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Zulli A, Tocchioni F, Oreglio C, Biagiotti R, Di Maurizio M, Morini F. Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2023. [DOI: 10.1016/j.epsc.2023.102627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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2
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Application of Color Doppler with 3- and 4-Dimensional Ultrasonography in the Prenatal Evaluation of Fetal Extracardiac and Placental Abnormalities. Healthcare (Basel) 2023; 11:healthcare11040488. [PMID: 36833022 PMCID: PMC9956359 DOI: 10.3390/healthcare11040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Using color Doppler flow imaging or high-definition flow imaging with three-dimensional volume or spatio-temporal image correlation (STIC) in the glass-body mode allows displaying both gray-scale and color information of the heart cycle-related flow events and vessel spatial relationship. Conventionally, STIC in the glass-body mode has been used to examine the fetal heart and assess heart defects. Recently, a novel application of STIC in the visualization of abdominal precordial veins and intraplacental vascularization in singleton pregnancies has been reported. The aim of this present review is to discuss the use of color Doppler with three- and four-dimensional ultrasonography in the evaluation of extracardiac, placental, umbilical cord and twin abnormalities with examples. The glass-body mode is complementary to conventional 2D ultrasonography. Further studies are required to investigate use of the glass-body mode in the assessment of intraplacental vascularization in singleton and twin pregnancies.
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Leung KY. Imaging of fetal precordial venous system by four-dimensional ultrasound with spatiotemporal image correlation technology. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:193-197. [PMID: 34939684 DOI: 10.1002/jcu.23111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Despite the use of two- and three- dimensional color Doppler ultrasonography, the prenatal sonographic evaluation of precordial venous system remains difficult. Spatiotemporal image correlation (STIC) technology has been well described for the assessment of the fetal heart, but not of precordial venous system. As demonstrated in this report, it is feasible to use four-dimensional ultrasound with STIC rendered volume in glass-body mode and tomographic ultrasound imaging to image this system including the connection and drainage of the ductus venosus, hepatic veins and inferior vena cava to the fetal heart. This novel approach can increase the understanding of this venous system.
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Affiliation(s)
- Kwok-Yin Leung
- Obstetrics and Gynaecology, Gleneagles Hospital Hong Kong, Hong Kong, China
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Gindes L, Salem Y, Gasnier R, Raucher A, Tamir A, Assa S, Weissman-Brenner A, Weisz B, Kasif E, Achiron R. Prenatal diagnosis of major aortopulmonary collateral arteries (MAPCA) in fetuses with pulmonary atresia with ventricular septal defect and agenesis of ductus arteriosus. J Matern Fetal Neonatal Med 2021; 35:5400-5408. [PMID: 33525939 DOI: 10.1080/14767058.2021.1881475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to describe the prenatal diagnosis of Major Aortopulmonary Collateral Arteries (MAPCAs), and to present a systematic ultrasound method for evaluating lung vascularity in fetuses with pulmonary atresia with ventricular septal defect (PAVSD) and agenesis of ductus arteriosus (DA). METHOD This retrospective study evaluated fetuses diagnosed with PAVSD with agenesis of DA, for the presence of the MAPCAs anomaly. Fetal pulmonary vasculature was investigated by 2D and 4D Spatio Temporal Image Correlation (STIC) technology using High Definition Color Doppler. RESULTS Over a 10 year period, six fetuses were diagnosed with MAPCAs. Prenatal diagnosis was made between 17 w 6 d and 28 w 4 d in five fetuses, with the sixth diagnosed at 37 w 6 d. All six had PAVSD with agenesis DA, four exhibited pulmonic atresia without any arterial outflow, while two fetuses presented with absent left pulmonary artery, and a miniscule right pulmonary artery. In five cases, the parents elected to terminate the pregnancy and the last, although born alive, did not survive an attempt at restorative surgery and died at the age of 5 months. Postnatal CT angiography imaging of this case revealed the subclavian origin of the MAPCAs. Chromosomal micro array analysis of the amniotic fluid revealed that five of the six fetuses were normal and one was lost to follow up. CONCLUSION MAPCAs should be investigated in cases of PAVSD with agenesis DA. A meticulous ultrasound evaluation using 2D and 4D STIC can permit the prenatal diagnosis of this anomaly and provide the parents with the opportunity for prenatal consultation.
