Computer analysis of three-dimensional power angiography images of foetal cerebral, lung and placental circulation in normal and high-risk pregnancy

Three-dimensional ultrasound in prenatal diagnosis

“…3D power Doppler has been used in normal fetuses and in those with malformations [18,19]. This modality has also been useful in the assessment of placental chorangioma [158,159], vasa previa [18,[110][111][112], aneurysm of the vein of Galen [26][27][28][29][30][31], marked splenomegaly [160], the hepatic circulation [161], conjoined twins [40,41], lung lesions [162,163], and vascularization of the fetus and placenta [164,165]. We have demonstrated the normal crossing of the ascending aorta and pulmonary artery [166], as well as their parallel course in transposition of the great vessels [18].…”

Reproducibility of regional placental vascularity/perfusion measurement using 3D power Doppler

“…Power Doppler displays ultrasound scatterer amplitude, with particular sensitivity for low velocity in smaller blood vessels1, 2. It developed from a tool for fine vascular depiction into one for quantification of blood flow or organ vascularity3, 4, as applied in multiple studies, including fetal, placental and in‐vitro evaluations5–12. Without a local standardizing value, power Doppler measurements relate to an arbitrary scale that cannot be compared between examinations of the same or other patients, unless the transducer is directly adjacent to the area of interest, minimizing attenuation, as in endosonography4.…”

“…Recently, ultrasound machines have been developed which automatically generate three‐dimensional (3D) indices that are said to relate to perfusion (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)), allowing a wealth of research papers attempting to describe perfusion in obstetrics. However, these techniques differ from FMBV and their reproducibility has been poorly addressed in most obstetric applications5, 9, 14–16, including placental imaging14, 15.…”

Future Uses of Three/Four Dimensional Power Doppler Signal in Fetal Medicine

“…Regarding the feto-placental unit, several attempts to correlate those indexes with regional perfusion of foetal brain (Hayashi et al 1998;Nardozza et al 2009), liver (C.-H. Chang et al 2003), and lungs in normal (Dubiel et al 2005) as well as pathologic in-utero conditions (Ruano et al 2006 (Bozkurt, Başgül Yigiter, et al 2010;Dar et al 2010;Guimarães Filho et al 2011;Morel et al 2010;Negrini et al 2011;A. O. Odibo et al 2011;Pomorski et al 2011;Rizzo et al 2009).…”