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Faden MS, Laurie M, Miller JL, Millard S, Rosner M, Baschat AA. Precise anatomical definition of fetal spina bifida using standardized three-dimensional annotation-assisted multiplanar volume contrast ultrasound imaging. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 59:122-124. [PMID: 34254390 DOI: 10.1002/uog.23737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/15/2021] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Affiliation(s)
- M S Faden
- Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M Laurie
- Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J L Miller
- Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Millard
- Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M Rosner
- Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A A Baschat
- Center for Fetal Therapy, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Kandasamy S, Paul Raj S. Nomogram of Fetal Thymus Using Thy-Box Technique in South Indian Population. JOURNAL OF FETAL MEDICINE 2018. [DOI: 10.1007/s40556-018-0160-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Coelho Neto MA, Ludwin A, Borrell A, Benacerraf B, Dewailly D, da Silva Costa F, Condous G, Alcazar JL, Jokubkiene L, Guerriero S, Van den Bosch T, Martins WP. Counting ovarian antral follicles by ultrasound: a practical guide. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 51:10-20. [PMID: 29080259 DOI: 10.1002/uog.18945] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/23/2017] [Accepted: 10/04/2017] [Indexed: 06/07/2023]
Abstract
This Consensus Opinion summarizes the main aspects of several techniques for performing ovarian antral follicle count (AFC), proposes a standardized report and provides recommendations for future research. AFC should be performed using a transvaginal ultrasound (US) probe with frequency ≥ 7 MHz. For training, we suggest a minimum of 20-40 supervised examinations. The operator should be able to adjust the machine settings in order to achieve the best contrast between follicular fluid and ovarian stroma. AFC may be evaluated using real-time two-dimensional (2D) US, stored 2D-US cine-loops and stored three-dimensional (3D) US datasets. Real-time 2D-US has the advantage of permitting additional maneuvers to determine whether an anechoic structure is a follicle, but may require a longer scanning time, particularly when there is a large number of follicles, resulting in more discomfort to the patient. 2D-US cine-loops have the advantages of reduced scanning time and the possibility for other observers to perform the count. The 3D-US technique requires US machines with 3D capability and the operators to receive additional training for acquisition/analysis, but has the same advantages as cine-loop and also allows application of different imaging techniques, such as volume contrast imaging, inversion mode and semi-automated techniques such as sonography-based automated volume calculation. In this Consensus Opinion, we make certain recommendations based on the available evidence. However, there is no strong evidence that any one method is better than another; the operator should choose the best method for counting ovarian follicles based on availability of resources and on their own preference and skill. More studies evaluating how to improve the reliability of AFC should be encouraged. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M A Coelho Neto
- Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - A Ludwin
- Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland
| | - A Borrell
- BCNatal, Hospital Clinic Barcelona, Barcelona, Catalonia, Spain
| | - B Benacerraf
- Department of Radiology and Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - D Dewailly
- CHU Lille, Department of Endocrine Gynecology and Reproductive Medicine, Hospital Jeanne de Flandre, Lille, France
| | - F da Silva Costa
- Department of Obstetrics and Gynaecology, Monash University and Monash Ultrasound for Women, Melbourne, Victoria, Australia
| | - G Condous
- Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School, University of Sydney, Sydney; and Nepean Hospital, Penrith, Australia
| | - J L Alcazar
- Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain
| | - L Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmo, Sweden
| | - S Guerriero
- Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
| | - T Van den Bosch
- Department of Obstetrics & Gynecology, University Hospitals KU Leuven, Leuven, Belgium
| | - W P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- SEMEAR Fertilidade, Reproductive Medicine, Ribeirão Preto, Brazil
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Kurian J, Sotardi S, Liszewski MC, Gomes WA, Hoffman T, Taragin BH. Three-dimensional ultrasound of the neonatal brain: technical approach and spectrum of disease. Pediatr Radiol 2017; 47:613-627. [PMID: 28058483 DOI: 10.1007/s00247-016-3753-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/11/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022]
Abstract
Brain pathology is an important cause of morbidity and mortality in neonates, especially in the premature population. While conventional two-dimensional neurosonography is traditionally used for screening, diagnosis and monitoring of brain disorders such as germinal matrix hemorrhage, periventricular leukomalacia and hydrocephalus, three-dimensional ultrasonography has gained popularity in a variety of clinical applications in recent years. Three-dimensional ultrasonography is not yet widely utilized in pediatric imaging but is a potentially powerful tool for evaluating the neonatal brain. Three-dimensional neurosonography allows imaging of the entire brain in a single volumetric sweep and offers the capability of reconstructing images in the axial plane and performing volumetric analyses that are unavailable in conventional two-dimensional neurosonography. The purpose of this article is two-fold: (1) to present the technical aspects of three-dimensional neurosonography and (2) to illustrate the potential applications of three-dimensional neurosonography in the context of commonly encountered neonatal neuropathology.