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Affiliation(s)
- Liat Gindes
- Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yishay Salem
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiology Unit, Department of Pediatrics, Sheba Medical Center, Tel-Hashomer, Israel
| | - Rose Gasnier
- Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alona Raucher
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiology Unit, Department of Pediatrics, Wolfson Medical Center, Holon, Israel
| | - Akiva Tamir
- Pediatric Cardiology Unit, Department of Pediatrics, Wolfson Medical Center, Holon, Israel
| | - Sagie Assa
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Cardiology Unit, Department of Pediatrics, Wolfson Medical Center, Holon, Israel
| | - Alina Weissman-Brenner
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Boaz Weisz
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Eran Kasif
- Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Reuven Achiron
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ultrasound Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
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Hata T, Koyanagi A, Yamanishi T, Bouno S, Takayoshi R, Miyake T. Fetal abdominal blood vessels and organ microvasculature detected by Slowflow HD. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:955-957. [PMID: 32291852 DOI: 10.1002/uog.22043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Affiliation(s)
- T Hata
- Department of Obstetrics and Gynecology, Miyake Clinic, Ohfuku, Minami-ku, Okayama, Japan
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Ikenobe, Miki, Kagawa, Japan
| | - A Koyanagi
- Department of Obstetrics and Gynecology, Miyake Clinic, Ohfuku, Minami-ku, Okayama, Japan
| | - T Yamanishi
- Department of Obstetrics and Gynecology, Miyake Clinic, Ohfuku, Minami-ku, Okayama, Japan
| | - S Bouno
- Department of Obstetrics and Gynecology, Miyake Clinic, Ohfuku, Minami-ku, Okayama, Japan
| | - R Takayoshi
- Department of Obstetrics and Gynecology, Miyake Clinic, Ohfuku, Minami-ku, Okayama, Japan
| | - T Miyake
- Department of Obstetrics and Gynecology, Miyake Clinic, Ohfuku, Minami-ku, Okayama, Japan
- Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Ikenobe, Miki, Kagawa, Japan
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Hata T, Koyanagi A, Yamanishi T, Bouno S, Takayoshi R, Miyake T. Superb microvascular imaging with Doppler luminance using an 18-MHz probe to visualize fetal intra-abdominal blood vessels and organ microvasculature. J Perinat Med 2020; 48:184-188. [PMID: 31851618 DOI: 10.1515/jpm-2019-0411] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/28/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Toshiyuki Hata
- Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan.,Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Kagawa, Japan
| | - Aya Koyanagi
- Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan
| | - Tomomi Yamanishi
- Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan
| | - Saori Bouno
- Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan
| | - Riko Takayoshi
- Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan
| | - Takahito Miyake
- Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan.,Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Kagawa, Japan
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Tang X, Tao R, Zhang X, Jin Q, He W. [Assessment of fetal superior mesenteric artery and vein by three-dimensional power Doppler sonography]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2019; 48:453-458. [PMID: 31901052 DOI: 10.3785/j.issn.1008-9292.2019.08.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze the application of three-dimensional power Doppler sonography (3-DPDS) in evaluation of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in second-trimester fetus. METHODS Three-dimensional volume probe was used to collect the 3-DPDS blood flow images in 50 normal fetuses of 22+0-24+6 weeks and 50 fetuses of 30+0-32+6 weeks, respectively. The characteristics of three-dimensional ultrasound were analyzed. The clinical and imaging data of 4 fetuses of 26+3-32+1 weeks with midgut volvulus were analyzed retrospectively. RESULTS The display rates of SMA and SMV were 93%in normal group by 3-DPDS and those in volvulus group were 4/4 and 3/4, respectively. The SMV trunk was parallel to and on the right side of the SMA in the normal group, while 3 cases in volvulus group showed the characteristic relationship of SMV swirling around SMA. CONCLUSIONS 3-DPDS can be used to observe the spatial relationship of SMA and SMV visually in fetus during the second trimester and is of value to diagnose and predict the outcome of midgut volvulus.
