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How to apply the DAZE technique: structured approach to fetal cardiac image optimization
M Perez1, M Sklansky2, T Anton3
1Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Scripps Clinic, La Jolla, CA, USA.
Insights
Improving prenatal diagnosis of congenital heart disease requires optimized ultrasound techniques. The DAZE (Depth, Angle, Zoom, Enhancement) method offers a systematic approach to enhance fetal cardiac imaging quality and accuracy.
Area of Science:
- Medical Imaging
- Obstetrics and Gynecology
- Fetal Medicine
Background:
- Prenatal detection of congenital heart disease (CHD) remains a significant challenge in routine obstetric practice.
- Missed CHD diagnoses are often linked to suboptimal ultrasound image acquisition and inconsistent application of optimization principles.
- High-quality fetal cardiac assessment necessitates deliberate optimization of technical parameters beyond standard anatomical views.
Purpose of the Study:
- To introduce and describe the DAZE (Depth, Angle, Zoom, Enhancement) technique.
- To provide a systematic and reproducible method for optimizing two-dimensional ultrasound imaging and color Doppler for fetal cardiac assessment.
- To emphasize the importance of technical parameter optimization for improving spatial and temporal resolution in fetal echocardiography.
Main Methods:
- The DAZE technique involves four sequential optimization steps: Depth, Angle, Zoom, and Enhancement.
- 'D': Adjustment of Depth and focal-zone placement.
- 'A': Optimization of sector Angle width and Angle of insonation.
- 'Z': Appropriate Zoom magnification.
- 'E': Enhancement of ultrasound system settings.
- Practical application of each DAZE component is detailed, focusing on optimizing grayscale and color Doppler imaging.
Main Results:
- The DAZE technique provides an organized approach to systematically optimize ultrasound parameters for fetal cardiac imaging.
- Implementation of DAZE aims to improve image quality, including spatial and temporal resolution.
- Enhanced optimization of color Doppler application is a key outcome of the DAZE technique.
Conclusions:
- The DAZE technique offers a structured methodology to enhance the quality of fetal cardiac ultrasound examinations.
- Systematic optimization of ultrasound parameters using DAZE can potentially improve the accuracy of prenatal CHD detection.
- Consistent application of the DAZE technique can lead to more reliable and reproducible fetal echocardiography.
Abstract:
Accurate prenatal detection of congenital heart disease continues to be challenging in routine obstetric practice, despite established screening guidelines. Missed diagnoses are frequently associated with suboptimal image acquisition and inconsistent application of fundamental ultrasound optimization principles. High-quality fetal cardiac assessment requires intentional optimization of technical parameters, in addition to acquiring the recommended anatomical views. We describe, in the context of fetal cardiac imaging, the 'DAZE' (Depth, Angle, Zoom, Enhancement) technique, an organized and reproducible approach for systematically optimizing two-dimensional ultrasound imaging and the application of color Doppler. The DAZE technique consists of four sequential steps: 'D', adjustment of Depth and focal-zone placement; 'A', optimization of sector Angle width and Angle of insonation; Z, appropriate Zoom magnification; and E, Enhancement of ultrasound system settings. Practical application of each component is described, with an emphasis on optimizing spatial and temporal resolution on two-dimensional grayscale imaging, as well as optimizing the application of color Doppler. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.
