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Merz E. Passing of the baton. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:579-581. [PMID: 38048781 DOI: 10.1055/a-2180-6817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
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Congenital Spinal Canal Stenosis (CSS): A Case Report of Two Similar Rare Anomalies. JOURNAL OF FETAL MEDICINE 2022. [DOI: 10.1007/s40556-022-00336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pashaj S, Merz E. Demonstration of the Normal and Abnormal Fetal Metopic Suture by Means of 3D Ultrasound. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2020; 41:468-470. [PMID: 33017855 DOI: 10.1055/a-1222-3072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Sonila Pashaj
- Centre for Ultrasound and Prenatal Medicine, Frankfurt/Main, Germany
| | - Eberhard Merz
- Centre for Ultrasound and Prenatal Medicine, Frankfurt/Main, Germany
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Gonçalves LF. Three-dimensional ultrasound of the fetus: how does it help? Pediatr Radiol 2016; 46:177-89. [PMID: 26829949 DOI: 10.1007/s00247-015-3441-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/30/2015] [Accepted: 07/13/2015] [Indexed: 01/20/2023]
Abstract
Three-dimensional ultrasonography (3-D US) was introduced to the field of fetal imaging in the early 1990s. Since then several publications have described potential applications for the diagnosis of congenital malformations as well as organ volumetry. This article reviews basic principles of 3-D US as well as its clinical applicability to prenatal diagnosis of abnormalities involving the face, spine and skeletal system, as well as potential applications of 3-D US for fetal cardiovascular and neuroimaging. Limitations related to motion artifacts, acoustic shadowing and barriers to clinical implementation of 3-D US in clinical practice are addressed.
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Affiliation(s)
- Luis F Gonçalves
- Department of Radiology and Department of Obstetrics & Gynecology, Beaumont Health System,, Divisions of Pediatric Radiology and Fetal Imaging,, 360 W. 13 Mile Road, Royal Oak, MI, 48073, USA.
- Department of Radiology and Department of Obstetrics & Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
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Paoletti D, Robertson M, Sia SB. A sonographic approach to prenatal classification of congenital spine anomalies. Australas J Ultrasound Med 2015; 17:20-37. [PMID: 28191204 PMCID: PMC5024920 DOI: 10.1002/j.2205-0140.2014.tb00081.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objective: To develop a classification system for congenital spine anomalies detected by prenatal ultrasound. Methods: Data were collected from fetuses with spine abnormalities diagnosed in our institution over a five-year period between June 2005 and June 2010. The ultrasound images were analysed to determine which features were associated with different congenital spine anomalies. Findings of the prenatal ultrasound images were correlated with other prenatal imaging, post mortem findings, post mortem imaging, neonatal imaging, karyotype, and other genetic workup. Data from published case reports of prenatal diagnosis of rare congenital spine anomalies were analysed to provide a comprehensive work. Results: During the study period, eighteen cases of spine abnormalities were diagnosed in 7819 women. The mean gestational age at diagnosis was 18.8w ± 2.2 SD. While most cases represented open NTD, a spectrum of vertebral abnormalities were diagnosed prenatally. These included hemivertebrae, block vertebrae, cleft or butterfly vertebrae, sacral agenesis, and a lipomeningocele. The most sensitive features for diagnosis of a spine abnormality included flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length. While reported findings at the time of diagnosis were often conservative, retrospective analysis revealed good correlation with radiographic imaging. 3D imaging was found to be a valuable tool in many settings. Conclusions: Analysis of the study findings showed prenatal ultrasound allowed detection of disruption to the normal appearances of the fetal spine. Using the three features of flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length, an algorithm was devised to aid with the diagnosis of spine anomalies for those who perform and report prenatal ultrasound.