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Affiliation(s)
- Xianpeng Tang
- Department of Ultrasonography, Changsha Central Hospital, Changsha 410004, China
| | - Ruoling Tao
- Department of Ultrasonography, the Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Xinghao Zhang
- Department of Ultrasonography, the Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Qiuzi Jin
- Department of Ultrasonography, the Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Wei He
- Department of Ultrasonography, the Third Xiangya Hospital, Central South University, Changsha 410013, China
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Yagel S, Cohen SM, Valsky DV. Simplifying imaging of the abdominal fetal precordial venous system. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:571-575. [PMID: 29573303 DOI: 10.1002/uog.19053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/10/2018] [Accepted: 03/16/2018] [Indexed: 06/08/2023]
Affiliation(s)
- S Yagel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel
| | - S M Cohen
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel
| | - D V Valsky
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel
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Molina Giraldo S, Alfonso Ayala DA, Arreaza Graterol M, Perez Olivo JL, Solano Montero AF. Three-dimensional Doppler ultrasonography for the assessment of fetal liver vascularization in fetuses with intrauterine growth restriction. Int J Gynaecol Obstet 2018; 144:260-264. [PMID: 30447077 DOI: 10.1002/ijgo.12715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/13/2018] [Accepted: 11/15/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To demonstrate changes in hepatic volume and vascular indices in fetuses with intrauterine growth restriction (IUGR) compared with normal-growth fetuses, using a noninvasive method (three-dimensional power Doppler ultrasound). METHODS The present cross-sectional study was conducted between September 1 and November 30, 2014, at a maternal-fetal medicine unit in Bogotá, Colombia; it included consecutive women at 24-34 weeks of pregnancy. The fetal liver volume and indices of hepatic vascularization were determined with three-dimensional power Doppler ultrasonography and compared between fetuses with and without a diagnosis of IUGR. Results A total of 119 women met study inclusion criteria; 97 fetuses had no growth restriction, whereas 22 fetuses had IUGR. The latter group had decreased liver volume (57.85 ± 29.71 mL vs 86.99 ± 31.24 mL; P=0.010) and increased vascular indices (vascularization index, 47.92 ± 34.44 versus 22.46 ± 18.95; flow index, 71.39 ± 42.01 versus 41.11 ± 23.24; vascularization flow index, 47.94 ± 47.96 versus 13.67 ± 22.38; P=0.003 for all comparisons). CONCLUSION Liver volume was decreased and liver vascular indices values were increased in fetuses with IUGR. These findings imply that evaluation of hepatic vascularization with three-dimensional hepatic Doppler could be useful in the diagnosis of IUGR.
