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Newborn Screening for Critical Congenital Heart Defects Using Pulse Oximetry
摘要： Critical congenital heart defects can lead to serious morbidity and mortality if not found at the appropriate time. Although prenatal ultrasound and postnatal neonatal physical examination can detect the majority of severe congenital heart disease, more than 20% of newborns are still not diagnosed before discharge from the birth hospital. The diagnosis of critical congenital heart defects using pulse oximetry can reduce these diagnostic problems, and it is necessary to consider introducing it as a neonatal screening test in Korea. However, as the prevalence rate of disease and the medical system vary from country to country, it is necessary to study whether this screening test is effective or cost effective in our country. Newborns with a positive result that did not pass a critical congenital heart defects screening using pulse oximetry would require thorough follow-up testing to identify not only severe congenital heart disease but also other potential causes of hypoxia. However, even if the neonate has passed the critical congenital heart defects screening test using pulse oximetry, this screening test has a low sensitivity and a high false positive rate, so it cannot be a perfect screening test for critical congenital heart defects. Therefore, when this screening test is performed at each hospital, it is important to educate and follow the caregivers of signs and symptoms of other congenital heart diseases other than hypoxemia.
关键词： Pulse oximetry,Congenital heart disease,Neonatal screening
更新于2025-09-19 17:15:36
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Dual-phase whole-heart imaging using image navigation in congenital heart disease
摘要： Background: Dual-phase 3-dimensional whole-heart acquisition allows simultaneous imaging during systole and diastole. Respiratory navigator gating and tracking of the diaphragm is used with limited accuracy. Prolonged scan time is common, and navigation often fails in patients with erratic breathing. Image-navigation (iNAV) tracks movement of the heart itself and is feasible in single phase whole heart imaging. To evaluate its diagnostic ability in congenital heart disease, we sought to apply iNAV to dual-phase sequencing. Methods: Healthy volunteers and patients with congenital heart disease underwent dual-phase imaging using the conventional diaphragmatic-navigation (dNAV) and iNAV. Acquisition time was recorded and image quality assessed. Sharpness and length of the right coronary (RCA), left anterior descending (LAD), and circumflex (LCx) arteries were measured in both cardiac phases for both approaches. Qualitative and quantitative analyses were performed in a blinded and randomized fashion. Results: In volunteers, there was no significant difference in vessel sharpness between approaches (p > 0.05). In patients, analysis showed equal vessel sharpness for LAD and RCA (p > 0.05). LCx sharpness was greater with dNAV (p < 0.05). Visualized length with iNAV was 0.5 ± 0.4 cm greater than that with dNAV for LCx in diastole (p < 0.05), 1.0 ± 0.3 cm greater than dNAV for LAD in diastole (p < 0.05), and 0.8 ± 0.7 cm greater than dNAV for RCA in systole (p < 0.05). Qualitative scores were similar between modalities (p = 0.71). Mean iNAV scan time was 5:18 ± 2:12 min shorter than mean dNAV scan time in volunteers (p = 0.0001) and 3:16 ± 1:12 min shorter in patients (p = 0.0001). Conclusions: Image quality of iNAV and dNAV was similar with better distal vessel visualization with iNAV. iNAV acquisition time was significantly shorter. Complete cardiac diagnosis was achieved. Shortened acquisition time will improve clinical applicability and patient comfort.
关键词： Respiratory motion correction,Dual phase imaging,Congenital heart disease,Steady-state free precession MRI
更新于2025-09-04 15:30:14