Abstract
Amaç: Fetal dönemde intrakardiyak ekojenik odağın (İKEF) önemi tartışmalıdır. İKEF’nin fetüste kardiyak malformasyon veya anomali riskini etkileyip etkilemediğini belirlemek için mevcut çalışma gerçekleştirildi.
Gereç ve Yöntemler: Aralık-2016 ile Mayıs-2019 tarihleri arasında çocuk kardiyoloji bölümüne fetal ekokardiyografi için yönlendirilen 248 intrakardiyak ekojenik odak saptanan fetüse ait özellikler retrospektif olarak incelendi. İKEF sayısı, yerleşim yeri, büyüklüğü, yapısal kardiyak anomali varlığı incelendi. İstatistiksel analiz için χ2 veya Fisher exact testi yapıldı.
Bulgular: İKEF’a sahip 248 fetüsün 10 unda kardiyak patoloji saptandı. Kardiyak anomali görülme prevelansı %4 olarak belirlendi. En sık tespit edilen kardiyak anomali ventriküler septal defektti. Ekojenik odağın yerleşimi en sık sol ventrikül (LV) (% 84.3) yerleşimli, ardından biventriküler (BV) (%9.7) yerleşimli ve 6 sağ ventrikül (RV) yereşimliydi. RV yerleşimli İKEF’si bulunan fetüslerde kardiyak anomali prevelansı LV ve BV yerleşimli İKEF bulunanlara göre anlamlı olarak yüksekti (sırasıyla % 13.3’e karşı %3.3 ve %4.1). Tüm fetüslerin %14.5’inde birden fazla İKEF vardı. İKEF varlığı ile anne yaşı arasında istatistiksel olarak anlamlı bir fark bulunmadı (p = 0.87).
Sonuç: Özellikle sağ ventrikülde İKEF’si olan fetüslerde daha sık kardiyak yapısal anomali tespit edildi. Sağ ventrikülde fetal ekojenik odağın histopatolojik özelliklerini incelemek için daha fazla araştırma yapılması gerekir.
Supporting Institution
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References
- 1. Levy DW, Mintz MC. The left ventricular echogenic focus: a normal finding. AJR Am J Roentgenol 1988;150:85–86
- 2. 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.
- 3. Chiu G, Zhao A, Zhang B, Zhang T. Intracardiac echogenic focus and its location: association with congenital heart defects. J Matern - Fetal Neo M 2019; 32: 3074-78.
- 4. Roberts DJ, Genest D. Cardiac histologic pathology characteristic of trisomies 13 and 21. Hum Pathol 1992;23:1130–1140.
- 5. Tennstedt C, Chaoui R, Vogel M, Goldner B, Dietel M. Pathologic correlation of sonographic echogenic foci in the fetal heart. Prenat Diagn 2000;20:287–292.
- 6. Copel JA, Pilu G, Green J, Hobbins JC, Kleinman CS. Fetal echocardiographic screening for congenital heart disease: the importance of the four-chamber view. Am J Obstet Gynecol 1987; 157:648–655.
- 7. Schechter AG, Fakhry J, Shapiro LR, Gewitz MH. In utero thickening of the chordae tendinae. A cause of intracardiac echogenic foci. J Ultrasound Med 1987;6:691-5.
- 8. Simpson JM, Cook A, Sharland G. The significance of echogenic foci in the fetal heart: a prospective study of 228 cases. Ultrasound Obstet Gynecol 1996;8:225-8.
- 9. Wolman I, Jaffa A, Geva E, Diamant S, Strauss S, Lessing JB, et al. Intracardiac echogenic focus: no apparent association with structural cardiac abnormality. Fetal Diagn Ther 2000; 15: 216–218.
- 10. Barsoom MJ, Feldman DM, Borgida AF, Esters D, Diana D, Egan FX. Is an isolated fetal cardiac echogenic focus an indication for fetal echocardiography? J Ultrasound Med 2001;20:1043-6.
- 11. Petrikovsky BM, Challenger M, Wyse LJ. Natural history of echogenic foci within ventricles of the fetal heart. Ultrasound Obstet Gynecol 1995;5:92-4.
- 12. Guo Y, He Y, Gu X, Zhang Y, Sun L, Liu X, et al. Echogenic intracardiac foci and fetal cardiac anomalies: A review of cases from a tertiary care center in China. J Clin Ultrasound 2018;46:103-7.
- 13. Gonçalves TR, Zamith MM, Murta CG, Bussamra LC, Torloni MR, Moron AF. Chromosomal and cardiac anomalies in fetuses with intracardiac echogenic foci. Int J Gynaecol Obstet 2006; 95: 132– 7.
- 14. Carriço A, Matias A, Areias JC. How important is a cardiac echogenic focus in a routine fetal examination? Rev Port Cardiol 2004;23:459-61.
- 15. Bronshtein M, Jakobi P, Ofir C. Multiple fetal intracardiac echogenic foci: not always a benign sonographic finding. Prenat Diagn 1996; 16:131–135.
- 16. Wax JR, Philput C. Fetal intracardiac echogenic foci: does it matter which ventricle? J Ultrasound Med 1998;17:141-4.
- 17. Perri T, Cohen-Sacher B, Hod M, Berant M, Meizner I, Bar J. Risk factors for cardiac malformations detected by fetal echocardiography in a tertiary center. J Matern Fetal Neonatal Med 2005;17:123-8.