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Affiliation(s)
- Saulo Molina Giraldo
- Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Clínica Materno Infantil Colsubsidio, Bogotá, Colombia.,Department of Gynecology and Obstetrics, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | - Diana A Alfonso Ayala
- Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Clínica Materno Infantil Colsubsidio, Bogotá, Colombia
| | - Mortimer Arreaza Graterol
- Section of Fetal Therapy and Fetal Surgery Unit, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Clínica Materno Infantil Colsubsidio, Bogotá, Colombia
| | - Jose L Perez Olivo
- Department of Gynecology and Obstetrics, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | - Armicson F Solano Montero
- Department of Gynecology and Obstetrics, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
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10
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Three-dimensional imaging of living transplanted kidney vasculature by 3D color Doppler ultrasonography. ASIAN BIOMED 2018. [DOI: 10.2478/abm-2010-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background: It is of clinical importance to display the vasculature of transplanted kidney in three-dimensional (3D) and in non-invasive way. 3D color Doppler ultrasonographic imaging (3D-CDUI) is a non-invasive technique to display the 3D vasculature of living organs. Objective: Probe into characteristics of 3D vasculature of living transplanted kidney by 3D-CDUI, and evaluate the clinical value of 3D-CDUI on monitoring complications after operation of renal transplant. Methods: Nine patients who received allogeneic transplantation of kidney were monitored with 3D-CDUI. The instruments used included ACUSON Sequoia 512 and TomTec computer station of 3D-CDUI. Using magnetic positioning free-hand scanning, the 3D reconstruction and display of renal tissue structure and blood flow were performed off-line. Results: All patients underwent 3D-CDUI examinations without any side effect or complication. When acute rejection occurred, the 3D distribution change of renal blood flow signal could be observed clearly. During treatment of acute necrosis of renal tubules, changes of renal blood flow signal in 3D color Doppler images could be detected earlier compared with 2D color Doppler images. The position of embolized vassels could be diagnosed accurately by 3D-CDUI. Conclusion: The 3D-CDUI was helpful to improve diagnosis level of ultrasonography by monitoring complications after renal transplantation.
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11
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Danon E, Weisz B, Achiron R, Pretorius DH, Weissmann-Brenner A, Gindes L. Three-dimensional ultrasonographic depiction of fetal brain blood vessels. Prenat Diagn 2016; 36:407-17. [DOI: 10.1002/pd.4791] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 01/03/2016] [Accepted: 01/30/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Eran Danon
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Boaz Weisz
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Reuven Achiron
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Dolores H. Pretorius
- Department of Radiology; University of California, San Diego, Thornton Hospital; San Diego CA USA
| | - Alina Weissmann-Brenner
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
| | - Liat Gindes
- Department of Obstetrics and Gynecology; Chaim Sheba Medical Center (Affiliated to the Sackler School of Medicine, Tel-Aviv University); Ramat Gan Israel
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Moshiri M, Zaidi SF, Robinson TJ, Bhargava P, Siebert JR, Dubinsky TJ, Katz DS. Comprehensive imaging review of abnormalities of the umbilical cord. Radiographics 2015; 34:179-96. [PMID: 24428290 DOI: 10.1148/rg.341125127] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A complete fetal ultrasonographic (US) study includes assessment of the umbilical cord for possible abnormalities. Knowledge of the normal appearance of the umbilical cord is necessary for the radiologist to correctly diagnose pathologic conditions. Umbilical cord abnormalities can be related to cord coiling, length, and thickness; the placental insertion site; in utero distortion; vascular abnormalities; and primary tumors or masses. These conditions may be associated with other fetal anomalies and aneuploidies, and their discovery should prompt a thorough fetal US examination. Further workup and planning for a safe fetal delivery may include fetal echocardiography and karyotype analysis. Doppler US is a critical tool for assessment and diagnosis of vascular cord abnormalities. US also can be used for follow-up serial imaging evaluation of conditions that could result in fetal demise. Recent studies suggest that three- or four-dimensional Doppler US of the fetal umbilical cord and abdominal vasculature allows more accurate diagnosis of vascular abnormalities. Doppler US also is invaluable in assessment of fetal growth restriction since hemodynamic changes in the placenta or fetus would appear as a spectral pattern of increased resistance to forward flow in the fetal umbilical artery. Early detection of umbilical cord abnormalities and close follow-up can reduce the risk of morbidity and mortality and assist in decision making.
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Affiliation(s)
- Mariam Moshiri
- From the Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195 (M.M., S.F.Z., T.J.R., P.B., T.J.D.); Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (P.B.); Department of Laboratories, Seattle Children's Hospital, Seattle, Wash (J.R.S.); and Department of Radiology, Winthrop-University Hospital, Mineola, NY (D.S.K.)
