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1.
Artigo em Inglês | MEDLINE | ID: mdl-31634851

RESUMO

Quality control / assessment of ultrasound (US) images is an essential step in clinical diagnosis. This process is usually done manually, suffering from some drawbacks, such as dependence on operator's experience and extensive labors, as well as high inter- and intra-observer variation. Automatic quality assessment of US images is therefore highly desirable. Fetal US cardiac four-chamber plane (CFP) is one of the most commonly used cardiac views, which was used in the diagnosis of heart anomalies in the early 1980s. In this paper, we propose a generic deep learning framework for automatic quality control of fetal US CFPs. The proposed framework consists of three networks: (1) a basic CNN (B-CNN), roughly classifying four-chamber views from the raw data; (2) a deeper CNN (D-CNN), determining the gain and zoom of the target images in a multi-task learning manner; and (3) the aggregated residual visual block net (ARVBNet), detecting the key anatomical structures on a plane. Based on the output of the three networks, overall quantitative score of each CFP is obtained, so as to achieve fully automatic quality control. Experiments on a fetal US dataset demonstrated our proposed method achieved a highest mean average precision (mAP) of 93.52% at a fast speed of 101 frames per second (FPS). In order to demonstrate the adaptability and generalization capacity, the proposed detection network (i.e., ARVBNet) has also been validated on the PASCAL VOC dataset, obtaining a highest mAP of 81.2% when input size is approximately 300×300.

2.
Med Image Anal ; 58: 101548, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31525671

RESUMO

It is essential to measure anatomical parameters in prenatal ultrasound images for the growth and development of the fetus, which is highly relied on obtaining a standard plane. However, the acquisition of a standard plane is, in turn, highly subjective and depends on the clinical experience of sonographers. In order to deal with this challenge, we propose a new multi-task learning framework using a faster regional convolutional neural network (MF R-CNN) architecture for standard plane detection and quality assessment. MF R-CNN can identify the critical anatomical structure of the fetal head and analyze whether the magnification of the ultrasound image is appropriate, and then performs quality assessment of ultrasound images based on clinical protocols. Specifically, the first five convolution blocks of the MF R-CNN learn the features shared within the input data, which can be associated with the detection and classification tasks, and then extend to the task-specific output streams. In training, in order to speed up the different convergence of different tasks, we devise a section train method based on transfer learning. In addition, our proposed method also uses prior clinical and statistical knowledge to reduce the false detection rate. By identifying the key anatomical structure and magnification of the ultrasound image, we score the ultrasonic plane of fetal head to judge whether it is a standard image or not. Experimental results on our own-collected dataset show that our method can accurately make a quality assessment of an ultrasound plane within half a second. Our method achieves promising performance compared with state-of-the-art methods, which can improve the examination effectiveness and alleviate the measurement error caused by improper ultrasound scanning.

3.
Cardiovasc Pathol ; 39: 38-50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30623879

RESUMO

The traditional classification of congenital aortic arch abnormalities was described by James Stewart and colleagues in 1964. Since that time, advances in diagnostic imaging technology have led to better delineation of the vasculature anatomy and the identification of previously unrecognized and unclassified anomalies. In this manuscript, we review the existing literature and propose a series of modifications to the original Stewart classification of congenital aortic arch abnormalities to incorporate this new knowledge. In brief, we propose the following modifications: (1) In Group I, we further divide subgroup B into left arch atretic and right arch atretic; (2) In Group II, we add three more subgroups, including aberrant right innominate artery, "isolated" right innominate artery (RIA), "isolated" right carotid artery with aberrant right subclavian artery; (3) In Groups I, II, and III, we add a subgroup of absence of both ductus arteriosus; and (4) In Group IV, we add three subgroups, including circumflex retro-esophageal aorta arch, persistent V aortic arch, and anomalous origin of pulmonary artery from ascending aorta.


Assuntos
Aorta Torácica/anormalidades , Cardiopatias Congênitas/classificação , Terminologia como Assunto , Malformações Vasculares/classificação , Aorta Torácica/diagnóstico por imagem , Tomada de Decisão Clínica , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/terapia , Humanos , Valor Preditivo dos Testes , Prognóstico , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/terapia
4.
IEEE Trans Med Imaging ; 38(1): 180-193, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30040635

RESUMO

Volumetric ultrasound is rapidly emerging as a viable imaging modality for routine prenatal examinations. Biometrics obtained from the volumetric segmentation shed light on the reformation of precise maternal and fetal health monitoring. However, the poor image quality, low contrast, boundary ambiguity, and complex anatomy shapes conspire toward a great lack of efficient tools for the segmentation. It makes 3-D ultrasound difficult to interpret and hinders the widespread of 3-D ultrasound in obstetrics. In this paper, we are looking at the problem of semantic segmentation in prenatal ultrasound volumes. Our contribution is threefold: 1) we propose the first and fully automatic framework to simultaneously segment multiple anatomical structures with intensive clinical interest, including fetus, gestational sac, and placenta, which remains a rarely studied and arduous challenge; 2) we propose a composite architecture for dense labeling, in which a customized 3-D fully convolutional network explores spatial intensity concurrency for initial labeling, while a multi-directional recurrent neural network (RNN) encodes spatial sequentiality to combat boundary ambiguity for significant refinement; and 3) we introduce a hierarchical deep supervision mechanism to boost the information flow within RNN and fit the latent sequence hierarchy in fine scales, and further improve the segmentation results. Extensively verified on in-house large data sets, our method illustrates a superior segmentation performance, decent agreements with expert measurements and high reproducibilities against scanning variations, and thus is promising in advancing the prenatal ultrasound examinations.


