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Elective Cesarean Section during Preterm Prevents Pulmonary Hypoplasia Development in Potter Sequence. Case Rep Pediatr 2023; 2023:3216232. [PMID: 36761252 PMCID: PMC9904929 DOI: 10.1155/2023/3216232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 02/03/2023] Open
Abstract
Potter syndrome, first reported in 1946 by Edith Potter, refers to fatal cases of bilateral renal aplasia with pulmonary hypoplasia, peculiar facial features, and limb deformities. Presently, patients with oligohydramnios showing similar pathological manifestations due to oligohydramnios caused by conditions other than bilateral renal aplasia have been reported, and are known as the Potter sequence. There are limited studies and unclear guidelines on the safest delivery time and detailed postpartum management for patients with the Potter sequence. We experienced a case of Potter sequence, in which the patient was born by elective cesarean section at gestational age (GA) of 34 weeks. Fetal ultrasound at GA of 26 weeks 4 days showed oligohydramnios, multilocular cystic lesions in the left kidney, and an absent right kidney. Prenatal fetal MRI at GA of 33 weeks and 3 days showed pulmonary hypoplasia, and the ratio of fetal lung volume (FLV) to fetal body weight (FBW) was 0.0135 ml/g. We suspected that the fetal lung could not grow because of persistent oligohydramnios, which leads to a further decline in the ratio of FLV to FBW during pregnancy. We performed a cesarean section at GA of 34 weeks to prevent the exacerbation of the imbalance between lung volume and physique. We struggled to keep her condition stabilized with strict management of her respiratory condition, dialysis, and nutrition. She was discharged from the hospital at 169 days of age. Elective caesarean section in the term of premature birth prevented the progression of pulmonary hypoplasia and made it possible to save her life. Potter sequence is still relatively unknown, and it is necessary for more studies to be conducted in the future.
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Dassios T. Critical functional lung volumes in neonatal intensive care: evidence and clinical applications. Pediatr Res 2023:10.1038/s41390-022-02450-9. [PMID: 36624281 DOI: 10.1038/s41390-022-02450-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/08/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
Respiratory disease is common in premature and sick newborn infants and can often necessitate the initiation of intensive care. Newborn infants often suffer from conditions that are associated with decreased lung volumes that occur as a result of abnormal or incomplete lung development. Such conditions are prematurity and respiratory distress syndrome, preterm premature rupture of membranes and the ensuing pulmonary hypoplasia and congenital lung anomalies such as congenital diaphragmatic hernia. These diseases have a structural component manifesting with lower lung volumes and a functional component that can present with increased oxygen and ventilatory requirements. The corresponding decreased functional lung volume is possibly responsible for some unfavourable pulmonary outcomes. Some infants are unable to wean off invasive respiratory support and, in extreme cases, unable to sustain independent breathing that can lead to long-term invasive ventilation or subsequent death. The aim of this review is to summarise the available evidence behind the concept of a critical functional lung volume in neonatal intensive care and describe the clinical implications that arise from decreased functional lung volumes in the main high-risk populations of newborn infants. IMPACT: Newborn infants suffer from diseases such as respiratory distress syndrome, pulmonary hypoplasia and congenital diaphragmatic hernia that are associated with a decrease in the total lung volume and impaired lung function. Critically decreased functional lung volumes during neonatal care are associated with failure to wean off invasive respiratory support, increased mortality and possibly longer-term respiratory complications.
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Affiliation(s)
- Theodore Dassios
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK. .,Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
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Gonçalves AN, Correia-Pinto J, Nogueira-Silva C. Imagiological methods for prediction of fetal pulmonary hypoplasia: a systematic review. J Matern Fetal Neonatal Med 2019; 34:1459-1468. [PMID: 31269833 DOI: 10.1080/14767058.2019.1636029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To compare the different imagiological methods for prediction of fetal pulmonary hypoplasia (PH) in general diseases and associated with preterm rupture of membranes (PROM), and congenital diaphragmatic hernia (CDH). METHODS According to PRISMA guidelines, all the literature on PH from 1988 to 2018 was reviewed. Twenty-nine articles were selected and analyzed for two- and three- dimensional-ultrasounds (2D and 3D-US) as predictors for the lethal outcome. RESULTS Overall, the results identify a general gap correlating prenatal pulmonary measurements and survival at birth; discrepant predictive values for the same imagiological methods are explained by the group heterogeneity in terms of diseases and degree of severity, with the 2D measurements being more affected than 3D; 2D and 3D-US present equally predictive values for groups with 0% of survival. Regarding PROM, results demonstrate comparable accuracies for similar survival rates suggesting a useful predictive value of 2D-US in outcome estimation; they also identify ultrasonographic methods as a more accurate prognostic factor than gestational age at rupture, latency or amniotic fluid index. In CDH, consistent with previous studies, our review shows magnetic resonance imaging as a better survival predictor followed by the 3D and 2D methods, while 2D-LHR was the more precise prognosticator correlating prenatal PH, survival at birth, and the need for neonatal respiratory support. CONCLUSION Ultrasonographic methods can be valuable predictors for lethal PH and should be validated for a broad set of diseases (e.g. PROM). For that, restricted studies for disease groups and correlating fetal PH with the needed of neonatal support, and survival at birth is critically recommended.
