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Codaccioni C, Mace P, Gorincour G, Grevent D, Heckenroth H, Merrot T, Chaumoitre K, Khen‐Dunlop N, Ville Y, Salomon LJ, Bretelle F. Can fetal MRI aid prognosis in gastroschisis: a multicenter study. Prenat Diagn 2022; 42:502-511. [DOI: 10.1002/pd.6123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Camille Codaccioni
- Centre Pluridisciplinaire de Diagnostic Prénatal Hopital Timone Enfants Assistance Publique Hôpitaux de Marseille AP‐HM Aix Marseille Université AMU
| | - Pierre Mace
- Unité de dépistage et de diagnostic prénatal Hôpital Privé Marseille Beauregard 23 rue des Linots13012 Marseille France
| | | | - David Grevent
- Service d’imagerie pédiatrique Hopital Necker Enfant Malades Assistance Publique Hôpitaux de Paris Paris
| | - Hélène Heckenroth
- Centre Pluridisciplinaire de Diagnostic Prénatal Hopital Timone Enfants Assistance Publique Hôpitaux de Marseille AP‐HM Aix Marseille Université AMU
| | - Thierry Merrot
- Service de chirurgie pédiatrique Hopital Timone Enfants Assistance Publique Hôpitaux de Marseille AP‐HM Aix Marseille Université AMU
| | - Katia Chaumoitre
- Service d’imagerie pédiatrique et prénatale Assistance Publique Hôpitaux de Marseille Aix Marseille Université AMU Hopital Nord
| | - Naziha Khen‐Dunlop
- Service de chirurgie pédiatrique Hopital Necker Enfant Malades Assistance Publique Hôpitaux de Paris Paris
| | - Yves Ville
- Service de Gynécologie‐Obstétrique Hopital Necker Enfant Malades Assistance Publique Hôpitaux de Paris Paris
| | - Laurent J Salomon
- Service de Gynécologie‐Obstétrique Hopital Necker Enfant Malades Assistance Publique Hôpitaux de Paris Paris
| | - Florence Bretelle
- Centre Pluridisciplinaire de Diagnostic Prénatal Hopital Timone Enfants Assistance Publique Hôpitaux de Marseille AP‐HM Aix Marseille Université AMU
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Agarwal P, Agarwal RK. Left atrial isomerism associated with aneurysmal enlargement of right atrial appendage: A case report with literature review. Indian J Radiol Imaging 2019; 29:318-323. [PMID: 31741603 PMCID: PMC6857260 DOI: 10.4103/ijri.ijri_341_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/07/2019] [Accepted: 09/10/2019] [Indexed: 11/21/2022] Open
Abstract
We present a prenatally diagnosed case of heterotaxy syndrome (HS) in which left atrial isomerism (LAI) was associated with an aneurysmal enlargement of the right atrial appendage (RAA). Although LAI is usually associated with complex cardiac and extracardiac anomalies, the association of LAI and right atrial appendage aneurysm (RAAA) is exceptional. Congenital RAAA itself is an idiopathic, very rare cardiac anomaly characterized by the enlargement of the appendage in the absence of any other cardiac or extra-cardiac defect. The prognosis of the heterotaxy is poor with associated major cardiac malformations and even cases with minor cardiac anomalies are at risk postnatally for complications like biliary atresia, intestinal rotational abnormalities, and immune disorders. In this case, the prenatal diagnosis of the isomerism was mainly based on the abnormalities of caval veins. Although no typical complex cardiac anomaly was present, the HS was associated with biliary atresia, polysplenia, and malrotation of the gut. Associated RAAA further imposed an additional risk of complications such as tachyarrhythmias, thromboembolic events, and aneurysmal rupture.
