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Tonni G, Peixoto AB, Werner H, Grisolia G, Ruano R, Sepulveda F, Sepulveda W, Araujo Júnior E. Ultrasound and fetal magnetic resonance imaging: Clinical performance in the prenatal diagnosis of orofacial clefts and mandibular abnormalities. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:346-361. [PMID: 36785498 DOI: 10.1002/jcu.23403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 06/18/2023]
Abstract
Cleft lip, with or without cleft palate, is the most common congenital craniofacial anomaly and the second most common birth defect worldwide. Micrognathia is a rare facial malformation characterized by small, underdeveloped mandible and frequently associated with retrognathia. Second- and third-trimester prenatal ultrasound is the standard modality for screening and identification of fetal orofacial abnormalities, with a detection rate in the low-risk population ranging from 0% to 73% for all types of cleft. The prenatal ultrasonography detection can also be performed during the first trimester of pregnancy. Given the potential limitations of obstetric ultrasound for examining the fetal face, such as suboptimal fetal position, shadowing from the surrounding bones, reduce amniotic fluid around the face, interposition of fetal limbs, umbilical cord and placenta, and maternal habitus/abdominal scars, the use of adjunct imaging modalities can enhance prenatal diagnosis of craniofacial anomalies in at-risk pregnancies. Fetal magnetic resonance imaging (MRI) is a potentially useful second-line investigation for the prenatal diagnosis of orofacial malformations with a pooled sensitivity of 97%. In this review, we discuss the role of ultrasound and fetal MRI in the prenatal assessment of abnormalities of the upper lip, palate, and mandible.
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Affiliation(s)
- Gabriele Tonni
- Prenatal Diagnostic Centre, Department of Obstetrics and Neonatology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Borges Peixoto
- Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba, Brazil
| | - Heron Werner
- Department of Fetal Medicine, Clínica de Diagnóstico por Imagem (CDPI - DASA), Rio de Janeiro, Brazil
| | - Gianpaolo Grisolia
- Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova, Mantova, Italy
| | - Rodrigo Ruano
- Division of Maternal-Fetal Medicine, UH Jackson Fetal Care, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Francisco Sepulveda
- FETALMED-Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile
| | - Waldo Sepulveda
- FETALMED-Maternal-Fetal Diagnostic Center, Fetal Imaging Unit, Santiago, Chile
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
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Tonni G, Grisolia G, Santana EF, Júnior EA. Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice? World J Radiol 2016; 8:922-927. [PMID: 28070244 PMCID: PMC5183926 DOI: 10.4329/wjr.v8.i12.922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 06/03/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To show imaging results from application of four-dimensional (4D) ultrasound lightening technique (HDlive™) in clinical obstetrics practice.
METHODS Normal and abnormal fetuses at second and third trimester of pregnancy undergoing routine scan with 4D HDlive™ (5DUS) in the rendering mode are described. Realistic features of fetal structures were provided by 5DUS in the rendering mode. Normal anatomy as well as pathology like cleft lip, hypoplastic face, micrognathia, low-set ears, corpus callosum, arthrogryposis, aortic arch, left congenital diaphragmatic hernia are highlighted in this study. Anatomical details of the fetuses were provided by 5DUS with higher quality imaging modality compared to those obtained using conventional 2D/3D ultrasound.
RESULTS Realistic views of fetal anatomy details were displayed by means of 5DUS in the rendering mode, with high image quality obtained either in low-risk or in high-risk obstetrics population. Corpus callosum, esophagus, and aortic arch were obtained in normal fetuses. Cleft lip, cleft lip and palate, micrognathia, hypoplastic face, low-set ears, arthrogryposis, left congenital diaphragmatic hernia, exomphalos, and clitoris hypertrophy were clearly rendered by 5DUS application.
CONCLUSION The use of 5DUS in the rendering mode, when clinical available, was diagnostic in a variety of congenital anomalies, aided understanding of the parents-to-be and improved prenatal counseling and perinatal management.