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Affiliation(s)
- Ana N Gonçalves
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Life and Health Sciences Research Institute /3B's - PT Government Associate Laboratory, Braga, Portugal
| | - Jorge Correia-Pinto
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Life and Health Sciences Research Institute /3B's - PT Government Associate Laboratory, Braga, Portugal.,Department of Paediatric Surgery, Hospital de Braga, Braga, Portugal
| | - Cristina Nogueira-Silva
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Life and Health Sciences Research Institute /3B's - PT Government Associate Laboratory, Braga, Portugal.,Department of Obstetrics and Gynaecology, Hospital de Braga, Braga, Portugal
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Fetal Lung Volumes by MRI: Normal Weekly Values From 18 Through 38 Weeks' Gestation. AJR Am J Roentgenol 2018; 211:432-438. [PMID: 29894217 DOI: 10.2214/ajr.17.19469] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of this study is to establish normal total fetal lung volume reference ranges from 18 to 38 weeks' gestation at 1-week intervals. MATERIALS AND METHODS A retrospective analysis of 665 patients who underwent fetal MRI at two tertiary fetal centers from 2001 to 2013 was performed. Total fetal lung volume was measured in at least two planes, either manually or using a 3D workstation. The mean, median, SD, minimum, maximum, and lower and upper quartiles for total fetal lung volume were determined per gestational week. A t test was used to compare our values to previously reported values. A new formula to calculate total fetal lung volume derived from our data was created using a regression model. Comparisons between total fetal lung volume obtained by different imaging planes and manual versus semiautomatic calculation were also performed. RESULTS The mean normal total fetal lung volume showed a weekly increase from 18 through 35 weeks' gestation. Means were compared with the expected total fetal lung volume generated by the Rypens formula, showing statistically significant lower mean total fetal lung volume from week 19 to week 22 (p < 0.05). Comparison between our data-derived total fetal lung volume formula and the Rypens formula showed very similar values at every gestational age. No difference in total fetal lung volume was seen when comparing imaging planes or manual versus semiautomatic methods. CONCLUSION Measured mean total fetal lung volume values at 19-22 weeks are significantly lower than those predicted by the Rypens formula. Therefore, we propose preferential use of our values for prenatal counseling and delivery planning.
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Tumanova UN, Lyapin VM, Burov AA, Shchegolev AI, Degtyarev DN. Postmortem Characteristics of Lung Hypoplasia at Diaphragmatic Hernia: MRI – Pathomorphological Comparisons. ACTA ACUST UNITED AC 2017. [DOI: 10.24835/1607-0763-2017-4-132-142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Purpose: the study of postmortem MRI possibilities for the diagnosis of lung hypoplasia in congenital diaphragmatic hernia.Materials and methods. A comparison of the results of postmortem MRI study and data of pathoanatomical autopsy of 23 newborns was performed. In group I, the bodies of 10 deceased newborns with congenital diaphragmatic hernia without operative intervention were examined. In group II – the bodies of 7 newborns who died after surgery for congenital diaphragmatic hernia. Group III (control) included 6 bodies of newborns without diaphragmatic hernia and signs of lung hypoplasia. Before the autopsy, an MRI study was performed on a 3T Magnetom Verio device (Siemens, Germany) in standard T1 and T2 modes. The volumes of the lungs and chest cavity were calculated in the analysis of the tomograms data and their 3D reconstruction. The stage of the lung development and number of radial alveoli were identified at the microscopic study of histological preparations.Results.As a result of the postmortem MRI study, it was established that the observations of group I are characterized by minimal lung volumes. The mean lung volume on the side of the diaphragmatic hernia was 4.1 times less than the contralateral lung (p < 0.01), and the mean values of the volume of both lungs were 4.6 times less than the corresponding values of the control group (p < 0.01) . The average value of the specific volume of the lungs in newborns who died as a result of congenital diaphragmatic hernia (group I) was 8.8%, which is 4.2 times less than the control group (p < 0.01) and was accompanied by histological signs of hypoplasia. The operation in Group II observations led to an increase in lung size. However, the specific volume of the lungs in this group remained by 18.6% less than the control group, and on histological specimens there were signs of lung hypoplasia.Conclusion.The postmortem MRI of dead newborns allows for an objective quantification of lung volumes and verifies the presence of hypoplasia. This helps to clarify the pathogenesis and determine the immediate cause of death. Indices of specific lung volume relative to the chest cavity of less than 20% indicate lung hypoplasia as the immediate cause of death of the newborn.
