Prenatal examination of the area and morphology of the atrioventricular valves using four-dimensional ultrasound in normal and abnormal hearts

Adriaanse, B. M. E.; Uittenbogaard, L. B.; Tromp, C. H. N.; Schaefer, S. S.; Heymans, Martijn W.; Vugt, J.M.G. van; Haak, Monique C.

doi:10.1002/pd.4569

Cited by 9 publications

(13 citation statements)

References 14 publications

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“…Systematic analysis of the areas and morphologic characteristics of the semilunar valves using 4D sonography with STIC is feasible in normal fetal hearts and fetal hearts with congenital heart disease. Comparable to our earlier study of the atrioventricular valves, 9 the valve opening and valve shape could be visualized in almost every STIC volume with good quality (96.1% in normal hearts and 97.4% in abnormal hearts). Although visualization of the valve leaflets is feasible, the success rates were lower than expected.…”

Section: Discussionsupporting

confidence: 58%

“…The project was designed to examine the morphologic characteristics of the fetal heart using 4D sonography. We described the morphologic characteristics and areas of the atrioventricular valves and the differential insertion of the atrioventricular valves earlier 9 , 10 . This study focused on the morphologic characteristics and areas of the semilunar valves.…”

Section: Methodsmentioning

confidence: 99%

“…Yagel et al 8 described visualization of these valves in STIC volumes from healthy fetuses and reported a high visualization success rate of 93.0%. We described the areas and morphologic characteristics of the atrioventricular valves in a systematic way earlier 9 . The areas and morphologic characteristics of the semilunar valves, however, were not examined before.…”

mentioning

confidence: 99%

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Prenatal Visualization of the Pulmonary and Aortic Valves and Leaflets Is Feasible Using 4‐Dimensional Sonography

Adriaanse

Uittenbogaard

Tromp

et al. 2016

J of Ultrasound Medicine

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Section: Discussionsupporting

confidence: 58%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Prenatal Visualization of the Pulmonary and Aortic Valves and Leaflets Is Feasible Using 4‐Dimensional Sonography

Adriaanse

Uittenbogaard

Tromp

et al. 2016

J of Ultrasound Medicine

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“…There is abundant literature detailing quantitative and qualitative assessments of many aspects of the fetal heart . Late‐gestation fetal cardiac assessment has also been described by some, and this study adds to the existing literature by quantifying atrial and atrioventricular valve disproportions and their associations with other findings, including aneurysms of the septum primum, tricuspid valve insufficiency, and mild flow aberrations in the ductal and aortic arches in late gestation.…”

Section: Discussionmentioning

confidence: 93%

Common Findings in Late‐Gestation Fetal Echocardiography

Tague

Donofrio

Fulgium

et al. 2017

J of Ultrasound Medicine

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Objective Fetal echocardiography (FE) provides detailed information about cardiac structure and function in-utero. Limited information is available regarding normal findings late in pregnancy. We therefore sought to identify and describe common cardiac findings in late gestation. Methods Fetuses with structurally normal hearts were identified in mid-gestation within a subset of pregnant women in a prospective study. Atrioventricular valves (AV), right and left atrium (RA/LA), aortic isthmus (AoI) and ductus arteriosus (DA) dimensions and flow abnormalities, aneurysm of septum primum, and presence/grade of tricuspid regurgitation (TR) were assessed throughout pregnancy. Linear and logistic regression analyses were used to characterize change in quantitative and qualitative FE parameters by gestational age. Results 40 fetuses between 24 and 38 weeks gestational age (GA) were studied. Each had a FE study completed before and after 34 weeks gestation that were compared. Tricuspid/mitral valve and RA/LA ratios increased with GA (p<0.001). More frequently noted after 34 weeks GA were tapering of the DA (2.5% vs. 32%), prominent AoI diastolic flow (5% vs. 67%), prominent DA diastolic flow (2.5% vs. 25%), trivial/mild TR (35% vs. 80%), and aneurysm of septum primum (37% vs 80%). These findings all increased linearly with GA (p<0.001). Conclusion AV valve and RA/LA disproportion, mild DA tapering, prominent AoI and DA diastolic flow, trivial/mild TR, and aneurysm of septum primum are frequently identified after 34 weeks GA. This suggests that these FE findings in isolation are likely normal and are a result of the physiologic alterations that occur late in the third trimester.

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“…From the STIC acquisition, three‐dimensional voxels were created that had an X, Y, and Z component, resulting in three simultaneously displayed images referred to as the A, B, and C planes (Figure ). Following the first publication describing the STIC technique, numerous studies have been reported describing the use of this technique for evaluation of fetal cardiovascular structures and function …”

Section: Introductionmentioning

confidence: 99%

4D fetal echocardiography—An update

2017

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With the introduction of the electronic 4-dimensional and spatial-temporal image Correlation (e-STIC), it is now possible to obtain large volume datasets of the fetal heart that are virtually free of artifact. This allows the examiner to use a number of imaging modalities when recording the volumes that include two-dimensional real time, power and color Doppler, and B-flow images. Once the volumes are obtained, manipulation of the volume dataset allows the examiner to recreate views of the fetal heart that enable examination of cardiac anatomy. The value of this technology is that a volume of the fetal heart can be obtained, irrespective of the position of the fetus in utero, and manipulated to render images for interpretation and diagnosis. This article presents a summary of the various imaging techniques and provides clinical examples of its application used for prenatal diagnosis of congenital heart defects and abnormal cardiac function.

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Prenatal examination of the area and morphology of the atrioventricular valves using four-dimensional ultrasound in normal and abnormal hearts

Abstract: Prenatal examination of the morphology and area of the AV valves using four-dimensional ultrasound is feasible. A rectangular valve opening is normal, which was visualized in about one third of the normal fetuses.

Cited by 9 publications

References 14 publications

Prenatal Visualization of the Pulmonary and Aortic Valves and Leaflets Is Feasible Using 4‐Dimensional Sonography

Prenatal Visualization of the Pulmonary and Aortic Valves and Leaflets Is Feasible Using 4‐Dimensional Sonography

Common Findings in Late‐Gestation Fetal Echocardiography

4D fetal echocardiography—An update

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