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Affiliation(s)
- Jessica Kurian
- Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 East 210th St., Bronx, NY, 10467, USA.
| | - Susan Sotardi
- Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 East 210th St., Bronx, NY, 10467, USA
| | - Mark C Liszewski
- Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 East 210th St., Bronx, NY, 10467, USA
| | - William A Gomes
- Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 East 210th St., Bronx, NY, 10467, USA
| | - Thomas Hoffman
- Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 East 210th St., Bronx, NY, 10467, USA
| | - Benjamin H Taragin
- Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 East 210th St., Bronx, NY, 10467, USA
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Tonni G, Martins WP, Guimarães Filho H, Araujo Júnior E. Role of 3-D ultrasound in clinical obstetric practice: evolution over 20 years. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1180-1211. [PMID: 25748522 DOI: 10.1016/j.ultrasmedbio.2014.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 06/04/2023]
Abstract
The use of 3-D ultrasound in obstetrics has undergone dramatic development over the past 20 years. Since the first publications on this application in clinical practice, several 3-D ultrasound techniques and rendering modes have been proposed and applied to the study of fetal brain, face and cardiac anatomy. In addition, 3-D ultrasound has improved calculations of the volume of fetal organs and limbs and estimations of fetal birth weight. And furthermore, angiographic patterns of fetal organs and the placenta have been assessed using 3-D power Doppler ultrasound quantification. In this review, we aim to summarize current evidence on the clinical relevance of these methodologies and their application in obstetric practice.
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Affiliation(s)
- Gabriele Tonni
- Department of Obstetrics and Gynecology, Guastalla Civil Hospital, ASL Reggio Emilia, Italy; Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil
| | - Wellington P Martins
- Department of Obstetrics and Gynecology, Ribeirão Preto School of Medicine, University of São Paulo (DGO-FMRP-USP), Ribeirão Preto-SP, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.
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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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Jantarasaengaram S, Praditphol N, Tansathit T, Vipupinyo C, Vairojanavong K. Three-dimensional ultrasound with volume contrast imaging for preoperative assessment of myometrial invasion and cervical involvement in women with endometrial cancer. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 43:569-574. [PMID: 23996676 DOI: 10.1002/uog.13200] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/15/2013] [Accepted: 08/23/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To evaluate the accuracy of transvaginal three-dimensional ultrasound with volume contrast imaging (VCI) for preoperative assessment of depth of myometrial invasion and cervical involvement in women with endometrial cancer. METHODS Transvaginal volume acquisition of the uterus was performed in 60 consecutive patients with histological diagnosis of endometrial cancer who were scheduled for primary surgical treatment. Depth of myometrial invasion and presence or absence of cervical involvement were assessed using VCI in multiplanar display mode. Results were compared to final postoperative histopathological findings. Patients with histological high-risk cell types, including Grade 3 endometrioid adenocarcinoma, clear cell carcinoma, papillary serous carcinoma and carcinosarcoma, were excluded. RESULTS Forty patients were included in the analysis. The accuracy of VCI in assessing single-stage myometrial invasion (superficial or deep) was 92.5%. In the prediction of deep myometrial invasion, sensitivity, specificity, PPV and NPV of VCI were 100%, 89.7%, 78.6% and 100%, respectively. The accuracy of VCI in assessing cervical involvement was 90.0%. Sensitivity, specificity, PPV and NPV of VCI in predicting the presence of cervical involvement were 100%, 86.2%, 73.3% and 100%, respectively. CONCLUSION Transvaginal VCI is an uncomplicated method that is able to predict with reasonable accuracy the depth of myometrial invasion and cervical involvement in women with endometrial cancer.