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Affiliation(s)
- U. N. Tumanova
- “Research Center for Obstetrics, Gynecology and Perinatology” Ministry of Healthcare of the Russian Federation
| | - V. M. Lyapin
- “Research Center for Obstetrics, Gynecology and Perinatology” Ministry of Healthcare of the Russian Federation
| | - A. A. Burov
- “Research Center for Obstetrics, Gynecology and Perinatology” Ministry of Healthcare of the Russian Federation
| | - A. I. Shchegolev
- “Research Center for Obstetrics, Gynecology and Perinatology” Ministry of Healthcare of the Russian Federation
| | - D. N. Degtyarev
- “Research Center for Obstetrics, Gynecology and Perinatology” Ministry of Healthcare of the Russian Federation
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Abstract
Pulmonary hypoplasia, although rare, is associated with significant neonatal morbidity and mortality. Conditions associated with pulmonary hypoplasia include those which limit normal thoracic capacity or movement, including skeletal dysplasias and abdominal wall defects; those with mass effect, including congenital diaphragmatic hernia and pleural effusions; and those with decreased amniotic fluid, including preterm, premature rupture of membranes, and genitourinary anomalies. The ability to predict severe pulmonary hypoplasia prenatally aids in family counseling, as well as obstetric and neonatal management. The objective of this review is to outline the imaging techniques that are widely used prenatally to assess pulmonary hypoplasia and to discuss the limitations of these methods.
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The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia. J Perinatol 2017; 37:265-269. [PMID: 27977015 DOI: 10.1038/jp.2016.208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/06/2016] [Accepted: 10/10/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To seek a simple approach for prenatally classifying congenital diaphragmatic hernia (CDH) severity using fetal magnetic resonance imaging (MRI) markers. STUDY DESIGN A retrospective, multicenter study using questionnaires to investigate fetal MRI findings. We included fetuses prenatally diagnosed with isolated left-sided CDH and delivered after 36 weeks of gestation. We focused on three fetal MRI morphological signs: incomplete pulmonary baseline (IPB), liver up (LU) and retrocardiac stomach (RCS). We also evaluated the fetal MRI score defined as the total number of positive signs; the primary outcome was survival at discharge. RESULTS In 256 patients (from 56 institutions), IPB, LU and RCS findings correlated with lower survival: odds ratio (95% confidence interval), 0.16 (0.08 to 0.33); 0.24 (0.12 to 0.51); and 0.14 (0.07 to 0.28); respectively. Patients with higher fetal MRI scores had a higher mortality rate. CONCLUSION IPB, LU and RCS on fetal MRI are related to CDH severity.
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Raafat M, El-Kalioubie M, Mansour SM. MRI and three dimensional ultrasonography in the assessment of pulmonary hypoplasia in fetuses with urinary tract anomalies. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Berger-Kulemann V, Berger R, Mlczoch E, Sternal D, Mailath-Pokorny M, Hachemian N, Prayer D, Weber M, Salzer-Muhar U. The Effects of Hemodynamic Alterations on Lung Volumes in Fetuses with Tetralogy of Fallot: An MRI Study. Pediatr Cardiol 2015; 36:1287-93. [PMID: 25894759 DOI: 10.1007/s00246-015-1159-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
This study assessed whether the presence of tetralogy of Fallot (TOF) affects fetal lung development and whether these fetuses are at risk of pulmonary hypoplasia (PH). Furthermore, we investigated whether the degree of the concomitant pulmonary valve (PV) stenosis or a stenosis in the branch pulmonary arteries correlates with the fetal lung volume. Lung volumetry was performed in 16 fetuses with TOF who underwent MRI between gestational weeks 21 and 35 and in 22 controls. Fetal biometric data and the diameters of the PVs were evaluated by ultrasound. PV and branch pulmonary artery diameters were standardized (z-scores), and fetal lung volume/fetal body weight (FLV/FBW) ratios (ml/g) were calculated. The mean FLV/FBW ratio (0.031 ± 0.009 ml/g) in the TOF group was statistically significantly lower than in the control group (0.041 ± 0.009 ml/g; P = 0.003). None of the fetuses with TOF met the criterion for PH. FLV did not correlate with the degree of PV stenosis, but rather with the presence of a significant stenosis in at least one branch pulmonary artery. The presence of TOF moderately affects fetal lung growth, which is apparently not dependent on the degree of the PV stenosis. However, only an additional stenosis in at least one branch pulmonary artery was associated with a small FLV, but not with PH. Thus, reduced pulmonary blood flow may be offset by additional factors, such as the ability to establish a sufficient collateral system and to alter structural vascular size and, thus, pulmonary vascular resistance.
