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Echogenic intracardiac focus: potential for misdiagnosis
Virginia D Winn1, Joy Sonson, Roy A Filly
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
Summary
Specular reflectors in the fetal heart can mimic true echogenic intracardiac foci (EIFs). Caution is advised during obstetric sonography to avoid misdiagnosing these common false EIFs, particularly those from the moderator band.
Area of Science:
- Medical Imaging
- Fetal Cardiology
- Diagnostic Ultrasound
Background:
- Echogenic intracardiac foci (EIFs) are common findings during fetal echocardiography.
- Distinguishing true EIFs from artifacts is crucial for accurate prenatal diagnosis.
Purpose of the Study:
- To determine the incidence of specular reflectors mimicking EIFs in the fetal heart.
- To identify common sources of false-positive EIFs.
Main Methods:
- Retrospective analysis of 200 obstetric sonograms from singleton pregnancies (18-22 weeks gestation).
- Classification of bright focal reflections as 'true' or 'false' EIFs.
- Identification of locations for spurious EIFs.
Main Results:
- The rate of true EIFs was 5.5% (11/200).
- The rate of false EIFs was 17% (34/200).
- Common sites for false EIFs included the endocardial cushion, moderator band, and tricuspid valve annulus.
Conclusions:
- Specular reflections, especially from the moderator band, frequently mimic EIFs.
- The high rate of false EIFs necessitates careful examination to avoid misdiagnosis.
- Caution is recommended when diagnosing EIFs due to potential artifactual origins.