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Affiliation(s)
- Debra Paoletti
- Fetal Medicine Unit Division of Women Youth and Children Canberra Hospital Garran Australian Capital Territory Department of Obstetrics and Gynaecology Australian National University Acton Australian Capital Territory Australia
| | - Meiri Robertson
- Fetal Medicine Unit Division of Women Youth and Children Canberra Hospital Garran Australian Capital Territory Department of Obstetrics and Gynaecology Australian National University Acton Australian Capital Territory Australia
| | - Sock Bee Sia
- Discipline of Medical Radiations School of Medical Sciences RMIT University Melbourne Victoria Australia
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Khodair SA, Hassanen OA. Abnormalities of fetal rib number and associated fetal anomalies using three dimensional ultrasonography. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kul S, Korkmaz HAA, Cansu A, Dinc H, Ahmetoglu A, Guven S, Imamoglu M. Contribution of MRI to ultrasound in the diagnosis of fetal anomalies. J Magn Reson Imaging 2011; 35:882-90. [DOI: 10.1002/jmri.23502] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 10/19/2011] [Indexed: 11/10/2022] Open
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Dückelmann AM, Kalache KD. Three-dimensional ultrasound in evaluating the fetus. Prenat Diagn 2010; 30:631-8. [PMID: 20572112 DOI: 10.1002/pd.2561] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In recent years three-dimensional (3D) ultrasound has made a place in clinical practice and has become a major field of research in obstetrics. In this article we will review the diagnostic performance of the most widely used 3D ultrasound applications in the assessment of fetal anomalies, explain the technique to gain correct 3D images and offer some practical advice for their efficient use. Examples are given to demonstrate the applicability and vividness of 3D in daily routine.
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Affiliation(s)
- Anna M Dückelmann
- Department of Obstetrics, Campus Charité Mitte, Charité University Hospital, Berlin, Germany
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Abstract
UNLABELLED Intrauterine fracture is an extremely rare finding, but can occur as the result of maternal trauma, osteogenesis imperfecta (OI), or theoretically other metabolic/structural abnormalities. Increased clinical awareness of the diagnosis and optimal management of these cases can lead to more positive outcomes for the patient and her child. Blunt abdominal trauma late in gestation increases the risk of fetal skull fracture, while a known diagnosis of OI or other abnormalities leading to decreased fetal bone density creates concern for long bone fracture. Biochemical and genetic tests can aid in the prenatal diagnosis of OI, while ultrasound is the best overall imaging modality for identifying fetal fracture of any etiology. When fetal fracture is diagnosed radiologically, specific management is recommended to promote optimal outcomes for mother and fetus, with special consideration given to the mother with OI. With the exception of fetal fractures due to lethal conditions, cesarean delivery is recommended in most cases, especially when fetal or maternal well-being cannot be assured. When a patient presents with risk factors for intrauterine fracture, careful evaluation via thorough history-taking, ultrasonography of the entire fetal skeleton, and laboratory tests should be performed. Heightened awareness of intrauterine fracture allows better postpartum management, whether for simple fracture care or for long-term care of patients with OI or genetic/metabolic abnormalities. TARGET AUDIENCE Obstetricians & Gynecologist, Family Physicians. LEARNING OBJECTIVES After completion of this educational activity, the reader will be able to compare x-ray, ultrasound modalities and MRI and their utility in diagnosing fetal fracture. Formulate a differential diagnosis for fetal fracture. Propose a delivery plan for a patient whose fetus has a prenatally diagnosed fetal fracture.
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Prager RW, Ijaz UZ, Gee AH, Treece GM. Three-dimensional ultrasound imaging. Proc Inst Mech Eng H 2010; 224:193-223. [PMID: 20349815 DOI: 10.1243/09544119jeim586] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This review is about the development of three-dimensional (3D) ultrasonic medical imaging, how it works, and where its future lies. It assumes knowledge of two-dimensional (2D) ultrasound, which is covered elsewhere in this issue. The three main ways in which 3D ultrasound may be acquired are described: the mechanically swept 3D probe, the 2D transducer array that can acquire intrinsically 3D data, and the freehand 3D ultrasound. This provides an appreciation of the constraints implicit in each of these approaches together with their strengths and weaknesses. Then some of the techniques that are used for processing the 3D data and the way this can lead to information of clinical value are discussed. A table is provided to show the range of clinical applications reported in the literature. Finally, the discussion relating to the technology and its clinical applications to explain why 3D ultrasound has been relatively slow to be adopted in routine clinics is drawn together and the issues that will govern its development in the future explored.