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Affiliation(s)
- Vanessa Berger-Kulemann
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, AKH, Waehringer Guertel 18-20, 1090, Vienna, Austria,
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Oka Y, Rahman M, Sasakura C, Waseda T, Watanabe Y, Fujii R, Makinoda S. Prenatal diagnosis of fetal respiratory function: evaluation of fetal lung maturity using lung-to-liver signal intensity ratio at magnetic resonance imaging. Prenat Diagn 2014; 34:1289-94. [PMID: 25081823 PMCID: PMC4305273 DOI: 10.1002/pd.4469] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/24/2014] [Accepted: 07/24/2014] [Indexed: 11/20/2022]
Abstract
Objective The purpose of this retrospective study is to determine the fetal lung-to-liver signal intensity ratio (LLSIR) on T2-weighted images for the prediction of neonatal respiratory outcome. Methods One hundred ten fetuses who underwent magnetic resonance imaging (MRI) examination for various indications after 22 weeks of gestation participated in this study. LLSIR was measured as the ratio of signal intensities of the fetal lung and liver on T2-weighted images at MRI. We examined the changes of the ratio with advancing gestation and the relations between LLSIR and the presence of the severe respiratory disorder (SRD) after birth. The best cut-off value of the LLSIR to predict respiratory outcome after birth was calculated using receiver operating characteristic (ROC) curve analysis. Results Lung-to-liver signal intensity ratio correlated significantly with advancing gestational age (R = 0.35, p < 0.001). The non-SRD group had higher LLSIR compared with the SRD group (2.15 ± 0.30 vs. 1.53 ± 0.40, p < 0.001). ROC curve analysis showed that fetuses with an LLSIR < 2.00 were more likely to develop SRD [sensitivity: 100%, 95% confidence interval (CI): 52–100%; specificity: 73%, 95% CI 54–88%]. Conclusion The fetal LLSIR on T2-weighted images is an accurate marker to diagnose the fetal lung maturity. © 2014 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Yasuko Oka
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Uchinada, Japan
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MRI-based ratio of fetal lung volume to fetal body volume as a new prognostic marker in congenital diaphragmatic hernia. AJR Am J Roentgenol 2014; 202:1330-6. [PMID: 24848832 DOI: 10.2214/ajr.13.11023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to evaluate the prognostic accuracy of the MRI-based ratio of fetal lung volume (FLV) to fetal body volume (FBV) for predicting survival and the need for extracorporeal membrane oxygenation (ECMO) therapy in fetuses with congenital diaphragmatic hernia (CDH). MATERIALS AND METHODS MRI was performed in 96 fetuses (34 females and 62 males; mean gestational age, 33 ± 5 [SD] weeks; range, 23-39 weeks) with CDH and 44 healthy control subjects. FLV and FBV were measured for each fetus by one of three investigators, and we calculated the FLV/FBV ratio. Additionally, a subgroup analysis of growth-restricted fetuses was performed. Logistic regression analysis was used to model the dependence of survival and ECMO requirement on the FLV/FBV ratio. Prognostic accuracy was evaluated by applying the area under the curve (AUC). RESULTS Seventy-eight of the 96 (81%) fetuses survived and 35 (36%) neonates needed ECMO therapy. The FLV/FBV ratio was significantly higher in fetuses who survived (p < 0.0001; AUC = 0.829). Neonates who received ECMO therapy showed a significantly lower prenatal FLV/FBV ratio (p = 0.0001; AUC = 0.811) than neonates who did not need ECMO therapy. A subgroup analysis (n = 13) showed a trend toward a higher FLV/FBV ratio of survivors in comparison with nonsurvivors (p = 0.065; AUC = 0.875). CONCLUSION In our study, the MRI-based FLV/FBV ratio was able to predict neonatal survival and ECMO requirement in children with CDH with high accuracy. Unlike other prognostic parameters, FLV/FBV ratio is independent of a reference to a control group and may enhance prognostic accuracy particularly in growth-restricted neonatal patients.
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Mlczoch E, Schmidt L, Schmid M, Kasprian G, Frantal S, Berger-Kulemann V, Prayer D, Michel-Behnke I, Salzer-Muhar U. Fetal cardiac disease and fetal lung volume: an in utero
MRI investigation. Prenat Diagn 2014; 34:273-8. [DOI: 10.1002/pd.4308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/10/2013] [Accepted: 12/16/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Elisabeth Mlczoch
- Division of Pediatric Cardiology, Pediatric Heart Center Vienna, Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Austria
| | - Lisa Schmidt
- Division of Pediatric Cardiology, Pediatric Heart Center Vienna, Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Austria
| | - Maximilian Schmid
- Division of Obstetrics and Fetomaternal Medicine, Department of Obstetrics and Gynecology; Medical University of Vienna; Austria
| | - Gregor Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology; Medical University Vienna; Austria
| | - Sophie Frantal
- Department for Medical Statistics; Medical University of Vienna; Austria
| | - Vanessa Berger-Kulemann
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology; Medical University Vienna; Austria
| | - Daniela Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology; Medical University Vienna; Austria
| | - Ina Michel-Behnke
- Division of Pediatric Cardiology, Pediatric Heart Center Vienna, Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Austria
| | - Ulrike Salzer-Muhar
- Division of Pediatric Cardiology, Pediatric Heart Center Vienna, Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Austria
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Trompoukis P, Papantoniou N, Chlapoutaki C, Mesogitis S, Antsaklis A. Fetal MRI: is it really helpful? J Matern Fetal Neonatal Med 2012; 25:2363-8. [PMID: 22708680 DOI: 10.3109/14767058.2012.696161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study is to emphasize on the diagnostic effectiveness of fetal MRI that led to increased utilization in fetal medicine as well as its value in prognosis and decision making in the modern obstetric practice. METHODS One hundred five (n = 105) pregnant women were referred for a fetal MRI examination after a high detailed ultrasound examination revealed a fetal abnormality. Fetal MRI was performed using 1, 5 Tesla units, with T1, T2-weighted and diffusion-weighted images. The findings were analyzed in comparison to the previous ultrasound findings, according to the fetal organ affected and the value of the MRI for therapeutic decision making was addressed. A statistical analysis was performed. RESULTS The fetal MRI provides a more accurate diagnosis compared to ultrasound examination, and when the ultrasound detects fetal anomalies, the MRI can efficiently either confirm or reject the finding, proving its high value for prenatal diagnosis and perinatal and management. The sensitivity, specificity and positive predictive value of fetal MRI as a screening tool approaches 100%. CONCLUSIONS Despite the fact that ultrasound is the method of choice for fetal screening, MRI can add up significantly to the diagnosis and management of congenital abnormalities and the indications for MRI continue to increase as new sequences and shorter acquisition times evolve.
