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Li W, Feng W, Chang C, Liu Y, Li X, Wang M, Gan L, Zhang J. Innovative cardiovascular casting technique features the complex malformation of berry syndrome. BMC Pregnancy Childbirth 2024; 24:194. [PMID: 38475705 DOI: 10.1186/s12884-024-06340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Prenatal diagnosis of Berry syndrome, a rare combination of cardiac anomalies including aortopulmonary window (APW), aortic origin of the right pulmonary artery (RPA), interrupted aortic arch (IAA), hypoplastic aortic arch, or coarctation of the aorta (COA), poses a significant challenge. Due to the rarity of the disease, and the limited case reports available to features the complex malformation of Berry syndrome postpartum, this article introduces an innovative approach to visually showcase this unusual disease. The proposed method provides a comprehensive display of the structural deformities, offering valuable insights for clinical practitioners seeking to comprehend this condition. CASE PRESENTATION In this report, we present a case where fetal echocardiography aided in diagnosing Berry syndrome, which was later confirmed through postpartum cardiovascular casting. Our experience highlights the importance of using the three-vessel view to diagnose APW and aortic origin of the right pulmonary artery. Additionally, obtaining true cross-sectional and sagittal views by continuously scanning from the three-vessel-trachea view to the long-axis view of the aortic arch is necessary to image IAA or coarctation of the aortic arch. CONCLUSIONS Early and accurate prenatal diagnosis of Berry syndrome is feasible and our cardiovascular cast can perfectly display the microvascular morphology of the fetal heart, which may have great application prospects for postpartum diagnosis and teaching of complex cardiac abnormalities.
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Affiliation(s)
- Wei Li
- Hubei Provinical Clinical Research Center for Accurate Fetus Malformation Diagnosis, Department of gynaecology and obstetrics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Wei Feng
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Caihong Chang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Ya Liu
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Xue Li
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Mofeng Wang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Ling Gan
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Jiaqi Zhang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China.
- Department of Ultrasound, Hubei University of Medicine, Xiangyang No.1 People's Hospital, No 15, Jiefang Avenue, Xiangyang, 441000, Hubei, China.
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Liang X, Zhang J, Wang Y, Wu Y, Liu H, Feng W, Si Z, Sun R, Hao Z, Guo H, Li X, Xu T, Wang M, Nan Z, Lv Y, Shang X. Comparative study of microvascular structural changes in the gestational diabetic placenta. Diab Vasc Dis Res 2023; 20:14791641231173627. [PMID: 37186815 DOI: 10.1177/14791641231173627] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
AIMS Microvascular morphology and pathological changes in gestational diabetes mellitus (GDM) placentas and normal placentas were observed via vascular casting technology, electron microscopy, and pathological detection technology. Vascular structure and histological morphology changes in GDM placentas were examined to generate basic experimental data for the diagnosis and prognostic determination of GDM. METHODS This case-control study involving 60 placentas, 30 from healthy controls and 30 from patients with GDM. Differences in size, weight, volume, umbilical cord diameter, and gestational age were assessed. Histological changes in the placentas in the two groups were analyzed and compared. A placental vessel casting model was constructed using a self-setting dental powder technique, to compare the two groups. The placental cast microvessels of the two groups were compared using scanning electron microscopy. RESULTS There were no significant differences in maternal age or gestational age between the GDM group and the control group (p > .05). The size, weight, volume, and thickness of the placentas in the GDM group were significantly greater than those in the control group, as was umbilical cord diameter (p < .05). Immature villus, fibrinoid necrosis, calcification, and vascular thrombosis were significantly greater in the placental mass in the GDM group (p < .05). The terminal branches of the microvessels in diabetic placenta casts were sparse, with significantly fewer ends and lower villous volume (p < .05). CONCLUSION Gestational diabetes can cause gross and histological changes in the placenta, particularly placental microvascular changes.