- 18. Anderson N, Jyoti R. Relationship of isolated fetal intracardiac echogenic focus to trisomy 21 at the mid-trimester sonogram in women younger than 35 years. Ultrasound Obstet Gynecol 2003;21:354– 358.
Abstract
Objective: The significance of intracardiac echogenic focus (ICEF) in the fetal period is controversial. We conducted the current study to determine whether ICEF affects the risk of cardiac malformation or anomaly in the fetus.
Material and Methods: The characteristics of the fetus with 248 intracardiac echogenic foci referred to the pediatric cardiology department for fetal echocardiography between December-2016 and May-2019 were retrospectively analyzed. The number, location, size of ICEF and presence of structural cardiac anomaly were examined. For statistical analysis, χ2 or Fisher’s exact test was used.
Results: Cardiac anomaly was detected in 10 of 248 fetuses with ICEF. The prevalence of cardiac anomaly was 4%. The most common cardiac anomaly was ventricular septal defect. The most common location of the echogenic focus was left ventricular (LV) (84.3%), followed by biventricular (BV) (9.7%) and right ventricular (RV) placement of 6%. The prevalence of cardiac anomalies in fetuses with ICEF located in RV was significantly higher than those with ICEF with LV and BV (13.3% vs. 3.3% and 4.1%, respectively). 14.5% of all fetuses had more than one ICEF. There was no statistically significant difference between the presence of ICEF and maternal age (p = 0.87).
Conclusion: Cardiac structural anomalies were found more frequently in fetuses with ICEF, especially in the right ventricle. More research is needed to examine the histopathological features of fetal echogenic focus in the right ventricle.
References
- 1. Levy DW, Mintz MC. The left ventricular echogenic focus: a normal finding. AJR Am J Roentgenol 1988;150:85–86
- 2. 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.
- 3. Chiu G, Zhao A, Zhang B, Zhang T. Intracardiac echogenic focus and its location: association with congenital heart defects. J Matern - Fetal Neo M 2019; 32: 3074-78.
- 4. Roberts DJ, Genest D. Cardiac histologic pathology characteristic of trisomies 13 and 21. Hum Pathol 1992;23:1130–1140.
- 5. Tennstedt C, Chaoui R, Vogel M, Goldner B, Dietel M. Pathologic correlation of sonographic echogenic foci in the fetal heart. Prenat Diagn 2000;20:287–292.
- 6. Copel JA, Pilu G, Green J, Hobbins JC, Kleinman CS. Fetal echocardiographic screening for congenital heart disease: the importance of the four-chamber view. Am J Obstet Gynecol 1987; 157:648–655.
- 7. Schechter AG, Fakhry J, Shapiro LR, Gewitz MH. In utero thickening of the chordae tendinae. A cause of intracardiac echogenic foci. J Ultrasound Med 1987;6:691-5.
- 8. Simpson JM, Cook A, Sharland G. The significance of echogenic foci in the fetal heart: a prospective study of 228 cases. Ultrasound Obstet Gynecol 1996;8:225-8.
- 9. Wolman I, Jaffa A, Geva E, Diamant S, Strauss S, Lessing JB, et al. Intracardiac echogenic focus: no apparent association with structural cardiac abnormality. Fetal Diagn Ther 2000; 15: 216–218.
- 10. Barsoom MJ, Feldman DM, Borgida AF, Esters D, Diana D, Egan FX. Is an isolated fetal cardiac echogenic focus an indication for fetal echocardiography? J Ultrasound Med 2001;20:1043-6.
- 11. Petrikovsky BM, Challenger M, Wyse LJ. Natural history of echogenic foci within ventricles of the fetal heart. Ultrasound Obstet Gynecol 1995;5:92-4.
- 12. Guo Y, He Y, Gu X, Zhang Y, Sun L, Liu X, et al. Echogenic intracardiac foci and fetal cardiac anomalies: A review of cases from a tertiary care center in China. J Clin Ultrasound 2018;46:103-7.
- 13. Gonçalves TR, Zamith MM, Murta CG, Bussamra LC, Torloni MR, Moron AF. Chromosomal and cardiac anomalies in fetuses with intracardiac echogenic foci. Int J Gynaecol Obstet 2006; 95: 132– 7.
- 14. Carriço A, Matias A, Areias JC. How important is a cardiac echogenic focus in a routine fetal examination? Rev Port Cardiol 2004;23:459-61.
- 15. Bronshtein M, Jakobi P, Ofir C. Multiple fetal intracardiac echogenic foci: not always a benign sonographic finding. Prenat Diagn 1996; 16:131–135.
- 16. Wax JR, Philput C. Fetal intracardiac echogenic foci: does it matter which ventricle? J Ultrasound Med 1998;17:141-4.
- 17. Perri T, Cohen-Sacher B, Hod M, Berant M, Meizner I, Bar J. Risk factors for cardiac malformations detected by fetal echocardiography in a tertiary center. J Matern Fetal Neonatal Med 2005;17:123-8.
- 18. Anderson N, Jyoti R. Relationship of isolated fetal intracardiac echogenic focus to trisomy 21 at the mid-trimester sonogram in women younger than 35 years. Ultrasound Obstet Gynecol 2003;21:354– 358.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | March 30, 2021 |
| Submission Date | December 29, 2020 |
| Published in Issue | Year 2021 Volume: 15 Issue: 2 |
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