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Affiliation(s)
- S Jantarasaengaram
- Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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Abstract
Recent ultrasonographic methods applied in the evaluation of fetal thoracic structures and anomalies are presented. Fetal lung volumetric assessment by 3D ultrasonography, analysis of the thoracic wall by 3D-rendered image and 3D skeletal-mode imaging, intrathoracic vessel evaluation by 3D power Doppler ultrasonography, analysis of heart anatomy and abnormalities by 4D spatiotemporal image correlation, identification of normal and abnormal intrathoracic almost isoechogenic structures by volume contrast imaging and evaluation of the heart and great vessels by 3 and 4D inverse mode will be reviewed.
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Affiliation(s)
- Rodrigo Ruano
- Universidade de São Paulo-Brazil, R. Valentim Magalhaes 100 ap. 52, São Paulo, SP, 03184-090, Brazil.
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Martinez LH, Araujo Júnior E, Simioni C, Nardozza LMM, Moron AF. Reference ranges for vertebral body areas of the fetal lumbosacral spine on 3-dimensional sonography using volume contrast imaging with OmniView. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1743-1752. [PMID: 23091244 DOI: 10.7863/jum.2012.31.11.1743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES; The purpose of this study was to establish reference ranges for vertebral body areas of the fetal lumbosacral spine in the coronal plane on 3-dimensional sonography using volume contrast imaging with OmniView (GE Healthcare, Zipf, Austria). METHODS; An observational cross-sectional study was conducted on 576 healthy pregnant women at gestational ages of 20 weeks to 34 weeks 6 days. Volume contrast imaging with OmniView was used to measure the vertebral body areas (L1-L5, S1, and S2) by positioning a curved line along the fetal lumbosacral spine. To create reference ranges, first- and second-degree linear regression models adjusted using residual analysis and the coefficient of determination (R(2)) were created. To assess reproducibility, two examiners evaluated 40 random volumes using the intraclass correlation coefficient. RESULTS; The mean areas of the vertebral bodies were 102.72 (range, 25-254), 107.29 (range, 30-245), 105.10 (range, 31-231), 99.09 (range, 31-211), 87.74 (range, 11-178), 65.80 (range, 18-161), and 46.54 (range, 12-129) mm(2) for L1, L2, L3, L4, L5, S1, and S2, respectively. In the intraobserver and interobserver reproducibility assessments, intraclass correlation coefficients of greater than 0.80 were found for all fetal vertebral body areas. CONCLUSIONS; Reference values for fetal lumbosacral spine vertebral body areas were determined by 3-dimensional sonography using volume contrast imaging with OmniView, and they were shown to be reproducible.
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Affiliation(s)
- Luis Henrique Martinez
- Department of Obstetrics, Federal University of São Paulo, 05303-000 São Paulo-SP, Brazil
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Ruano R, da Silva MM, Salustiano EMA, Kilby MD, Tannuri U, Zugaib M. Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops: a single center cohort and a literature review. Prenat Diagn 2012; 32:1127-32. [PMID: 22990987 DOI: 10.1002/pd.3969] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the perinatal outcomes in hydropic fetuses with congenital microcystic pulmonary lesions that underwent percutaneous, invasive, laser therapy. METHOD This retrospective study reviews the literature and our experience between 2004 and 2010. Characteristics of the cystic lung lesions, liquor volume (presence of polyhydramnios or not), localization of ablation (vascular vs interstitial) and gestational age at which the procedure was performed were related to outcome (survival). RESULTS In total, 16 fetuses with congenital lung lesions underwent 'invasive' percutaneous laser ablation, seven performed in our center and nine published cases. Survival rate was higher in fetuses with a subsequent postnatal diagnosis of bronchopulmonary sequestration (87.5%) compared with congenital adenomatoid malformation (28.6%; p = 0.04). The technique of vascular ablation was more successful (100%) than interstitial ablation (25.0%, p < 0.01). CONCLUSION Percutaneous vascular laser ablation seems to be effective for bronchopulmonary sequestration in hydropic fetuses. Outcomes were worst following interstitial ablation for microcystic congenital adenomatoid with hydrops.
