Abstract
Objective
This study aimed to assess the feasibility and usefulness of transabdominal color Doppler flow imaging (CDFI) technology and the high-definition flow imaging (HDFI) technique in detecting fetal pulmonary veins (PVs) in the first trimester (11–13+6 weeks).
Methods
From December 2018 to October 2019, 328 pregnant women with 328 normal singleton fetuses (crown-rump length: 45–84 mm) who had undergone CDFI and HDFI scans for fetal heart and vessel examination were enrolled in this study. The cases were divided into three groups according to the gestational age: group A, 11+0 −11+6 weeks; group B, 12+0 −12+6 weeks; and group C, 13+0 −13+6 weeks. Baseline sonograms and CDFI and HDFI images were analyzed by two senior radiologists independently and blindly. The abilities of CDFI and HDFI to display PVs were compared.
Results
Successful PV display rates via CDFI and HDFI were 2.3% and 68.2% (P<0.01), 22.4% and 82.4% (P<0.01), 41.5% and 91.2% (P<0.01) for group A, group B, and group C, respectively. The total successful display rates for the two methods were 28.9% (CDFI) and 84.8% (HDFI) (P<0.01).
Conclusions
The HDFI technique is more valuable than CDFI for detecting PVs in early pregnancy (11–13+6 weeks). HDFI can detect at least one PV in all cases and may be used to detect pulmonary venous anomalies early.
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References
Paladini D, Pistorio A, Wu LH, et al. Prenatal diagnosis of total and partial anomalous pulmonary venous connection: multicenter cohort study and meta-analysis. Ultrasound Obstet Gynecol, 2018,52(1):24–34
Karamlou T, Gurofsky R, Al Sukhni E, et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation, 2007,115(12):1591–1598
Kawazu Y, Inamura N, Shiono N, et al. “Post-LA space index” as a potential novel marker for the prenatal diagnosis of isolated total anomalous pulmonary venous connection. Ultrasound Obstet Gynecol, 2014,44(6):682–687
Burroughs JT, Edwards JE. Total anomalous pulmonary venous connection. Am Heart J, 1960,59:913–931
Liu L, He Y, Li Z, et al. Low-frequency high-definition power Doppler in visualizing and defining fetal pulmonary venous connections. J Med Ultrason (2001), 2014,41(3):333–338
Dong FQ, Zhang YH, Li ZA, et al. Evaluation of normal fetal pulmonary veins from the early second trimester by enhanced-flow (e-flow) echocardiography. Ultrasound Obstet Gynecol, 2011,38(6):652–657
Sun X, Zhang Y, Fan M, et al. Role of four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation in detecting fetal pulmonary veins. Echocardiography, 2017,34(6):906–914
Seale AN, Carvalho JS, Gardiner HM, et al. Total anomalous pulmonary venous connection: impact of prenatal diagnosis. Ultrasound Obstet Gynecol, 2012,40(3):310–318
He YH, Liu K, Gu XY, et al. The application of high definition flow imaging in fetal hemodynamics. Clin Exp Obstet Gynecol, 2015,42(1):11–17
Lei W, Ying Z, Cai AL, et al. Evaluation of Normal Fetal Ductus Venosus Using B-Flow Imaging with Spatiotemporal Image Correlation and Traditional Color Doppler Echocardiography. Echocardiogr J Card, 2015,32(2):325–331
Zhang Y, Shao Q, Sun L, et al. Prenatal diagnosis of total anomalous pulmonary venous connection by 2D and 3D fetal echocardiography. Echocardiography, 2017,34(12):1852–1857
Zhang Y, Ding C, Fan M, et al. Evaluation of normal fetal pulmonary veins using B-flow imaging with spatiotemporal image correlation and by traditional color Doppler echocardiography. Prenat Diagn, 2012, 32(12):1186–1191
Sun X, Lei W, Wang Y, et al. Two- and four-dimensional echocardiography with high-definition flow imaging and spatiotemporal image correlation in the diagnosis of fetal isolated partial anomalous pulmonary venous connection. Echocardiography, 2018,35(4):566–570
Salomon LJ, Alfirevic Z, Bilardo CM, et al. ISUOG practice guidelines: performance of first-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol, 2013,41(1):102–113
Wfumb/Isuog. WFUMB/ISUOG statement on the safe use of Doppler ultrasound during 11–14 week scans (or earlier in pregnancy). Ultrasound Med Biol, 2013,39(3):373
Bhide A, Acharya G, Bilardo CM, et al. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol, 2013,41(2):233–239
Hutchinson D, McBrien A, Howley L, et al. First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks’Gestational Age. J Am Soc Echocardiogr, 2017,30(8):763–772
Mao YK, Zhao BW, Zheng FH, et al. Z-scores for fetal left atrial size and left atrium-descending aorta distance in fetuses with isolated total anomalous pulmonary venous connection. Prenat Diagn, 2017,37(10):992–1000
Acknowledgments
We are grateful to Xiu-hui ZHAN for her guidance with the statistical analysis of the data presented in this article. We also thank Dr. Xian-qin JIANG for helping us to collect the general clinical data.
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The authors declare that they have no conflicts of interest.
This study was supported by grants from the Clinical Research Foundation of the Seventh Affiliated Hospital of Sun Yat-sen University (No. ZSQYLCKYJJ202010), the General Program of Science and Technology Project of Shenzhen (No. JCYJ20190814170205768), and the Foundation of the Key Program of Social Science and Technology Development Project of Dongguan (No. 202050715041216).
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Lin, Dm., Zhu, Yx., Tan, Y. et al. Feasibility of Transabdominal Real-time CDFI and HDFI Techniques for Fetal Pulmonary Vein Display in the First Trimester. CURR MED SCI 42, 635–641 (2022). https://doi.org/10.1007/s11596-022-2569-5
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DOI: https://doi.org/10.1007/s11596-022-2569-5