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Affiliation(s)
- Xinyan Liang
- Postgraduate Training Base of Xiangyang First People's Hospital, Jinzhou Medical University, Xiangyang, China
| | - Jiaqi Zhang
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Hubei Clinical Medical Research Center for Accurate Diagnosis of fetal Complex Malformations, Xiangyang, China
| | - Yu Wang
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Hubei Clinical Medical Research Center for Accurate Diagnosis of fetal Complex Malformations, Xiangyang, China
| | - You Wu
- Department of Medical Imaging, Changsha Medical College, Changsha, China
| | - Hui Liu
- Department of Medical Imaging, Changsha Medical College, Changsha, China
| | - Wei Feng
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Hubei Clinical Medical Research Center for Accurate Diagnosis of fetal Complex Malformations, Xiangyang, China
| | - Ziyi Si
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Hubei Clinical Medical Research Center for Accurate Diagnosis of fetal Complex Malformations, Xiangyang, China
| | - Ruige Sun
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Hubei Clinical Medical Research Center for Accurate Diagnosis of fetal Complex Malformations, Xiangyang, China
| | - Zizhou Hao
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Hubei Clinical Medical Research Center for Accurate Diagnosis of fetal Complex Malformations, Xiangyang, China
| | - Hongzhi Guo
- Postgraduate Training Base of Xiangyang First People's Hospital, Jinzhou Medical University, Xiangyang, China
| | - Xue Li
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Tao Xu
- Department of Ultrasound, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Mofeng Wang
- Postgraduate Training Base of Xiangyang First People's Hospital, Jinzhou Medical University, Xiangyang, China
| | - Zhen Nan
- Postgraduate Training Base of Xiangyang First People's Hospital, Jinzhou Medical University, Xiangyang, China
| | - Yang Lv
- Xiangyang Maternal and Child Health Hospital, Xiangyang, China
| | - Xinan Shang
- Xiangzhou District People's Hospital, Xiangyang, China
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Tie HX, Ma B, Zhang DC, Li TG. Prenatal diagnosis of fetal inferior vena cava malformation using HDlive flow combined with spatiotemporal image correlation. Echocardiography 2022; 39:685-690. [PMID: 35355321 DOI: 10.1111/echo.15346] [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: 12/18/2021] [Revised: 03/01/2022] [Accepted: 03/13/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study aimed to examine the application value of high-definition live (HDlive) flow combined with spatiotemporal image correlation (STIC) in the diagnosis of fetal inferior vena cava malformation (IVCM). METHODS Twenty cases of IVCMs were diagnosed using two-dimensional HDlive flow and HDlive flow combined with STIC and retrospectively analyzed to examine the impact of using HDlive flow combined with STIC in the diagnosis of IVCM. RESULTS HDlive flow combined with STIC detected one case of duplicated IVC, four cases of left IVC (two cases with complex malformations), and 15 cases of interrupted IVC (two cases of isolated IVC disconnection, five cases with left atrial heterogeneous syndrome, and eight cases with other complex malformations). CONCLUSION HDlive flow combined with STIC can help in the diagnosis of IVCM, and this technique has important clinical value.
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Affiliation(s)
- Hong-Xia Tie
- The First Clinical Medical College of Ultrasound Diagnosis, Gansu University of traditional Chinese Medicine, Lanzhou, Gansu Province, P. R. China.,Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, P. R. China
| | - Bin Ma
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, P. R. China.,Gansu Provincial Ultrasound Imaging Clinical Medicine Research Center, Lanzhou, Gansu Province, P. R. China
| | - Deng-Cai Zhang
- Department of Pathological diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, P. R. China
| | - Tian-Gang Li
- Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu Province, P. R. China.,Gansu Provincial Ultrasound Imaging Clinical Medicine Research Center, Lanzhou, Gansu Province, P. R. China
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An P, Wang Y, Zhou SF, Xie MY, Gan L, He QY, Zeng H, Yuan W. New teaching method for prenatal cardiac screening: vascular and tracheal model. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:139-141. [PMID: 32672381 DOI: 10.1002/uog.22154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 06/11/2023]
Affiliation(s)
- P An
- Department of Medical Imaging, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
| | - Y Wang
- Department of Medical Imaging, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
- Department of Internal Medicine and Public Health, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - S F Zhou
- Department of Cardiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - M Y Xie
- Department of Internal Medicine and Public Health, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - L Gan
- Department of Medical Imaging, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - Q Y He
- Anatomy Laboratory, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - H Zeng
- Anatomy Laboratory, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - W Yuan
- Anatomy Laboratory, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
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Utility of a modified vascular corrosion casting technique in the diagnosis of fetal total anomalous pulmonary venous connection. Sci Rep 2021; 11:11281. [PMID: 34050234 PMCID: PMC8163765 DOI: 10.1038/s41598-021-90681-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/04/2021] [Indexed: 12/30/2022] Open