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Cáceres F, Castañon M, Lerena J, Cusi V, Badosa J, Morales L. [Mesenteric flow in an experimental model of ischaemia-reperfusion in rats]. An Pediatr (Barc) 2013; 80:151-8. [PMID: 23831202 DOI: 10.1016/j.anpedi.2013.05.022] [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: 01/07/2013] [Revised: 04/29/2013] [Accepted: 05/19/2013] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Maintained acute occlusion followed by reperfusion of the superior mesenteric artery (SMA) in a few hours can trigger irreversible bowel damage. The aim of the study was to determine the changes in mesenteric flow measured by colour Doppler Ultrasound and correlating with histological lesions in an experimental model of ischaemia-reperfusion. METHOD AND MATERIAL Three groups of Sprague-Dawley 17 day-old rats were studied (control, ischemia and reperfusion). The model used was ischaemia-reperfusion over the SMA. Intra-abdominal ultrasound was then performed. The parameters recorded were: Maximum systolic velocity (MSV), pulsatility index (PI), resistance (RI) and systole-diastole (S/D). The histological variables were: intestinal lesion (Wallace/Keenan-Chiu scale), morphometrics (mean villus height [MVH]), and goblet cells. The Spearman (rs) correlation was used. RESULTS The MSV in the reperfusion group was 74.3 cm/s, the PI 7.33 and S/D 25.75 in the SMA, which were higher than the controls (41.35 cm/s; 3.12 and 12.45, respectively). A direct association (P<.01) was found between MSV, PI and S/D regarding: Wallace/Kennan scoring system (rs = 0.655; rs = 0.593; rs = 0.63) and the Chiu (rs = 0.569; rs = 0.522; rs = 0.47). While the correlation was the reverse (P<.01) when associated with the MVH (rs = -0,495; rs = -0,452; rs = -0,459) and goblet cells of the colon (rs = -0,525; rs = -0,45; rs = -0,518). CONCLUSIONS The reperfusion phase increased mesenteric flow expressed by the MSV and PI and could significantly predict the potential bowel damage at macroscopic and microscopic level.
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Affiliation(s)
- F Cáceres
- Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
| | - M Castañon
- Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España; Sección de Cirugía Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - J Lerena
- Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - V Cusi
- Servicio de Anatomía Patológica, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - J Badosa
- Servicio de Diagnóstico por la Imagen, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - L Morales
- Cátedra de Pediatría, Universidad de Barcelona, Hospital Sant Joan de Déu, Universidad de Barcelona, Esplugues de Llobregat, Barcelona, España
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Leal DB, Maggiolini M, Bianchi A. Prenatal Diagnosis and Postnatal Follow-up of Patients with Persistent Right Umbilical Vein. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10009-1231] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Objective
Through a prospective study the incidence and neonatal results of patients with persistent right umbilical vein are evaluated.
Materials and methods
During the period between August 2009 and February 2011, 3,576 low-risk obstetric sonographies were performed by the same technician at four different centers of prenatal diagnosis. Persistent right umbilical vein was diagnosed during a customary ultrasound examination, in the abdominal transverse section used to measure abdominal perimeter. Patients were asked to bring their children several months after delivery for a clinical and sonographic evaluation.
Results
Persistent right umbilical vein was found in nine fetuses. In one case, it was associated with single umbilical artery. All fetuses had good growth and development. In some children, the postnatal sonography showed the gallbladder toward the left of falciform ligament.
Conclusion
The incidence of persistent right umbilical vein in this population was of 1:397. We did not find any association with severe malformations as mentioned in the first articles related to this topic. There was only one case with single umbilical artery. All newborns developed normally. The question is raised why, being this anomaly so frequent and obvious, it is not more often diagnosed. Gallbladder position in respect to falciform ligament is a finding to assess.
How to cite this article
Leal DB, Maggiolini M, Bianchi A. Prenatal Diagnosis and Postnatal Follow-up of Patients with Persistent Right Umbilical Vein. Donald School J Ultrasound Obstet Gynecol 2012;6(1):104-108.