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Affiliation(s)
- Rodrigo Ruano
- Department of Obstetrics and Gynecology; Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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Sotiriadis A, Dimitrakopoulos I, Eleftheriades M, Agorastos T, Makrydimas G. Thalamic volume measurement in normal fetuses using three-dimensional sonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2012; 40:207-213. [PMID: 22286969 DOI: 10.1002/jcu.21888] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 12/14/2011] [Indexed: 05/31/2023]
Abstract
PURPOSE Brain thalami are important for a wide range of sensorimotor and neuropsychiatric functions. This study was carried out to calculate normative values for thalami volume during fetal life. METHODS Fetal thalami volumes were measured using 3D ultrasound in 122 normal, singleton fetuses at 20(+0) -34(+6) weeks' gestation. Virtual Organ Computer-aided AnaLysis (VOCAL) was used to obtain a sequence of six sections of each thalamus, starting from the transthalamic view of the brain at an axial plane. Thalamic contour was drawn manually. Volume contrast imaging was used to enhance image quality when needed. The volume of the thalamus distal to the transducer was also measured by a second operator in 30 randomly selected cases, blind to the measurements of the first, to calculate interobserver agreement. RESULTS Thalamic volume increased with gestational age, following a quadratic equation (R(2) = 0.83). There was no significant difference in volume between the right and left thalamus. The mean volume of each thalamus increased from 0.45 ml at 20(+0) weeks, to 1.39 ml at 28(+0) weeks, to 2.17 ml at 34(+0) weeks. The 95% limits of interobserver agreement for thalamic volume were -14.3% to +17.2%. CONCLUSIONS The increase in thalamic volume with gestation can be described adequately by a quadratic equation. The moderate interobserver repeatability is attributed to the similar echogenicity between the thalamus and its surrounding structures.
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Affiliation(s)
- Alexandros Sotiriadis
- Fourth Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Ippokrateion Hospital, 49 Konstantinoupoleos Street, Thessaloniki, Greece
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Abitayeh G, Ruano R, Martinovic J, Barthe B, Aubry MC, Benachi A. Prenatal diagnosis of main stem bronchial atresia using 3-dimensional ultrasonographic technologies. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:633-638. [PMID: 20375382 DOI: 10.7863/jum.2010.29.4.633] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The purpose of this series was to report the contribution of 3-dimensional ultrasonographic (3DUS) technologies in performing the prenatal diagnosis of main stem bronchial atresia (BA). METHODS We report 2 cases in which the prenatal diagnosis of main stem BA was performed using 3DUS technologies. Both fetuses presented with extremely enlarged hyperechoic right lungs, shifting the mediastinum to the left, associated with hydrops and polyhydramnios. A revision of the literature was made, focusing on the prenatal characteristics and perinatal prognosis of main stem BA. RESULTS In the first case, a congenital type III cystic adenomatoid malformation was suspected initially, but a posterior 3DUS analysis on multiplanar imaging allowed identification of a dilated right bronchus, and a right main stem BA was confirmed at autopsy. In the second case, volume contrast imaging was used during fetal scanning, which also allowed identification of the right main bronchial dilatation. In reviewing the literature, we found a tendency for main stem BA to be more severe than lobar and segmental atresias. CONCLUSIONS Three-dimensional ultrasonographic technologies may improve the pre-natal diagnosis of main stem BA.
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Affiliation(s)
- Georges Abitayeh
- Maternity Department, Necker-Enfants Malades Hospital, 75015 Paris, France
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Achiron R, Gindes L, Zalel Y, Lipitz S, Weisz B. Three- and four-dimensional ultrasound: new methods for evaluating fetal thoracic anomalies. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 32:36-43. [PMID: 18548479 DOI: 10.1002/uog.5308] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To study three- (3D) and four-dimensional (4D) ultrasound applications for the evaluation of fetal thoracic anomalies. METHODS Volume datasets of 23 fetuses with thoracic anomalies were acquired with static 3D and cine 4D ultrasound, i.e. spatiotemporal image correlation (STIC) mode. The volumes were analyzed and displayed by multiplanar and tomographic ultrasound imaging (TUI) modes and static volume contrast imaging (VCI). Color Doppler was added to the volumes acquired, and various rendering modes were used to display the volume datasets. RESULTS The mean gestational age at evaluation was 22 (range, 14-34) weeks. The anomalies were identified as: diaphragmatic hernia (n = 5), lung dysplasia (n = 11), skeletal dysplasia with small thorax/thanatophoric dysplasia (n = 2), abnormal situs (n = 2), hydrothorax (n = 2) and esophageal atresia (n = 1). The TUI mode achieved optimal display of the thorax, thereby aiding the diagnosis of diaphragmatic hernia and lung dysplasia. In right diaphragmatic hernias, the VCI mode proved invaluable as it distinguished liver from lung tissue. High-definition color Doppler with glass-body rendering significantly contributed to the detection of abnormal vascularization in lung dysplasia. Maximal transparent mode with a transvaginal transducer provided accurate diagnosis of skeletal dysplasia in the first trimester. Situs abnormalities were best viewed with a minimal transparent mode, in which abnormal organs and positions of vessels were clearly identified. Pleuroamniotic shunt localization was monitored precisely by 3D in a fetus with hydrothorax, and inversion mode added important information regarding the size of an esophageal pouch in a fetus with esophageal atresia. CONCLUSION The 3D-4D technique is a novel, useful sonographic tool for evaluating the fetal thorax. It enhances precise diagnosis and provides better spatial visualization of the anomalies involved.