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Tonni G, Castigliego AP, Grisolia G, Lituania M, Meagher S, Da Silva Costa F, Araujo Júnior E. Three-dimensional ultrasonography by means of HDlive rendering in the first trimester of pregnancy: A pictorial review. J Turk Ger Gynecol Assoc 2016; 17:110-9. [PMID: 27403079 DOI: 10.5152/jtgga.2016.15201] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/22/2016] [Indexed: 01/30/2023] Open
Abstract
Our objective was to describe early embryo/fetus anatomy and abnormalities provided by three and four-dimensional (3D/4D) ultrasound using HDlive rendering technology in the first trimester of pregnancy. Normal and pathologic embryonic and fetal volume data set with postprocessing using HDlive rendering mode. Virtual fetoscopic imaging of the normal and pathologic fetus even at early stage of development with increasing maternal-fetal bonding process. HDlive represents a novel and valuable lightening system for 3D/4D ultrasound application that may aid the prenatal interpretation of early congenital malformations although limitations and cautions are still needed for inclusion in obstetric clinical practice.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gynecology, Prenatal Diagnostic Service, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy
| | - Anna Pia Castigliego
- Department of Obstetrics and Gynecology, Prenatal Diagnostic Service, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy
| | - Gianpaolo Grisolia
- Department of Obstetrics and Gynecology, Prenatal Diagnostic Service, "Carlo Poma" Hospital, Mantua, Italy
| | - Mario Lituania
- Department of Obstetrics and Gynecology, Preconceptional and Prenatal Medicine, IRCCS Gabbliera Hospital, Genoa, Italy
| | - Simon Meagher
- Monash Ultrasound for Women, Melbourne, Victoria, Australia
| | - Fabrício Da Silva Costa
- Monash Ultrasound for Women, Melbourne, Victoria, Australia; Department of Perinatal Medicine, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Edward Araujo Júnior
- Department of Obstetrics, Federal University of São Paulo and Paulista School of Medicine, São Paulo, Brazil
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Inubashiri E, Abe K, Watanabe Y, Akutagawa N, Kuroki K, Sugawara M, Maeda N, Minami K, Nomura Y. HDlive rendering images of the fetal stomach: a preliminary report. J Med Ultrason (2001) 2015; 42:71-5. [PMID: 26578492 DOI: 10.1007/s10396-014-0556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/26/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to show reconstruction of the fetal stomach using the HDlive rendering mode in ultrasound. METHODS Seventeen healthy singleton fetuses at 18-34 weeks' gestational age were observed using the HDlive rendering mode of ultrasound in utero. RESULTS In all of the fetuses, we identified specific spatial structures, including macroscopic anatomical features (e.g., the pyrous, cardia, fundus, and great curvature) of the fetal stomach, using the HDlive rendering mode. In particular, HDlive rendering images showed remarkably fine details that appeared as if they were being viewed under an endoscope, with visible rugal folds after 27 weeks' gestational age. CONCLUSION Our study suggests that the HDlive rendering mode can be used as an additional method for evaluating the fetal stomach. The HDlive rendering mode shows detailed 3D structural images and anatomically realistic images of the fetal stomach. This technique may be effective in prenatal diagnosis for examining detailed information of fetal organs.
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Affiliation(s)
- Eisuke Inubashiri
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan.
| | - Kiyotaka Abe
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Yukio Watanabe
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Noriyuki Akutagawa
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Katumaru Kuroki
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Masaki Sugawara
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Nobuhiko Maeda
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Kunihiro Minami
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
| | - Yasuhiro Nomura
- Sapporo Toho Hospital, Kita 17, Higashi 15, Higashi-ku, Sapporo, Hokkaido, 065-0017, Japan
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Araujo Júnior E, Santana EFM, Nardozza LMM, Moron AF. Assessment of embryo/fetus during pregnancy by threedimensional ultrasonography using the HD live software: iconographic essay. Radiol Bras 2015; 48:52-5. [PMID: 25798008 PMCID: PMC4366029 DOI: 10.1590/0100-3984.2013.1875] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fetal development is studied since the advent of two-dimensional ultrasonography. However, a detailed assessment of structures and surfaces improved with three-dimensional ultrasonography. Currently, it is possible to identify embryonic components and fetal parts with greater detail, at all pregnancy trimesters, using the HD live software, where the images gain realistic features by means of appropriate control of lighting and shadowing effects. In the present study, the authors utilized this resource to follow-up, by means of images, the development of a normal pregnancy along all trimesters.
