrome: a meta-analysis. Obstet Gynecol 2003;101: 1009-1016.

Nicolaides KH : Screening for chromosomal defects [editorial]. Ultrasound Obstet Gynecol 2003;21:313-321.

Coco C , Jeanty, P , Jeanty C : An isolated echogenic heart focus is not an indication for amniocentesis in 12,672 unselected patients. J Ultrasound Med 2004;23:489-496.

Vintzileos AM , Guzman ER , Smulian JC , Yeo L , Scorza WE , Knuppel RA : Down syndrome risk estimation after normal genetic sonography. Am J Obstet Gynecol 2002;187:1226-1229.

10.

Bromley B , Lieberman E , Shipp TD , Benacerraf BR : The genetic sonogram: a method of risk assessment for Down syndrome in the second trimester. J Ultrasound Med 2002;21:1087-1096.

11.

Shipp TD , Bromley B , Lieberman E , Benacerraf BR : The frequency of the detection of fetal echogenic intracardiac foci with respect to maternal race. Ultrasound Obstet Gynecol 2000;15:460-462.

12.

Ranzini AC , McLean DA , Sharma S , Vintzileos AM : Fetal intracardiac echogenic foci: visualization depends on the orientation of the 4-chamber view. J Ultrasound Med 2001;20:763-766.

13.

Ehrenberg HM , Fischer RL , Hediger ML , Hansen C , Stine D : Are maternal and sonographic factors associated with the detection of a fetal echogenic cardiac focus? J Ultrasound Med 2001;20:1047-1052.

14.

Levine D , Mehta TS , Min KK , Hulka CA , McArdle CR : Technical factors influencing sonographic visualization of fetal echogenic intracardiac foci. J Clin Ultrasound 2000;28:479-484.

15.

Filly RA , Benacerraf BR , Nyberg DA , Hobbins JC : Choroid plexus cyst and echogenic intracardiac focus in women at low risk for chromosomal anomalies [editorial]. J Ultrasound Med 2004;23:447-449.

16.

Doubilet PM , Copel JA , Benson CB , Bahado-Singh RO , Platt LD : Choroid plexus cyst and echogenic intracardiac focus in women at low risk for chromosomal anomalies: the obligation to inform the mother [editorial counterpoint]. J Ultrasound Med 2004;23:883-885.

17.

Filly RA : Echogenic intracardiac foci and choroid plexus cysts [letter]. J Ultrasound Med 2004;23:1135-1138.

18.

Doubilet PM , Copel JA , Benson CB , Bahado-Singh RO , Platt LD : Echogenic intracardiac foci and choroid plexus cysts [reply to letter]. J Ultrasound Med 2004;23:1138-1139.

19.

Winn VD , Sonson J , Filly RA : Echogenic intracardiac focus: potential for misdiagnosis. J Ultrasound Med 2003;22:1207-1214.

Influence of Fetal Heart Orientation on the Sonographic Identification of an Echogenic Intracardiac Focus in the Left Ventricle

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