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Affiliation(s)
- R Achiron
- Department of Obstetrics and Gynecology, Ultrasound Unit, The Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel. e-mail:
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Pasquali R, Potier A, Gorincour G. [Fetal lung imaging]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2008; 36:587-602. [PMID: 18486517 DOI: 10.1016/j.gyobfe.2008.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2008] [Accepted: 03/31/2008] [Indexed: 05/26/2023]
Abstract
Exponential improvements in imaging techniques over the last ten years, through patients' and physicians' wishes for less invasive fetal work-up, now allow us to better explore and understand fetal lung physiology during pregnancy. Diagnostic and prognostic consequences at stake are huge, especially for fetuses at risk of pulmonary hypoplasia. We will decline in three parts (normal lung, malformative lung and pulmonary hypoplasia), through a review of the literature and at the light of our experience, the potentialities and limitations of all imaging modalities (Ultrasound, Doppler, 3D, MRI). Then, we will dwell on future leads and the need for large-scale collaborative studies.
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Affiliation(s)
- R Pasquali
- Service de radiologie pédiatrique, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Ruano R, de A Pimenta EJ, Marques da Silva M, Maksoud JG, Zugaib M. Percutaneous intrauterine laser ablation of the abnormal vessel in pulmonary sequestration with hydrops at 29 weeks' gestation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:1235-41. [PMID: 17715320 DOI: 10.7863/jum.2007.26.9.1235] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Rodrigo Ruano
- Department of Obstetrics, Faculty of Medicine, São Paulo University, São Paulo, Brazil.
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Viñals F, Muñoz M, Naveas R, Giuliano A. Transfrontal three-dimensional visualization of midline cerebral structures. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2007; 30:162-8. [PMID: 17605149 DOI: 10.1002/uog.4073] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To compare sonographic visualization of midline cerebral structures obtained by two-dimensional (2D) imaging and three-dimensional (3D) multiplanar and volume contrast imaging in the coronal plane (VCI-C), with transfrontal 3D acquisition. METHODS Sixty consecutive healthy fetuses in vertex presentation at a mean gestational age of 24 (range, 20-33) weeks underwent 2D and 3D ultrasound examination. Sagittal cerebral planes were reconstructed using 3D acquisition from axial planes by multiplanar analysis and by VCI-C. The reconstructed midline images of both these techniques were compared with the midline structures visualized directly in the A-plane by transfrontal 3D acquisition using a sweep angle of 30 degrees . Measurement of the corpus callosum and cerebellar vermis and visualization of the fourth ventricle and the main vermian fissures were compared. The sharpness of the images was also assessed qualitatively. Mid-sagittal tomographic ultrasound imaging (TUI) was also performed. 3D planes were compared with 2D transfontanelle median planes obtained by transabdominal or, when required, transvaginal sonography. RESULTS The midline plane could be obtained in 88% of multiplanar, 82% of VCI-C and 87% of transfrontal analyses. Measurements of the corpus callosum and cerebellar vermis obtained by 3D median planes were highly correlated. The clearest and sharpest definition of midline structures was obtained with transfrontal acquisition. Primary and secondary fissures of the cerebellar vermis could be detected in 13-26% of multiplanar, 18-35% of VCI-C and 52-79% of transfrontal analyses. 2D visualization was superior or equal to the 3D transfrontal approach in all the parameters compared. CONCLUSION 3D planes obtained from axial acquisitions are simpler and easier to display than are transfrontal ones. However, artifacts and acoustic shadowing are frequent in 3D axial acquisition and spatial resolution is better in the direct visualization transfrontal technique. If the standard examination includes a view of the fetal facial profile, a quick 3D acquisition through the frontal sutures provides direct visualization for assessment of the midline structures. We believe that this volumetric methodology could represent a step towards incorporating a comprehensive fetal neuroscan into routine targeted organ evaluation.