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Affiliation(s)
- Edward Araujo Júnior
- Private Docents, Associate Professors, Department of Obstetrics, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Eduardo Félix Martins Santana
- Post graduate student, Department of Obstetrics, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Luciano Marcondes Machado Nardozza
- Private Docents, Associate Professors, Department of Obstetrics, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Antonio Fernandes Moron
- Private Docent, Full Professor, Department of Obstetrics, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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Tonni G, Martins WP, Guimarães Filho H, Araujo Júnior E. Role of 3-D ultrasound in clinical obstetric practice: evolution over 20 years. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1180-1211. [PMID: 25748522 DOI: 10.1016/j.ultrasmedbio.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 06/04/2023]
Abstract
The use of 3-D ultrasound in obstetrics has undergone dramatic development over the past 20 years. Since the first publications on this application in clinical practice, several 3-D ultrasound techniques and rendering modes have been proposed and applied to the study of fetal brain, face and cardiac anatomy. In addition, 3-D ultrasound has improved calculations of the volume of fetal organs and limbs and estimations of fetal birth weight. And furthermore, angiographic patterns of fetal organs and the placenta have been assessed using 3-D power Doppler ultrasound quantification. In this review, we aim to summarize current evidence on the clinical relevance of these methodologies and their application in obstetric practice.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gynecology, Guastalla Civil Hospital, ASL Reggio Emilia, Italy; Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil
| | - Wellington P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto School of Medicine, University of São Paulo (DGO-FMRP-USP), Ribeirão Preto-SP, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.
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Bonilla-Musoles F, Caballero O, Raga F, Bonilla F, Castillo JC. HDlive 3D ultrasound and follicular development. J Med Ultrason (2001) 2014; 41:401-5. [PMID: 27277919 DOI: 10.1007/s10396-013-0512-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 11/05/2013] [Indexed: 11/25/2022]
Abstract
Two-dimensional (2D) ultrasonography is the fundamental technology on which diagnosis, management, and control in reproductive medicine depends. Over the years there have been efforts to improve 2D ultrasound image quality. In recent years, a series of software has appeared that has generated enormous interest. The goal of these modes has been to improve image quality and diagnostic accuracy. HDlive incorporates a movable virtual adjustable light source which, as it penetrates, produces selective illumination with respective shadows that result from the structures where light is reflected. This combination of light and shadow results in spectacular images which appear much more real than those obtained with conventional 3D ultrasonography.
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Affiliation(s)
- Fernando Bonilla-Musoles
- Department of Obstetrics and Gynecology, University of Valencia Medical School, Av. Blasco Ibañez no. 17, 46011, Valencia, Spain.
| | - Oscar Caballero
- Department of Obstetrics and Gynecology, University of Valencia Medical School, Av. Blasco Ibañez no. 17, 46011, Valencia, Spain
| | - Francisco Raga
- Department of Obstetrics and Gynecology, University of Valencia Medical School, Av. Blasco Ibañez no. 17, 46011, Valencia, Spain
| | - Francisco Bonilla
- Department of Obstetrics and Gynecology, University of Valencia Medical School, Av. Blasco Ibañez no. 17, 46011, Valencia, Spain
| | - Juan Carlos Castillo
- Department of Obstetrics and Gynecology, University of Valencia Medical School, Av. Blasco Ibañez no. 17, 46011, Valencia, Spain
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Zajicek M, Achiron R, Weisz B, Shrim A, Gindes L. Sonographic assessment of fetal secondary palate between 12 and 16 weeks of gestation using three-dimensional ultrasound. Prenat Diagn 2013; 33:1256-9. [DOI: 10.1002/pd.4242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/09/2013] [Accepted: 09/19/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Michal Zajicek
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Reuven Achiron
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Boaz Weisz
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Alon Shrim
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
| | - Liat Gindes
- Department of Obstetrics and Gynecology; The Chaim Sheba Medical Center; Ramat-Gan Israel
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