Quantitative Parameters Analysis for Prenatally Echocardiographic Diagnosis of Atrioventricular Septal Defects

Background: Atrioventricular septal defects (AVSDs) are screened and diagnosed usually rely on the imaging characteristics of fetal echocardiography (FE). However, diagnosis on images is heavily depended on sonographers' experience and the quantitative data are rarely studied. Objective: This study aimed to realize the prenatal diagnosis of AVSDs by analyzing the quantitative data on FE. Methods: One hundred and thirteen cardiac quantitative data was analyzed in 370 normal and 49 AVSDs fetuses retrospectively. The top six with the highest diagnostic accuracy rate were acquired according to the area under the curve (AUC), and the diagnostic value of six variables was analyzed. Results: Six parameters obtained on the four-chamber view (4CHV), including the atrial to ventricular length ratio in end-diastole (AVLR-ED), AVLR-ED combined with the atrial to ventricular length ratio in end-systole (AVLR-ES), quantile score (Q score) of AVLR-ED, Q score of AVLR-ES, Q score of ventricle length in end-diastole (VL-ED), and AVLR-ES, were the top six with the highest diagnostic value, and the AUC was 0.99 (95%CI 0.99-1.00), 0.99 (95%CI 0.99-1.00), 0.99 (95% CI 0.98- 1.00), 0.95 (95%CI 0.91-0.99), 0.93 (95%CI 0.87-0.99), and 0.91 (95%CI 0.83-1.00), respectively. And within the 20% false positive rate, the diagnostic sensitivity was greater than 100%, 100%, 100%, 90%, 90%, and 88%, respectively. Conclusions: Six variables could be used for prenatal diagnosis of AVSDs. Among them, AVLR-ED and Q score of AVLR-ED, obtained on the 4CHV, were more convenient to acquire and had higher diagnostic accuracy.