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Affiliation(s)
- P Trompoukis
- 1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Athens, Greece.
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Gupta S, Singh AH, Shabbir A, Hahn PF, Harris G, Sahani D. Assessing renal parenchymal volume on unenhanced CT as a marker for predicting renal function in patients with chronic kidney disease. Acad Radiol 2012; 19:654-60. [PMID: 22578224 DOI: 10.1016/j.acra.2012.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Revised: 02/10/2012] [Accepted: 02/13/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To estimate renal volume in chronic kidney disease (CKD) patients using a semiautomated software and compare them with split renal function estimates from radionuclide renogram (RR). We proposed that renal volume from unenhanced computed tomography (CT) scans may serve as surrogate marker for assessing renal function in CKD patients. MATERIALS AND METHODS Unenhanced multidetector CT scans of 26 patients with CKD (estimated glomerular filtration rate [eGFR] <60 mL/kg/body surface area [BSA]) and 10 controls (eGFR >60 mL/kg/BSA) were analyzed to calculate renal volumes using a semiautomated software (AMIRAV5.2.0). Volumes obtained were then correlated with corresponding eGFR and split renal function estimates from RR. Volumes were also compared with those obtained on enhanced scans in 10 cases (five disease group, five controls). Bland-Altman analysis was used to assess agreement between methods. RESULTS A moderately positive correlation was found between renal volume obtained on unenhanced CT and eGFR (r = 0.65, P < .0001), whereas a significantly high correlation with split function estimates from RR (r = 0.95, P < .001) was found. Bland-Altman analysis revealed a good agreement between renal volume from CT and renal function from RR (34/36 observations were within 95% CI and there were two outliers). Correlation between volumes obtained from unenhanced and enhanced CT scans was also significant (r = 0.96). CONCLUSION In patients with CKD, renal volume derived from unenhanced CT can possibly serve as a surrogate marker for assessing and monitoring renal function reserves to plan further management.
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Affiliation(s)
- Supriya Gupta
- Department of Abdominal and Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
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Castellote A, Mencho S, Carreras E, Higueras T, Cadavid L, Piqueras J, Enriquez G. Correlation between US and MRI for prenatal lung volumetry in diaphragmatic hernia, and use of Doppler to identify the ipsilateral lung cap. Pediatr Radiol 2011; 41:1569-77. [PMID: 21938506 DOI: 10.1007/s00247-011-2200-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 03/28/2011] [Accepted: 05/16/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pulmonary hypoplasia is a common cause of neonatal death. OBJECTIVE To describe the correlation between relative fetal lung volume (RFLV) and lung-to-head ratio (LHR) in fetuses with unilateral diaphragmatic hernia. Additionally, to describe identification of the ipsilateral lung cap by power Doppler. MATERIALS AND METHODS Single-institution study of consecutive fetuses with diaphragmatic hernia. LHR (by US) and RFLV (by MRI) were correlated in fetuses with and without an ipsilateral lung cap seen at MRI. In four, color/power Doppler was used to follow the pulmonary artery of the ipsilateral lung to identify the compressed cap. RESULTS The study included 48 fetuses of 20-38 weeks' gestational age (mean, 26 weeks). Mean LHR was 1.52 (range, 0.6-3) in fetuses with a lung cap and 1.15 (range, 0.6-2.58) in fetuses without (P = 0.043). Mean RFLV was 47.4% (range, 18-80%) in fetuses with and 32.9% (range, 14-57%) in fetuses without a lung cap (P = 0.005). RFLV and LHR correlated (r = 0.41, P = 0.01 in those with a cap; r = 0.50, P = 0.05 in those without). Power Doppler identified the ipsilateral lung cap and pulsed Doppler confirmed pulmonary vascularization in four of four fetuses. CONCLUSION LHR underestimates lung volume in fetuses with an ipsilateral lung cap. Power Doppler may be useful for identifying the cap.