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Affiliation(s)
- Prateek Agarwal
- Department of Radiodiagnosis, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka
| | - Rajesh Kumar Agarwal
- Department of Ultrasound, Meera Hospital, Shiv Marg, Bani Park, Jaipur, Rajasthan, India
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Buca DIP, Khalil A, Rizzo G, Familiari A, Di Giovanni S, Liberati M, Murgano D, Ricciardulli A, Fanfani F, Scambia G, D'Antonio F. Outcome of prenatally diagnosed fetal heterotaxy: systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:323-330. [PMID: 28603940 DOI: 10.1002/uog.17546] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/22/2017] [Accepted: 06/02/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The main aim of this systematic review was to evaluate the prevalence and type of associated anomalies in fetuses with heterotaxy diagnosed prenatally on ultrasound; the perinatal outcome of these fetuses was also studied. METHODS An electronic search of MEDLINE, EMBASE and CINAHL databases was performed. Only studies reporting the prenatal diagnosis of isomerism were included. Outcomes observed included associated cardiac and extracardiac anomalies, fetal arrhythmia, abnormal karyotype, type of surgical repair and perinatal mortality. The analysis was stratified according to the type of heterotaxy syndrome (left (LAI) or right (RAI) atrial isomerism). Meta-analyses of proportions were used to combine data. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. RESULTS Sixteen studies (647 fetuses) were included in the analysis. Atrioventricular septal defect was the most common associated major cardiac anomaly found both in fetuses with LAI (pooled proportion (PP), 59.3% (95% CI, 44.0-73.7%)), with obstructive lesions of the right outflow tract occurring in 35.5% of these cases, and in fetuses with RAI (PP, 72.9% (95% CI, 60.4-83.7%)). Fetal arrhythmias occurred in 36.7% (95% CI, 26.9-47.2%) of cases with LAI and were mainly represented by complete atrioventricular block, while this finding was uncommon in cases with RAI (PP, 1.3% (95% CI, 0.2-3.2%)). Abnormal stomach and liver position were found, respectively, in 59.4% (95% CI, 38.1-79.0%) and 32.5% (95% CI, 11.9-57.6%) of cases with LAI, and in 54.5% (95% CI, 38.5-70.1%) and 45.9% (95% CI, 11.3-83.0%) of cases with RAI, while intestinal malrotation was detected in 14.2% (95% CI, 2.5-33.1%) of LAI and 27.1% (95% CI, 7.9-52.0%) of RAI cases. Hydrops developed in 11.8% (95% CI, 2.9-25.6%) of fetuses diagnosed prenatally with LAI. Biventricular repair was accomplished in 78.2% (95% CI, 64.3-89.4%) of cases with LAI, while univentricular repair or palliation was needed in 17.0% (95% CI, 9.7-25.9%); death during or after surgery occurred in 26.8% (95% CI, 4.6-58.7%) of LAI cases. Most children with RAI had univentricular repair and 27.8% (95% CI, 15.5-42.1%) died during or after surgery. CONCLUSIONS Fetal heterotaxy is associated with a high prevalence of cardiac and extracardiac anomalies. Approximately one quarter of fetuses with heterotaxy died during or after surgery. Abnormal heart rhythm, especially heart block, is common in fetuses with LAI, while this finding is uncommon in RAI. Biventricular repair was common in LAI while univentricular repair was required in the majority of children affected by RAI. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- D I P Buca
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - A Khalil
- St George's, University of London & St George's University Hospitals NHS Foundation Trust Molecular and Clinical Sciences Research Institute, London, UK
| | - G Rizzo
- Department of Obstetrics and Gynaecology, Università di Roma Tor Vergata, Rome, Italy
| | - A Familiari
- Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy
| | - S Di Giovanni
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - M Liberati
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - D Murgano
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - A Ricciardulli
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - F Fanfani
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - G Scambia
- Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy
| | - F D'Antonio
- Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway
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Meder JF, Ducou le Pointe H, Hédon B, Benachi A. Guidelines for coordinated radiologist/gynecologist-obstetrician management of patients requiring fetal MRI or CT. Diagn Interv Imaging 2017; 98:515-516. [DOI: 10.1016/j.diii.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lesieur E, Boubnova J, Héry G, Lafouge A, Quarello E, Bretelle F, Sigaudy S, Gorincour G. Prenatal imaging presentation of Meckel diverticulum. Diagn Interv Imaging 2017; 98:569-570. [PMID: 28412231 DOI: 10.1016/j.diii.2017.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Affiliation(s)
- E Lesieur
- Center for Prenatal Diagnosis, La Timone Children Hospital, 13000 Marseille, France
| | - J Boubnova
- Department of Pediatric Surgery, La Timone Children Hospital, 13000 Marseille, France
| | - G Héry
- Department of Pediatric Surgery, La Timone Children Hospital, 13000 Marseille, France
| | - A Lafouge
- Cabinet de radiologie, Toulon, France
| | - E Quarello
- Institut méditerranéen de la reproduction, 13000 Marseille, France
| | - F Bretelle
- Center for Prenatal Diagnosis, La Timone Children Hospital, 13000 Marseille, France
| | - S Sigaudy
- Center for Prenatal Diagnosis, La Timone Children Hospital, 13000 Marseille, France
| | - G Gorincour
- Center for Prenatal Diagnosis, La Timone Children Hospital, 13000 Marseille, France; Department of Prenatal and Pediatric Imaging, La Timone Children Hospital, 13000 Marseille, France.
