Analysis of dominant views in ultrasound examination of common congenital heart diseases in children_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

PAN Yanan ,  YU Jin , YE Jingjing , LIU Qingqing

Department of Ultrasound Diagnosis, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China;

Corresponding author：

YU Jin, Email: 6503067@zju.edu.cn

Keywords：

Echocardiography; congenital heart disease; ultrasonic view; analysis

DOI：

10.7507/1007-4848.202410013

Video：

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Objective To explore the dominant views with positive results when performing echocardiography on common congenital heart diseases (CHD) in children using the "Seven-Step Screening Method for Pediatric Echocardiography". Methods The echocardiographic data of children with atrial septal defect, patent foramen ovale, ventricular septal defect, and patent ductus arteriosus were collected from September 2021 to February 2022. The disease type distribution, view distribution, and the dominant view distribution were analyzed. Dominant view refered to the view with a high ratio of positive result images per view to the total image in each disease. Results A total of 8 353 images of 1 633 children with common CHD were collected. There were 813 males and 820 females at age of 0-7 years. Including 3 613 images in 701 patients with atrial septal defect, 1 178 images in 206 patients with patent foramen ovale, 2 857 images in 576 patients with ventricular septal defect, and 705 images in 150 patients with patent ductus arteriosus. The dominant views of atrial septal defect were subxiphoid 2-chamber view (92.96%), subxiphoid 4-chamber view (85.61%), parasternal 4-chamber view (62.07%), and parasternal short-axis view (38.50%). The dominant views of patent foramen ovale were subxiphoid 2-chamber view (82.69%) and subxiphoid 4-chamber view (65.41%). The dominant views of ventricular septal defect were parasternal 5-chamber view (79.73%), parasternal short-axis view (79.41%), parasternal 4-chamber view (58.18%), and parasternal long-axis view (51.11%). The dominant view of patent ductus arteriosus were parasternal short-axis view (98.80%). Conclusions The analysis of the lesion key areas of common CHD showed that there were 4 dominant views for atrial septal defect and ventricular septal defect, 2 for patent foramen ovale, and only 1 for patent ductus arteriosus. Clarifying the dominant views of common CHD were conducive to rapid and accurate diagnosis of diseases, clinical, teaching and scientific research.

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14.	赵镭, 林慧佳, 俞劲, 等. 小儿先天性心脏病超声七步筛查法在极低出生体重儿动脉导管未闭诊疗中的应用. 浙江医学, 2022, 44(20): 2149-2153.Zhao L, Lin HJ, Yu J, et al. Application of seven-step echocardiographic screening of congenital heart disease in predicting clinical outcome of very lowbirth weight infants with patent ductus arteriosus. J Zj Med, 2022, 44(20): 2149-2153.
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16.	贺新建, 魏九茹, 崔云, 等. 超声心动图对婴幼儿右位动脉导管未闭的筛查诊断方法及价值. 中华超声影像学杂志, 2023, 32(8): 679-684.He XJ, Wei JR, Cu Y, et al. Diagnostic method and value of echocardiography for sereening right patent ductus arteriosus in infants. Chin J Ultrasonogr, 2023, 32(8): 679-684.
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18.	吴云潇潇, 张立波, 龚丁旭, 等. 人工智能在先天性心脏病影像诊断中应用研究进展. 中华实用诊断与治疗杂志, 2024, 38(08): 856-859.Wu YXX, Zhang LB, Gong DX, et al. Application of artificial intelligence in the imaging diagnosis of congenital heart disease. J Chin Pract Diagn Ther, 2024, 38(08): 856-859.
19.	Sermesant M, Delingette H, Cochet H, et al. Applications of artificial intelligence in cardiovascular imaging. Nat Rev Cardiol, 2021, 18(8): 600-609.
20.	Omar AMS, Krittanawong C, Narula S, et al. Echocardiographic data in artificial intelligence research: Primer on concepts of big data and latent states. JACC Cardiovasc Imaging, 2020, 13(1): 170-172.
21.	Gearhart A, Goto S, Deo RC, et al. An automated view classification model for pediatric echocardiography using artificial intelligence. J Am Soc Echocardiogr, 2022, 35(12): 1238-1246.
22.	Jiang X, Yu J, Ye J, et al. A deep learning-based method for pediatric congenital heart disease detection with seven standard views in echocardiography. World J Pediatr Surg, 2023, 6(3): e000580.
23.	Wang J, Xie W, Cheng M, et al. Assessment of transcatheter or surgical closure of atrial septal defect using interpretable deep keypoint stadiometry. Research (Wash D C), 2022: 9790653.