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Affiliation(s)
- Amparo Castellote
- Department of Pediatric Radiology, University Children's Hospital Vall d'Hebron, Ps. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
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Mayer S, Klaritsch P, Petersen S, Done E, Sandaite I, Till H, Claus F, Deprest JA. The correlation between lung volume and liver herniation measurements by fetal MRI in isolated congenital diaphragmatic hernia: a systematic review and meta-analysis of observational studies. Prenat Diagn 2011; 31:1086-96. [DOI: 10.1002/pd.2839] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 06/28/2011] [Accepted: 06/29/2011] [Indexed: 11/06/2022]
Affiliation(s)
| | - Philipp Klaritsch
- Centre for Surgical Technologies, Faculty of Medicine; Katholieke Universiteit Leuven; B-3000; Leuven; Belgium
| | - Scott Petersen
- Centre for Surgical Technologies, Faculty of Medicine; Katholieke Universiteit Leuven; B-3000; Leuven; Belgium
| | | | | | - Holger Till
- Department of Paediatric Surgery; University Hospital Leipzig; D-40103; Leipzig; Germany
| | - Filip Claus
- Department of Radiology, Division of Medical Imaging; Katholieke Universiteit Leuven; B-3000; Leuven; Belgium
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Bulas D, Egloff AM. Fetal Chest Ultrasound and Magnetic Resonance Imaging: Recent Advances and Current Clinical Applications. Radiol Clin North Am 2011; 49:805-23. [DOI: 10.1016/j.rcl.2011.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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18
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Kuratsuji G, Hokuto I, Higuchi M, Koinuma G, Morikawa Y, Hoshino K, Tanaka M, Miyakoshi K, Ikeda K. Final diagnosis in patients with congenital cystic lung disease detected by fetal ultrasonography. Pediatr Int 2011; 53:131-2. [PMID: 21342346 DOI: 10.1111/j.1442-200x.2010.03301.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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20
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Ruano R, Aubry MCÃ, Barthe B, Dumez Y, Benachi A. Three-dimensional ultrasonographic measurements of the fetal lungs for prediction of perinatal outcome in isolated congenital diaphragmatic hernia. J Obstet Gynaecol Res 2009; 35:1031-41. [DOI: 10.1111/j.1447-0756.2009.001060.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Balassy C, Kasprian G, Brugger PC, Weber M, Csapo B, Herold C, Prayer D. Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging. Eur Radiol 2009; 20:829-37. [DOI: 10.1007/s00330-009-1633-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Revised: 08/07/2009] [Accepted: 08/26/2009] [Indexed: 11/29/2022]
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22
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Paciente asintomático y alteración pulmonar. Rev Clin Esp 2009; 209:192-3. [DOI: 10.1016/s0014-2565(09)71314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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23
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Pugash D, Brugger PC, Bettelheim D, Prayer D. Prenatal ultrasound and fetal MRI: the comparative value of each modality in prenatal diagnosis. Eur J Radiol 2008; 68:214-26. [PMID: 18790583 DOI: 10.1016/j.ejrad.2008.06.031] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 06/23/2008] [Indexed: 11/24/2022]
Abstract
Fetal MRI is used with increasing frequency as an adjunct to ultrasound (US) in prenatal diagnosis. In this review, we discuss the relative value of both prenatal US and MRI in evaluating fetal and extra-fetal structures for a variety of clinical indications. Advantages and disadvantages of each imaging modality are addressed. In summary, MRI has advantages in demonstrating pathology of the brain, lungs, complex syndromes, and conditions associated with reduction of amniotic fluid. At present, US is the imaging method of choice during the first trimester, and in the diagnosis of cardiovascular abnormalities, as well as for screening. In some conditions, such as late gestational age, increased maternal body mass index, skeletal dysplasia, and metabolic disease, neither imaging method may provide sufficient diagnostic information.
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Affiliation(s)
- Denise Pugash
- Department of Radiology, University of British Columbia, Vancouver, Canada.
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24
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Ruano R, Fettback PBT, Ribeiro VL, Silva MM, Maksoud JG, Zugaib M. To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: a case report. SAO PAULO MED J 2008; 126:239-41. [PMID: 18853037 DOI: 10.1590/s1516-31802008000400011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Accepted: 06/17/2008] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. CASE REPORT A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310/g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term.
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Affiliation(s)
- Rodrigo Ruano
- Department of Obstetrics, Fetal Medicine Unit, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
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25
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Predicting Neonatal Deaths and Pulmonary Hypoplasia in Isolated Congenital Diaphragmatic Hernia Using the Sonographic Fetal Lung Volume–Body Weight Ratio. AJR Am J Roentgenol 2008; 190:1216-9. [DOI: 10.2214/ajr.07.3078] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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26
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Matsushita M, Ishii K, Tamura M, Takahashi Y, Kamura T, Takakuwa K, Tanaka K. Perinatal magnetic resonance fetal lung volumetry and fetal lung-to-liver signal intensity ratio for predicting short outcome in isolated congenital diaphragmatic hernia and cystic adenomatoid malformation of the lung. J Obstet Gynaecol Res 2008; 34:162-7. [DOI: 10.1111/j.1447-0756.2008.00754.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prayer D, Brugger PC. Investigation of normal organ development with fetal MRI. Eur Radiol 2007; 17:2458-71. [PMID: 17342486 DOI: 10.1007/s00330-007-0604-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Revised: 12/15/2006] [Accepted: 01/22/2007] [Indexed: 01/28/2023]
Abstract
The understanding of the presentation of normal organ development on fetal MRI forms the basis for recognition of pathological states. During the second and third trimesters, maturational processes include changes in size, shape and signal intensities of organs. Visualization of these developmental processes requires tailored MR protocols. Further prerequisites for recognition of normal maturational states are unequivocal intrauterine orientation with respect to left and right body halves, fetal proportions, and knowledge about the MR presentation of extrafetal/intrauterine organs. Emphasis is laid on the demonstration of normal MR appearance of organs that are frequently involved in malformation syndromes. In addition, examples of time-dependent contrast enhancement of intrauterine structures are given.