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Affiliation(s)
- R W Prager
- Department of Engineering, University of Cambridge, Cambridge, UK.
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Abstract
Central nervous system maldevelopment can have different presentations in twins. We report on a case of different presentations of spina bifida occulta in monozygotic twins. The first twin presented at birth with a lipomyelomeningocele; a tethered cord was diagnosed in the second twin at 2 years of age. Neural tube defects (NTDs) are a group of common congenital malformations of the brain and spine generated during neurulation. The genetic basis of this process is still not well known. Whenever an NTD is diagnosed in one of a pair of twins, the other twin should also be evaluated for NTDs.
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Affiliation(s)
- Barbara Spacca
- Department of Neurosurgery-Littlewoods Neuroscience Unit, Royal Liverpool Children's Hospital NHS Trust, Liverpool, United Kingdom
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Gindes L, Benoit B, Pretorius DH, Achiron R. Abnormal number of fetal ribs on 3-dimensional ultrasonography: associated anomalies and outcomes in 75 fetuses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2008; 27:1263-1271. [PMID: 18716135 DOI: 10.7863/jum.2008.27.9.1263] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to describe the clinical importance of an abnormal number of fetal ribs. METHODS A retrospective study of all fetuses that were found to have an abnormal number of ribs during routine ultrasonographic examinations was performed. Volume data sets of the fetal ribs were acquired by either static 3- or 4-dimensional volume contrast imaging in plane C. In all cases, a meticulous survey of the fetal anatomy was performed, and prenatal and postnatal records were reviewed. RESULTS Seventy-five fetuses were found retrospectively to have an abnormal number of ribs. Ultrasonographic examinations were done between 14 and 31 weeks' gestation (mean, 21.8 weeks; median, 23 weeks). More than 24 ribs were found in 28 fetuses (37%), and fewer than 24 ribs were found in 47 (63%). Additional anomalies were found in 22 fetuses (29%). Cardiovascular anomalies were detected in 10 fetuses. Seven fetuses had renal anomalies. Two fetuses had mild ventriculomegaly, and 1 fetus had holoprosencephaly. Lung dysplasia was found in 2 cases. One fetus had enlarged nuchal translucency with wormian bones. Termination of pregnancy was performed in 3 cases because of major malformations. The other 19 fetuses with associated abnormalities and the 53 without associated anomalies were born alive with only minor anomalies. CONCLUSIONS An abnormal number of fetal ribs is an isolated finding in most cases. It may also be seen with major anomalies; however, more frequently the anomalies are minor, and the overall prognosis is good.
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Affiliation(s)
- Liat Gindes
- Department of Obstetrics and Gynecology, Sheba Medical Center, Affiliated with the Sackler School of Medicine, Tel-Aviv University, Ramat Gan, Israel .
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Abstract
PURPOSE OF REVIEW Several technological advances have greatly improved three-dimensional sonography, which have improved acquisition and display capabilities. This review describes these technical changes as well as current applications of 3D sonography in prenatal diagnosis. RECENT FINDINGS Recently published papers have emphasized the potential of getting a precise 'any plane of choice' from a three-dimensional volume, as a new way of scanning, based on the off-line analysis of a volume dataset. Surface mode has been used to demonstrate malformations and genetic diseases. The maximum rendering mode, which highlights bones, has great potential for imaging the nasal bones and the frontal bones with the metopic suture. Organ volume can be measured, but the utility of this in clinical practice remains to be determined. Three-dimensional ultrasound needs to be standardized. SUMMARY Three-dimensional ultrasonography is the most rapidly developing technique in fetal imaging. New features will permit the transition from the era of 'sonography in two-dimensional planes' to 'volume ultrasound'.