1. Zhao L, Chen L, Yang T, et al. Birth prevalence of congenital heart disease in China, 1980-2019: A systematic review and meta-analysis of 617 studies. Eur J Epidemiol, 2020, 35: 631-42.
2. Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol, 2019, 48(2): 455-463.
3. Zhao QM, Liu F, Wu L, et al. Prevalence of congenital heart disease at live birth in China. J Pediatr, 2019, 204: 53-58.
4. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1204-1222.
5. Qiu YX, Jiang W, Zhang JY, et al. Using echocardiography in newborn screening for congenital heart disease may reduce missed diagnoses. World J Pediatr, 2022, 18(9): 629-631.
6. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 卵圆孔未闭规范化诊疗中国专家共识. 中华心血管病杂志, 2024, 52(4): 369-383.Chinese Medical Association Cardiovascular Branch, Editorial Board of Chinese Journal of Cardiology. Chinese expert consensus on the standardized diagnosis and treatment of patent foramen ovale. Chin J Cardiol, 2024, 52(4): 369-383.
7. Liu X, Xu W, Yu J, et al. Screening for congenital heart defects: Diversified strategies in current China. World Jnl Ped Surgery, 2019(2): e000051.
8. 王音, 王峥, 徐鹏, 等. 西北地区单中心胎儿先心病超声诊断与一体化管理的初步研究. 中华超声影像学杂志, 2018, 27(9): 759-765.WangY, Wang Z, Xu P, et al. Study on diagnosis of fetal congenital heart disease by echocardiography and integrated management in a single center in northwestern region of China. Chin J Ultrasonogr, 2018, 27(9): 759-765.
9. 叶菁菁, 徐玮泽, 俞劲, 等. 小儿先天性心脏病超声七步筛查法. 国作登字-2019-L-00817470. 2019.7. 1. Ye JJ, Xu WZ, Yu J, et al. Seven-step screening method for pediatric echocardiography. 2019-L-00817470.
10. 刘玉清. 先天性心脏病诊断的节段分析法. 中华放射学杂志, 1998, 32(08): 25-28.Liu YQ. Segmental analysis for the diagnosis of congenital heart disease. Chin J Radiol, 1998, 32(08): 25-28.
11. Lai WW, Geva T, Shirali GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: A report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr, 2006, 19(12): 1413-1430.
12. 赵博文, 任卫东, 王建华. 美国超声心动图学会《小儿超声心动图操作指南和标准》简介与解读. 中华医学超声杂志(电子版), 2015, 12(03): 177-183.Zhao BW, Ren WD, Wang JH. Introduction and interpretation of guidelines and standards for performance of a pediatric echocardiogram: A report from the Task Force of the Pediatric Council of the American Society of Echocardiography. Chin J Med Ultrasound(Electronic Edition), 2015, 12(03): 177-183.
13. 叶菁菁, 楼丹娜, 俞劲, 等. 进修医生小儿超声心动图基础的问卷调查与对策研究. 中国高等医学教育, 2023(4): 121-122.Ye JJ, Lou DN, Yu J, et al. Questionnaire survey and countermeasure study of pediatric echocardiography basis for doctors in training. Chin Higher Med Education, 2023(4): 121-122.
14. 赵镭, 林慧佳, 俞劲, 等. 小儿先天性心脏病超声七步筛查法在极低出生体重儿动脉导管未闭诊疗中的应用. 浙江医学, 2022, 44(20): 2149-2153.Zhao L, Lin HJ, Yu J, et al. Application of seven-step echocardiographic screening of congenital heart disease in predicting clinical outcome of very lowbirth weight infants with patent ductus arteriosus. J Zj Med, 2022, 44(20): 2149-2153.
15. 国家卫生健康委员会国家结构性心脏病介入质量控制中心, 国家心血管病中心结构性心脏病介入质量控制中心, 中华医学会心血管病学分会先心病经皮介入治疗指南工作组, 等. 常见先天性心脏病经皮介入治疗指南(2021版). 中华医学杂志, 2021, 101(38): 3054-3076.National Center for Quality Control of Structural Heart Disease Interventions of the National Health Commission, National Center for Cardiovascular Disease Quality Control for Structural Cardiology Interventions, Working Group on Guidelines for Percutaneous Interventional Treatment of Congenital Heart Disease, Branch of Cardiovascular Medicine, Chinese Medical Association, et al. Guidelines for percutaneous interventional treatment of common congenital heart diseases. Natl Med J China, 2021, 101(38): 3054-3076.
16. 贺新建, 魏九茹, 崔云, 等. 超声心动图对婴幼儿右位动脉导管未闭的筛查诊断方法及价值. 中华超声影像学杂志, 2023, 32(8): 679-684.He XJ, Wei JR, Cu Y, et al. Diagnostic method and value of echocardiography for sereening right patent ductus arteriosus in infants. Chin J Ultrasonogr, 2023, 32(8): 679-684.
17. 王新房, 谢明星, 主编. 超声心动图学. 第5版. 北京: 人民卫生出版社, 2015.787-848. Wang XF, Xie MX, Editor. Textbook of echocardiography. Fifth edition. Beijing: People’s Medical Publishing House, 2015.787-848.
18. 吴云潇潇, 张立波, 龚丁旭, 等. 人工智能在先天性心脏病影像诊断中应用研究进展. 中华实用诊断与治疗杂志, 2024, 38(08): 856-859.Wu YXX, Zhang LB, Gong DX, et al. Application of artificial intelligence in the imaging diagnosis of congenital heart disease. J Chin Pract Diagn Ther, 2024, 38(08): 856-859.
19. Sermesant M, Delingette H, Cochet H, et al. Applications of artificial intelligence in cardiovascular imaging. Nat Rev Cardiol, 2021, 18(8): 600-609.
20. Omar AMS, Krittanawong C, Narula S, et al. Echocardiographic data in artificial intelligence research: Primer on concepts of big data and latent states. JACC Cardiovasc Imaging, 2020, 13(1): 170-172.
21. Gearhart A, Goto S, Deo RC, et al. An automated view classification model for pediatric echocardiography using artificial intelligence. J Am Soc Echocardiogr, 2022, 35(12): 1238-1246.
22. Jiang X, Yu J, Ye J, et al. A deep learning-based method for pediatric congenital heart disease detection with seven standard views in echocardiography. World J Pediatr Surg, 2023, 6(3): e000580.
23. Wang J, Xie W, Cheng M, et al. Assessment of transcatheter or surgical closure of atrial septal defect using interpretable deep keypoint stadiometry. Research (Wash D C), 2022: 9790653.

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