Comparison of 2D versus M-mode echocardiography for assessing fetal myocardial wall thickness

Abstract

Objective: M-mode and 2D have been proposed for evaluating fetal myocardial thickness. However, studies comparing the performance of both modalities are lacking. We aimed to compare 2D versus M-mode reproducibility for assessing myocardial wall thicknesses.

Methods: A prospective study including 45 healthy fetuses from low-risk pregnancies evaluated between 18 and 41 weeks of gestation. Left and right ventricular free-wall and septal myocardial thicknesses were measured at end-diastole (ED) and end-systole (ES) in transverse 4-chamber view using 2D and M-mode. Intra- and interobserver reproducibility was evaluated by the concordance correlation coefficient (CCC). Both techniques were compared by t-test of the CCC.

Results: 2D and M-mode demonstrated excellent and similar intraobserver repeatability, with the best concordance in ES septal thickness (M-mode CCC 0.956 versus 2D-mode CCC 0.914). Interobserver reproducibility demonstrated also a high concordance, optimal in ES left ventricular free wall (M-mode 0.925 versus 2 D 0.855). Comparison of both techniques demonstrated a high concordance in all measurements, except for ED septal thickness with better reproducibility using M-mode (CCC 0.954 versus 0.847, p = .017).

Conclusions: 2D and M-mode can be used in a reproducible manner for measuring fetal myocardial thickness, with a slightly better performance of M-mode for assessing ED septal wall thickness.

Keywords:

• Reproducibility
• fetal heart
• echocardiography
• ultrasound
• comparison

Disclosure statement

The authors report no declarations of interest.

This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

Additional information

Funding

This project has been cofunded with support of the Erasmus Mundus Joint Doctorate in Fetal and Perinatal Medicine Programme of the European Union (Framework Agreement number: 2013-0040). Additionally, the research leading to these results has received funding from “la Caixa” Foundation; Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); the Instituto de Salud Carlos III (PI14/00226, PI15/00263, PI15/00130 and INT16/00168) as part of the Plan Nacional de I + D+I and cofunded by ISCIII-Subdirección General de Evaluación y el fondo europeo de desarrollo regional (FEDER) “Otra manera de hacer Europa” (Spain) and the support of the Secretaria d’Universitat i Recerca del Departament d’Economia i Coneixement de la Generalitat de Catalunya (Grant SGR n° 928 and 2016FI_B01184). Iris Soveral was supported by a grant (Ajut Josep Font) from Hospital Clinic, Barcelona.