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Affiliation(s)
- Rabih Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany.
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Espinoza J, Hassan SS, Gotsch F, Kusanovic JP, Lee W, Erez O, Gonçalves LF, Schoen ML, Romero R. A systematic approach to the use of the multiplanar display in evaluation of abnormal vascular connections to the fetal heart using 4-dimensional ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:1461-7. [PMID: 17957040 PMCID: PMC2678920 DOI: 10.7863/jum.2007.26.11.1461] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The multiplanar display is a modality that allows the simultaneous visualization of 3 orthogonal planes from volume data sets obtained with 3- and 4-dimensional ultrasonography. Simultaneous display of standard views used in fetal echocardiography and their orthogonal planes may provide novel ultrasonographic views for examination of the fetal heart and its vascular connections. This study was designed to determine the clinical utility of the multiplanar display in the examination of abnormal vascular connections to the fetal heart. METHODS We reviewed 4-dimensional volume data sets, acquired with the spatiotemporal image correlation technique, from patients with abnormal vascular connections to the fetal heart. Multiplanar views of the fetal heart were used to simultaneously display standard planes used in fetal echocardiography and their corresponding orthogonal planes. RESULTS This study included 4 volume data sets from fetuses with confirmed abnormal vascular connections to the heart, including: (1) an interrupted inferior vena cava with azygos or hemiazygos vein continuation; (2) a persistent left superior vena cava draining into a dilated coronary sinus; and (3) a dilated superior vena cava associated with a thoracic lymphangioma. Simultaneous visualization of orthogonal planes displaying abnormal vascular connections to the fetal heart facilitated identification of the abnormal vessels and their spatial relationships with other vascular structures. CONCLUSIONS Multiplanar imaging can be used to assess abnormal vascular connections to the fetal heart and may provide novel ultrasonographic planes for fetal echocardiography using 3- and 4-dimensional ultrasonography.
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Affiliation(s)
- Jimmy Espinoza
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland and Detroit, Michigan
- Wayne State University, Department of Obstetrics and Gynecology, Detroit, Michigan
| | - Sonia S Hassan
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland and Detroit, Michigan
| | - Francesca Gotsch
- Wayne State University, Department of Obstetrics and Gynecology, Detroit, Michigan
| | - Juan Pedro Kusanovic
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland and Detroit, Michigan
| | - Wesley Lee
- Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan
| | - Offer Erez
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland and Detroit, Michigan
| | - Luis F. Gonçalves
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland and Detroit, Michigan
- Wayne State University, Department of Obstetrics and Gynecology, Detroit, Michigan
| | - Mary Lou Schoen
- Wayne State University, Department of Obstetrics and Gynecology, Detroit, Michigan
| | - Roberto Romero
- Perinatology Research Branch, NICHD, NIH, DHHS, Bethesda, Maryland and Detroit, Michigan
- Wayne State University, Center for Molecular Medicine and Genetics, Detroit, Michigan
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Pretorius DH, Gattu S, Ji EK, Hollenbach K, Newton R, Hull A, Carmona S, D'Agostini D, Nelson TR. Preexamination and postexamination assessment of parental-fetal bonding in patients undergoing 3-/4-dimensional obstetric ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1411-21. [PMID: 17060427 DOI: 10.7863/jum.2006.25.11.1411] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether there is a change in parental bonding and couples' attitudes toward their fetus after undergoing 3-/4-dimensional ultrasonography (3D/4DUS). METHODS Sixty-five fathers and 124 mothers were asked to fill out a maternal-fetal attachment questionnaire relating to how they felt about their fetus before and after 3D/4DUS and to mark on a line indicating their feelings about the ultrasonography experience. In addition, 135 parents filled out a positive feelings questionnaire consisting of 5 sections assessing their feelings about the fetus. The 3D/4DUS examination included rendering of the fetal face, limbs, and thorax. RESULTS One hundred forty-two patients filled out all questions and were analyzed for the total attachment score. The difference of the total score for the maternal-fetal attachment questionnaire before and after 3D/4DUS had a z value of 5.6 for all patients and was statistically significant (P < .0001). In analyzing each question, 5 were found to have a statistically significantly different score for women, but only 2 were found so for men. The scores for the line, before and after 3D/4DUS, showed a significant difference for men but not women. The women studied did not show a change using this instrument because their median response was at the maximum measurement before their sonograms. The positive feelings questionnaire showed a statistically significant change for women in all sections but for men in only 2. CONCLUSIONS Parents have a change in attitude regarding their fetus after undergoing 3D/4DUS. Mothers showed an increase in bonding to their fetus after 3D/4DUS in more categories than fathers.