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Weichert J, Hartge D, Germer U, Axt-Fliedner R, Gembruch U. Persistent right umbilical vein: a prenatal condition worth mentioning? ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:543-8. [PMID: 20922781 DOI: 10.1002/uog.7764] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2010] [Indexed: 05/09/2023]
Abstract
OBJECTIVES To investigate the incidence and clinical impact of prenatally diagnosed persistent right umbilical vein (PRUV) in a referral population and to evaluate the findings together with those from previous publications. METHODS This was a retrospective analysis of 39 cases with PRUV diagnosed in three tertiary referral centers for prenatal medicine between 1996 and 2009. Fetuses with situs inversus, situs ambiguous and heterotaxy (left and right isomerism) were excluded. During the study period 46 653 consecutive high- and low-risk pregnancies were examined. The prenatal sonograms and neonatal outcome data of affected individuals were reviewed. Our findings were analyzed together with findings retrieved from the scientific literature. RESULTS Twenty-nine fetuses had an isolated PRUV as a single anomaly, whereas 10/39 (25.6%) were found to have PRUV accompanied by additional minor and major abnormalities. These anomalies comprised mainly cardiovascular, genitourinary and gastrointestinal malformations. In common with our series, previously published cases of isolated PRUV (n = 197) displayed an uneventful course of pregnancy and a favorable postnatal outcome. Sixty-six previously reported cases of PRUV with additional anomalies were identified in the literature. Intrahepatic umbilical drainage is the most frequent type of PRUV. Including our cases, there were 16 cases (5.3%) with extrahepatic drainage of PRUV, all of which had additional anomalies. CONCLUSIONS Consistent with previous reports, in the majority of cases (74.8%) PRUV is an isolated finding. While these cases carry an excellent prognosis, PRUV can be associated with severe congenital anomalies, so this finding should prompt detailed prenatal assessment of the fetus.
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Affiliation(s)
- J Weichert
- Division of Prenatal Medicine, Department of Gynecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Luebeck, Germany.
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Chang PL, Mrazek-Pugh B, Blumenfeld YJ. Prenatal diagnosis of cross-fused renal ectopia: does color Doppler and 3-dimensional sonography help? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:578-580. [PMID: 21460160 DOI: 10.7863/jum.2011.30.4.578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Achiron R, Gindes L, Gilboa Y, Weissmann-Brenner A, Berkenstadt M. Umbilical vein anomaly in fetuses with Down syndrome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2010; 35:297-301. [PMID: 20069683 DOI: 10.1002/uog.7542] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To describe the prevalence of abnormal umbilical vein (UV) anatomy in fetuses with Down syndrome. METHODS This was a retrospective survey covering a 24-month period of fetuses with a genetic diagnosis of Down syndrome following a routine early second-trimester (12-16-week) detailed fetal anomaly scan at a single academic tertiary referral center. In our unit this exam includes fetal umbilicoportal venous system evaluation. RESULTS During the study period, 37 fetuses were diagnosed with Down syndrome and had a detailed early anatomy scan. In four (11%) the detailed early anomaly scan revealed that the UV was connected to the hepatic portion of the inferior vena cava (IVC) at a position lower than its usual site. Their average gestational age at diagnosis was 13 + 6 (range, 11 + 6 to 15 + 2) weeks. Three of the four fetuses had a nuchal translucency thickness of 3-4 mm. In one fetus there was an additional finding of significant tricuspid regurgitation and the one with normal nuchal translucency thickness had an atrioventricular septal defect (atrioventricular canal) and umbilical cord hernia. During the same period three of 2500 (0.12%) fetuses with normal karyotype demonstrated similar anomalous insertion of the UV into the IVC, creating a portocaval shunt which had normal ductus venosus-like Doppler flow in all three cases. The odds ratio for abnormal umbilicoportal venous system in fetuses with Down syndrome compared with the normal population was 107.4 (95% CI, 19.2-637.1). CONCLUSIONS Fetuses with Down syndrome demonstrate an increased prevalence of abnormal connection of the UV to the IVC.
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Affiliation(s)
- R Achiron
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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