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Affiliation(s)
- Daniela Prayer
- Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria.
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Abstract
PURPOSE OF REVIEW Fetal magnetic resonance imaging is becoming more used in the evaluation of complex fetal abnormalities. Rapid advances in the technology and application of fetal magnetic resonance imaging necessitate a review of this subject. RECENT FINDINGS Diffusion-weighted imaging, magnetic resonance spectroscopy and functional magnetic resonance imaging may allow assessment of fetal brain even before anatomical abnormalities are demonstrated. We discuss the uses of fetal magnetic resonance imaging in better assessment of pulmonary hypoplasia, congenital diaphragmatic hernia and renal anomalies. SUMMARY The additional information from fetal magnetic resonance imaging, beyond that obtained by ultrasound, is invaluable in prenatal counseling, delivery planning and planning for pre- or postnatal intervention. As intrauterine and neonatal surgery evolve, so will the utilization of fetal magnetic resonance imaging.
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Affiliation(s)
- Kumaresan Sandrasegaran
- Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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Abstract
Ultrasonography is the screening method of choice for the evaluation of the fetus. It is safe, inexpensive, and easily performed. However, it is operator dependent, and evaluation may be limited because of fetal position, maternal obesity, overlying bone, and/or oligohydramnios. Magnetic resonance imaging is an alternative modality that uses no ionizing radiation, has excellent tissue contrast and a large field of view, is not limited by obesity or overlying bone, and can image the fetus in multiple planes, no matter the fetal lie. Faster scanning techniques allow studies to be performed without sedation in the second and third trimester with minimal motion artifact.
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Affiliation(s)
- Dorothy Bulas
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, George Washington University School of Medicine, Washington, DC 20010, USA.
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Ward VL, Nishino M, Hatabu H, Estroff JA, Barnewolt CE, Feldman HA, Levine D. Fetal Lung Volume Measurements: Determination with MR Imaging—Effect of Various Factors. Radiology 2006; 240:187-93. [PMID: 16793978 DOI: 10.1148/radiol.2393050583] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To retrospectively determine the effect of gestational age (GA), imaging plane, section thickness, and inter- and intraobserver variability on fetal lung volume (FLV) measurements obtained with magnetic resonance (MR) imaging in a cohort of fetuses without thoracic abnormalities. MATERIALS AND METHODS Institutional review board approval was obtained. Informed consent for this retrospective cohort study was waived, and the conduct of this study was HIPAA compliant. FLV was measured in 30 fetuses (GA, 17-36 weeks) referred for MR imaging for indications other than pulmonary abnormalities. Measurements were made on single-shot fast spin-echo images by tracing free-form regions of interest on individual consecutive sections in the transverse, sagittal, and coronal planes. Measurements were performed twice by two observers independently. Correlations between FLV and GA, imaging plane, and section thickness were assessed, as were intra- and interobserver variability. Time to perform FLV was assessed in a subset of fetuses. RESULTS Total FLV ranged from 2 to 110 mL. Mixed-effects regression model showed significant quadratic trend in FLV with increasing GA, with comparable strength of correlation (r = 0.89-0.91) in the three imaging planes of measurement. Intraobserver agreement was good in all three planes (r = 0.65-0.83) and was highest in the transverse plane. Interobserver agreement was good in all three planes (r = 0.68-0.76). FLV showed no significant dependence on section thickness (P = .23) or imaging plane (P = .82). Mean time to obtain FLV measurements ranged from 48 seconds at GA of 21 weeks to 77 seconds at GA of 29-30 weeks. CONCLUSION GA-based FLV measurements obtained with MR images are independent of section thickness and imaging plane and can be performed with good inter- and intraobserver agreement in less than 2 minutes.
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Affiliation(s)
- Valerie L Ward
- Department of Radiology, Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
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Abstract
With the technical progress made in fetal and neonatal intensive care, perinatal mortality has decreased by 25% over the last decade and has expanded the surviving premature population. Prematurity drastically changes the environment of the developing organism. Striking evidence from a number of disciplines has focused attention on the interplay between the developing organism and the circumstances in which it finds itself. The environmental event during a sensitive period in development, induces injury and/or biological adaptations that lead to altered differentiation of tissues. The organism can express specific adaptive responses to its environment which include short-term changes in physiology as well as long-term adjustments. This review addresses these short-term as well as longer-term changes occurring in lung and brain tissue and illustrates how these changes can be studied using advanced imaging techniques such as magnetic resonance imaging
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Affiliation(s)
- Petra Huppi
- Child Development Unit, Department of Pediatrics, University of Geneva, Geneva, Switzerland.