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Affiliation(s)
- Dolores H Pretorius
- Department of Radiology, University of California, San Diego, La Jolla, CA 92037 USA.
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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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Ji EK, Pretorius DH, Newton R, Uyan K, Hull AD, Hollenbach K, Nelson TR. Effects of ultrasound on maternal-fetal bonding: a comparison of two- and three-dimensional imaging. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 25:473-477. [PMID: 15846757 DOI: 10.1002/uog.1896] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the effect of two-dimensional (2DUS) compared to three-dimensional ultrasound (3DUS) imaging on the maternal-fetal bonding process. METHODS Fifty mothers who had 2DUS and 50 who had 2DUS and 3DUS were included in the study. A postpartum survey by telephone interview was carried out to assess maternal-fetal bonding. Bonding was evaluated by analysis of extent of prenatal image sharing, maternal ability to form a mental picture of the baby and mother's comments about their ultrasound images. Data were analyzed using the independent t-test, Chi-square and Mann-Whitney U-tests. RESULTS Mothers who received 3DUS showed their ultrasound images to more people (median, 27.5; interquartile range, 14.5-40.0) than mothers receiving 2DUS alone (median, 11.0; interquartile range, 5.0-25.5) (P < 0.001, Z = -3.539). Eighty-two percent of the subjects screened with 3DUS had a greater tendency to form a mental picture of the baby postexamination compared to 39% of the 2DUS subjects (P < 0.001, Z = -3.614). Mothers receiving a 3DUS study were more likely to receive comments on the similarities/differences of the neonate compared to those having 2DUS studies. Furthermore, 70% of the mothers receiving 3DUS felt they 'knew' the baby immediately after birth vs. 56% of the mothers receiving 2DUS (P = 0.009, Z = -2.613). Both 2DUS and 3DUS experiences were positive, however, the comments made by the mothers undergoing 3DUS (n = 18) were more exclamatory (amazed, wonderful, fabulous) than those undergoing 2DUS (n = 4). Patients having a 3DUS examination consistently scored higher than those having a 2DUS examination alone for all categories of maternal-fetal bonding. CONCLUSION 3DUS appears to more positively influence the perceptions of mothers to their babies postbirth compared to 2DUS. Specifically, mothers who had 3DUS showed their ultrasound images to a greater number of people compared to mothers who had 2DUS alone and this may represent mother's social support system. 3DUS may have a greater impact on the maternal-fetal bonding process.