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Fievet A, Morel B, Sembély-Taveau C, Thoreau B, Perrotin F, Sirinelli D. [Fetal MRI practices in a university prenatal center]. ACTA ACUST UNITED AC 2017; 45:276-282. [PMID: 28343908 DOI: 10.1016/j.gofs.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/20/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Fetal MRI is a third intention examination to prenatal diagnosis. If its diagnostic value is well known in many pathologies, its place in the management of pregnancies remains unclear. METHODS We collected retrospectively demographical, radiological (fetal MRI indications, fetal anatomical region and diagnostic information provided by fetal MRI) and obstetrical data of pregnant patients in university prenatal center during a 5 years' period. RESULTS Among 2439 patients of the prenatal center, 196 (8%) patients with fetal MRI were included. The main anatomical regions studied were the brain (n=132, 67%), the thorax (n=31, 16%) and the abdomen (n=25, 13%). No cardiac fetal MRI was performed. Ninety-five percent of fetal MRI was consecutively of an ultrasound sign. Fetal brain MRI was abnormal in 65% of cases, the thoracic and abdominopelvic MRI in 81.5%. The ultrasound diagnosis was unchanged in 42%, completed in 50% and redirected in 8% of cases. A termination of pregnancy was deemed admissible in 31% of patients with MRI versus 21% in patients without MRI (P=0.001). CONCLUSION Fetal MRI requires selective indications and provides additional diagnostic information with important implications for the future of the pregnancy, particularly in case of severe and incurable pathologies. Our results could be useful as a reference basis for the comparison with others prenatal center practices.
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Affiliation(s)
- A Fievet
- Radiologie pédiatrique, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37044 Tours cedex 9, France
| | - B Morel
- Radiologie pédiatrique, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37044 Tours cedex 9, France; Faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours cedex 9, France.
| | - C Sembély-Taveau
- Radiologie pédiatrique, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37044 Tours cedex 9, France
| | - B Thoreau
- Médecine interne, hôpital Bretonneau, CHRU de Tours, 10, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - F Perrotin
- Faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours cedex 9, France; Pôle de gynécologie-obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe-de-Gouges, hôpital Bretonneau, CHRU de Tours, 10, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - D Sirinelli
- Radiologie pédiatrique, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37044 Tours cedex 9, France; Faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours cedex 9, France
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Degenhardt K, Rychik J. Fetal Situs, Isomerism, Heterotaxy Syndrome: Diagnostic Evaluation and Implication for Postnatal Management. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2016; 18:77. [PMID: 27844411 DOI: 10.1007/s11936-016-0494-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OPINION STATEMENT A hallmark of vertebrate anatomy is asymmetry of structures, especially internal organs, on the left and right side of the body. Heterotaxy syndrome is the combination of correct-sided, and incorrect-sided organs. The establishment of the left-right axis is an early event in vertebrate embryogenesis. Failure to establish this axis has numerous consequences for later development and can result in a wide range of potential defects. Congenital heart disease is among the more frequent and serious problems. Heterotaxy syndrome is diagnosed prenatally with increasing frequency due to improved screening practices. The key to proper management of fetal heterotaxy syndrome is reliable determination of left and right in the fetus, a thorough understanding of associated defects and comprehensive imaging.
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Affiliation(s)
- Karl Degenhardt
- The Fetal Heart Program at the Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, Division of Cardiology, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
| | - Jack Rychik
- The Fetal Heart Program at the Cardiac Center at the Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Division of Cardiology, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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[Segmental approach to congenital heart diseases: Principles and applications to prenatal imaging]. ACTA ACUST UNITED AC 2016; 44:428-34. [PMID: 27451065 DOI: 10.1016/j.gyobfe.2016.06.003] [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: 05/24/2016] [Accepted: 06/03/2016] [Indexed: 11/21/2022]
Abstract
This pictorial essay will initially present the origin, definitions, objectives and main principles of the segmental approach to congenital heart diseases. Then, through ultrasound scans iconography we will consider its practical applications to prenatal screening. Eventually, through both ultrasound and MRI cases, we will discuss its potential use in fetal diagnostic evaluation.
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