Abstract
Total anomalous pulmonary venous connection (TAPVC) is a rare congenital cardiac malformation, and prenatal detection of TAPVC malformation remains a challenging. TAPVC can be easily missed or misdiagnosed in prenatal examinations. This study was aimed to use the modified vascular corrosion casting technique to prepare fetal cardiovascular casts with TAPVC and investigate the utility of cardiovascular casting for the demonstration of fetal TAPVC. The retrospective study enrolled twenty fetuses (22 to 29 + 4 gestational weeks) with TAPVC diagnosed by prenatal echocardiography and casting technique from May 2015 to May 2020. Pre- and postnatal medical records, including results obtained by prenatal ultrasound, postpartum computed tomography angiography, as well as anatomic and cardiovascular casting findings were carefully reviewed and analyzed. In twenty cases, 80% (16/20) had intra- or extracardiac malformations. The TAPVC types were supracardiac (n = 8), cardiac (n = 6), infracardiac (n = 4), and mixed (n = 2). The diagnosis of 1 case each of supracardiac and cardiac TAPVC was modified to partial anomalous pulmonary venous connection; additionally, 4 malformations were missed and 2 were misdiagnosed, including an anomalous left brachiocephalic vein in supracardiac TAPVC, abnormal inflow of the hepatic vein and a double inferior vena cava in infracardiac TAPVC; and bilateral ductus arteriosus in infracardiac TAPVC; a tetralogy of Fallot in cardiac TAPVC that was corrected to right ventricular double outlet; and an absence of ductus arteriosus that was misdiagnosed as slim ductus arteriosus. Comparing with ultrasound, casting technique has its own superiority in exhibiting TAPVC abnormalities, especially in certain types such as course, origin and absence abnormalities of ductus. Postpartum cardiovascular casts can accurately depict the branch structure of the heart's larger vessels, and may be used as a clinical assessment and teaching method in complex cardiac malformations.
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An P, Ye YJ, Li QX, Liu B, Lian K, Yin JB, Hao JZ, Zhou S, Gan L. Medical disputes in relation to prenatal ultrasound in China. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:11-14. [PMID: 32608569 DOI: 10.1002/uog.22020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 06/11/2023]
Affiliation(s)
- P An
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
| | - Y-J Ye
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
- Department of Internal Medicine and Public Health, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - Q-X Li
- Department of Internal Medicine and Public Health, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - B Liu
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
- Department of Internal Medicine and Public Health, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - K Lian
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
- Department of Internal Medicine and Public Health, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Hubei, China
| | - J-B Yin
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
| | - J-Z Hao
- China Fair Judicial Appraisal Center, Xiangyang, Hubei, China
| | - S Zhou
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
| | - L Gan
- Second Department of Ultrasound and Radiology, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Hubei, China
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Wang Y, Zhang J, Feng W, Cao H, He Q, Xu J, Zeng H, Xie M. Description of misdiagnosis and missed diagnosis of fetal complex heart malformations by prenatal echocardiography combined with postnatal cardiovascular casting. Prenat Diagn 2020; 40:792-802. [PMID: 32239683 DOI: 10.1002/pd.5689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/22/2019] [Accepted: 03/21/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare prenatal echocardiography with postnatal cardiovascular casting for detection of fetal cardiovascular malformations, and to discuss the causes of prenatal misdiagnosis and missed diagnosis. METHODS We retrospectively identified patients from 2013 to 2018 at our Maternal-Fetal Medicine Center who were reported to have a fetal diagnosis of severe congenital heart malformations (CHMs). Subjects had postnatal confirmation of CHMs. Prenatal and postnatal medical records, including ultrasound results and casting findings, were reviewed and analyzed. RESULTS Postnatal casting showed that all 35 fetuses had complex CHMs. In these 35 cases, 90 cardiovascular malformations were found by postnatal casting, and 69 were detected by prenatal echocardiography. Among the other 21 cardiovascular malformations, 7 were misdiagnosed and 14 diagnoses were missed by prenatal ultrasound. CONCLUSION Prenatal echocardiography may lead to misdiagnosis and missed diagnoses, especially in cases with great arterial branching anomalies. Postnatal casting can demonstrate the configuration of the great vessels and smaller branches directly. Thus, understanding of such malformations via postnatal casting may help to improve prenatal diagnostic accuracy.
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Affiliation(s)
- Yu Wang
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Jiaqi Zhang
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Wei Feng
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Haiyan Cao
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiaoyue He
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Jinzhi Xu
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - He Zeng
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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