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Affiliation(s)
- E-K Ji
- Department of Radiology, CHA General Hospital, Pochon CHA University, Seoul, Republic of Korea
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Benoit B, Chaoui R. Three-dimensional ultrasound with maximal mode rendering: a novel technique for the diagnosis of bilateral or unilateral absence or hypoplasia of nasal bones in second-trimester screening for Down syndrome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 25:19-24. [PMID: 15690554 DOI: 10.1002/uog.1805] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Three-dimensional (3D) ultrasound of the fetal face with maximal mode rendering allows accurate visualization of the bony face and the distinct demonstration of both nasal bones in second-trimester fetuses. The aim of this study was to analyze the feasibility of assessing nasal bones spatially on prenatal ultrasound in second- and third-trimester fetuses with present and absent nasal bones. METHODS The faces of 38 fetuses between 17 and 33 weeks' gestation were examined with 3D ultrasound and volumes were stored for offline evaluation. Eighteen fetuses had normal karyotype and an apparently normal nasal bone on 2D ultrasound; these were examined to standardize the 3D rendering technique. Twenty fetuses had trisomy 21. RESULTS In all 18 healthy fetuses both nasal bones could be demonstrated on 3D ultrasound. Nine of the 20 Down syndrome fetuses had a hypoplastic or absent nasal bone on two-dimensional ultrasound. On 3D ultrasound three of the nine had discrepant findings between left and right nasal bones with evidence of absence of one side, and hypoplasia (n = 2) or normal length (n = 1) of the other. CONCLUSIONS Unilateral absence or hypoplasia of nasal bones is an important and new observation in fetuses with Down syndrome. This differentiation is best demonstrated on 3D ultrasound with maximal mode rendering. This observation of unilaterality of findings could explain some discrepant findings on absence of nasal bones on two-dimensional ultrasound but their "presence" on lateral postmortem radiographs.
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Affiliation(s)
- B Benoit
- Maternité, Hôpital Princesse Grace, Monaco
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Bekker MN, Twisk JWR, van Vugt JMG. Reproducibility of the fetal nasal bone length measurement. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:1613-1618. [PMID: 15557304 DOI: 10.7863/jum.2004.23.12.1613] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To investigate the reproducibility of the fetal nasal bone length measurement in the first trimester. METHODS In this prospective study, crown-rump length, nuchal translucency, and nasal bone length were measured in 90 singleton pregnancies between 11 and 14 weeks of pregnancy. The study was divided into 2 equal substudies. Three investigators measured the nasal bone in study I. After an intensive 3-month training program, the same 3 investigators measured the nasal bone in study II. Measurement of the nasal bone was standardized. All investigators were blinded and measured the nasal bone 3 times. The intraclass correlation coefficient (intra-CC) and interclass correlation coefficient (inter-CC) were calculated. RESULTS Nasal bone length measurement was successfully performed in all cases. The median nasal bone lengths were 2.3 (range, 1.5-3.2), 2.6 (range, 1.4-4.2), and 2.9 (range, 2.1-3.8) mm between 77 and 83, 84 and 90, and 91 and 98 days' gestational age, respectively; median crown-rump length was 63.0 (range, 45.0-83.3) mm; and median nuchal translucency measurement was 1.3 (range, 0.9-2.5) mm. The correlation between the 3 observers was poor (inter-CC, 0.32) in the first study. After the training program, the interobserver correlation improved but was still moderate (inter-CC, 0.64). In both studies the interobserver variability did not differ between 11, 12, and 13 weeks' gestational age. There was no relationship between the mean nasal bone length and interobserver difference in both studies. The intraobserver variability was good for each investigator in both studies (intra-CC: study I, 0.93, 0.95, and 0.97; study II, 0.98, 0.97, and 0.97, respectively). CONCLUSIONS This study shows that the reproducibility of the fetal nasal bone length measurement in the first trimester is inadequate.
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Affiliation(s)
- Mireille N Bekker
- Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Stafgebouw L-348, de Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
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Gonçalves LF, Espinoza J, Mazor M, Romero R. Newer imaging modalities in the prenatal diagnosis of skeletal dysplasias. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2004; 24:115-120. [PMID: 15287046 DOI: 10.1002/uog.1712] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- L F Gonçalves
- Department of Obstetrics Gynecology, Wayne State University, Detroit, MI, USA
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