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Affiliation(s)
- F Viñals
- Centro AGB Ultrasonografía, Clínica Sanatorio Alemán, Concepción, Chile.
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Viñals F, Muñoz M, Naveas R, Shalper J, Giuliano A. The fetal cerebellar vermis: anatomy and biometric assessment using volume contrast imaging in the C-plane (VCI-C). ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 26:622-7. [PMID: 16254881 DOI: 10.1002/uog.2606] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To describe the normal appearance and study the biometry of the fetal cerebellar vermis by three-dimensional (3D) volume contrast imaging in the coronal (C-) plane (VCI-C). METHODS A total of 203 normally developed fetuses were examined prospectively at 18-33 weeks' gestation. At the level of the view used to measure the transverse cerebellar diameter (TCD), a VCI-C plane was displayed to examine, using a transabdominal probe, the fetal mid-saggital vermis. The volumes acquired were stored for later review and measurement of the anteroposterior (AP) diameter, craniocaudal (CC) diameter and surface area of the cerebellar vermis. Each dataset was evaluated by two independent observers. Measurements as a function of gestational age (GA), biparietal diameter (BPD), head circumference (HC) and TCD were expressed by regression equations. Interobserver variability was evaluated. Nomograms were produced. In order to validate the use of VCI in fetal biometry, datasets from 57 patients were selected arbitrarily for comparison of their VCI-C measurements with those from mid-sagittal sections of a stored 3D multiplanar examination. Intraclass correlation was used to evaluate the agreement between these measurements. RESULTS The mean maternal age was 32 years. We were able to measure mid-sagittal CC diameter, mid-sagittal AP diameter and cerebellar vermis surface area in all fetuses. Interobserver variability analysis showed no significant differences between the two observers (P > 0.05). Measurements of the cerebellar vermis (AP diameter, CC diameter and surface area) correlated linearly with GA, BPD, HC and TCD (r > or = 0.82, P < 0.0001). CC and AP diameters estimated from the mid-sagittal section of the multiplanar measurements were significantly correlated with VCI-C measurements (r = 0.96, P < 0.00001 and r = 0.95, P < 0.00001, respectively). CONCLUSIONS VCI-C is a valuable tool, allowing intrauterine assessment of the normal appearance of the fetal cerebellar vermis. The nomograms developed in this study should enable accurate evaluation of the cerebellar vermis.
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Affiliation(s)
- F Viñals
- Centro AGB Ultrasonografía, Universidad de Concepción, Concepción, Chile.
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Jouannic JM, Rosenblatt J, Demaria F, Jacobs R, Aubry MC, Benifla JL. Contribution of three-dimensional volume contrast imaging to the sonographic assessment of the fetal uterus. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2005; 26:567-70. [PMID: 16041830 DOI: 10.1002/uog.1956] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To investigate the contribution of volume contrast imaging (VCI) in assessing the fetal uterus in normally developed female fetuses. METHODS The pelvis of 38 normal female fetuses was examined at 20-22 and 32-34 weeks' gestation using both conventional two-dimensional (2D) ultrasound and VCI on the same transverse or oblique longitudinal view of the fetal pelvis. Two experienced sonographers evaluated the ability of both techniques to image the fetal uterus. Results were compared by kappa index to evaluate the interobserver variability. RESULTS A clear picture of the fetal uterus was obtained in 50% and 82-87% of the cases at 20-22 weeks' gestation and in 80-85% and 95-100% of the cases at 32-34 weeks' gestation using conventional 2D ultrasound and VCI, respectively. There was moderate to good agreement of uterus visualization between the two observers, with kappa values ranging from 0.43 to 0.65. The lower level of agreement was obtained for conventional 2D ultrasound during the second trimester. CONCLUSIONS Our results suggest that VCI may be successfully applied to prenatal ultrasonography of the fetal pelvis anatomy. By enhancing the contrast between the intrapelvic organs, VCI provides a clearer picture of the fetal uterus.
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Affiliation(s)
- J-M Jouannic
- Service de Gynécologie-Obstétrique, Hôpital Rothschild, AP-HP Paris VI, France.
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