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Peralta CFA, Kazan-Tannus JF, Bunduki V, Santos EM, de Castro CC, Cerri GG, Zugaib M. Evaluation of the agreement between 3-dimensional ultrasonography and magnetic resonance imaging for fetal lung volume measurement. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:461-7. [PMID: 16567435 DOI: 10.7863/jum.2006.25.4.461] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the agreement between 3-dimensional ultrasonography (3DUS) and magnetic resonance imaging (MRI) for lung volumetry in fetuses with and without abnormalities associated with lung hypoplasia. METHODS Fifty-nine singleton pregnancies were evaluated. Cases were separated into groups 1 and 2, according to the presence or absence of malformations associated with lung hypoplasia, respectively. Fetal lung volume was calculated by the Virtual Organ Computer-Aided Analysis (VOCAL) program of the 3DUS and the MRI. In both groups, measurements performed with all VOCAL angles were compared among themselves and with those obtained by MRI. Bland-Altman tests and analysis of variance were used for this purpose. RESULTS In groups 1 and 2, the mean lung volume obtained with each rotation angle of the VOCAL technique was significantly smaller than the mean volume calculated by MRI (P < .001), and the mean volume obtained with the 30 degrees rotation step was significantly smaller than those obtained with the other rotation steps of the VOCAL technique. Bland-Altman tests confirmed this underestimation and showed a broad 95% confidence interval when the VOCAL angles were compared with those of MRI and when the 30 degrees rotation step was compared with the other VOCAL steps. CONCLUSIONS There was a substantial discrepancy between 3DUS and MRI and between the 30 degrees rotation step of the VOCAL technique and the other rotation angles, for lung volume measurement in fetuses with and without abnormalities associated with lung hypoplasia.
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Kasprian G, Balassy C, Brugger PC, Prayer D. MRI of normal and pathological fetal lung development. Eur J Radiol 2006; 57:261-70. [PMID: 16413987 DOI: 10.1016/j.ejrad.2005.11.031] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2005] [Revised: 11/14/2005] [Accepted: 11/16/2005] [Indexed: 10/25/2022]
Abstract
Normal fetal lung development is a complex process influenced by mechanical and many biochemical factors. In addition to ultrasound, fetal magnetic resonance imaging (MRI) constitutes a new method to investigate this process in vivo during the second and third trimester. The techniques of MRI volumetry, assessment of signal intensities, and MRI spectroscopy of the fetal lung have been used to analyze this process and have already been applied clinically to identify abnormal fetal lung growth. Particularly in conditions such as oligohydramnios and congenital diaphragmatic hernia (CDH), pulmonary hypoplasia may be the cause of neonatal death. A precise diagnosis and quantification of compromised fetal lung development may improve post- and perinatal management. The main events in fetal lung development are reviewed and MR volumetric data from 106 normal fetuses, as well as different examples of pathological lung growth, are provided.
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Affiliation(s)
- Gregor Kasprian
- University Clinic of Radiodiagnostics, Medical University of Vienna, Allgemeines Krankenhaus, AKH, Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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35
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Gonçalves LF, Lee W, Espinoza J, Romero R. Three- and 4-dimensional ultrasound in obstetric practice: does it help? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:1599-624. [PMID: 16301717 PMCID: PMC7062383 DOI: 10.7863/jum.2005.24.12.1599] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The purpose of this article was to review the published literature on 3-dimensional ultrasound (3DUS) and 4-dimensional ultrasound (4DUS) in obstetrics and determine whether 3DUS adds diagnostic information to what is currently provided by 2-dimensional ultrasound (2DUS) and, if so, in what areas. METHODS A PubMed search was conducted for articles reporting on the use of 3DUS or 4DUS in obstetrics. Seven-hundred six articles were identified, and among those, 525 were actually related to the subject of this review. Articles describing technical developments, clinical studies, reviews, editorials, and studies on fetal behavior or maternal-fetal bonding were reviewed. RESULTS Three-dimensional ultrasound provides additional diagnostic information for the diagnosis of facial anomalies, especially facial clefts. There is also evidence that 3DUS provides additional diagnostic information in neural tube defects and skeletal malformations. Large studies comparing 2DUS and 3DUS for the diagnosis of congenital anomalies have not provided conclusive results. Preliminary evidence suggests that sonographic tomography may decrease the examination time of the obstetric ultrasound examination, with minimal impact on the visualization rates of anatomic structures. CONCLUSIONS Three-dimensional ultrasound provides additional diagnostic information for the diagnosis of facial anomalies, evaluation of neural tube defects, and skeletal malformations. Additional research is needed to determine the clinical role of 3DUS and 4DUS for the diagnosis of congenital heart disease and central nervous system anomalies. Future studies should determine whether the information contained in the volume data set, by itself, is sufficient to evaluate fetal biometric measurements and diagnose congenital anomalies.
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Affiliation(s)
- Luís F. Gonçalves
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
- Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, USA
| | - Wesley Lee
- Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan, USA
| | - Jimmy Espinoza
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
- Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, USA
| | - Roberto Romero
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Current awareness in prenatal diagnosis. Prenat Diagn 2005; 25:429-34. [PMID: 15948307 DOI: 10.1002/pd.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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