Assuntos
Imagem Tridimensional/métodos , Ultrassonografia Pré-Natal/métodos , Algoritmos , Feminino , Feto/diagnóstico por imagem , Humanos , Gravidez
5.
Nan Fang Yi Ke Da Xue Xue Bao ; 37(6): 721-729, 2017 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-28669943

RESUMO

OBJECTIVE: To evaluate the development of the cerebral sulci and gyrus and cerebral blood flow in fetuses with tetralogy of Fallot (ToF) in the second and third trimesters using ultrasound imaging. METHODS: Forty fetuses (23-33+6 weeks) with ToF diagnosed using ultrasound imaging between December, 2015 and September, 2016 were analyzed in this study. The development of the cerebral sulci and gyrus was evaluated by measuring the parietal-occipital fissure (POF) depth, POF angle, sylvian fissure (SF) depth, SF width, uncovered insular width, calcarine fissure (CF) depth, hemisphere depth on the views of POF, SF and CF, uncovered insular ratio, biparietal diameter (BPD), and head circumference (HC). Cerebral hemodynamics were assessed by measuring the umbilical artery resistance index, umbilical artery pulsation index, middle cerebral artery pulsation index (MCA-PI), middle cerebral artery resistance index, the cerebral-to-placental resistance ratio, and the cerebroplacental ratio. RESULTS: In ToF fetuses, the POF depth, SF depth, CF depth, BPD, HC and hemisphere depth on the views of parietal-occipital sulcus and calcarine sulcus were significantly smaller than those in the control group (P<0.05). The middle cerebral artery resistance index, middle cerebral artery pulsation index, the cerebral-to-placental resistance ratio and the cerebroplacental ratio were also significantly lower in ToF fetuses than in the control group (P<0.05). CONCLUSION: The cerebral sulci and gyrus in ToF fetuses in second and third trimesters show underdevelopment compared with those in normal fetuses, and the changes in hemodynamics caused by abnormal cardiac structure might be one of the reasons for cerebral sulci and gyrus underdevelopment in fetuses with ToF.


Assuntos
Córtex Cerebral/efeitos dos fármacos , Circulação Cerebrovascular , Tetralogia de Fallot/diagnóstico por imagem , Ultrassonografia Pré-Natal , Feminino , Feto , Humanos , Artéria Cerebral Média , Gravidez
6.
Chin Med J (Engl) ; 130(8): 920-928, 2017 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-28397721

RESUMO

BACKGROUND: Fetal brain development is a complicated process that continues throughout pregnancy. Fetal sulcus development has typical morphological features. Assessment of fetal sulcus development to understand the cortical maturation and development by prenatal ultrasound has become widespread. This study aimed to explore a reliable method to assess cortical sulcus and to describe the normal sonographic features of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation. METHODS: A cross-sectional study was designed to examine the fetal cortical sulcus development at 18-41 weeks of gestation. Ultrasound was used to examine the insula, sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine fissure (CF). Bland-Altman plots were used for assessing the concordance, and the intraclass correlation coefficient was used for assessing the reliability. RESULTS: SF images were successfully obtained in 100% of participants at 22 weeks of gestation, while the POF images and CF images could be obtained in 100% at 23 weeks of gestation and 24 weeks of gestation, respectively. The SF width, temporal lobe depth, POF depth, and the CF depth increased with the developed gestation. The width of uncovered insula and the POF angle decreased with the developed gestation. By 23 weeks of gestation, the insula was beginning to be covered. Moreover, it completed at 35 weeks of gestation. The intra- and inter-observer agreements showed consistent reproducibility. CONCLUSIONS: This study defined standard views of the fetal sulcus as well as the normal reference ranges of these sulcus measurements between 18 and 41 weeks of gestation. Such ultrasonographic measurements could be used to identify fetuses at risk of fetal neurological structural disorders.


Assuntos
Encéfalo/embriologia , Desenvolvimento Fetal/fisiologia , Feto/embriologia , Ultrassonografia Pré-Natal/métodos , Adulto , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Gravidez
7.
J Ultrasound Med ; 35(4): 739-45, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26939599

RESUMO

OBJECTIVES: The purpose of this study was to describe the echocardiographic features and perinatal outcomes of congenital absence of the aortic valve diagnosed by first-trimester echocardiography. METHODS: This retrospective study assessed the feasibility of first-trimester echocardiography in detecting absence of the aortic valve. All cases of absence of the aortic valve diagnosed by first-trimester fetal echocardiography from January 2010 to December 2014 were identified at a single referral center using an established perinatal database. Demographic information, echocardiograms, perinatal outcomes, and autopsy reports were reviewed. Echocardiographic features were described. RESULTS: A total of 50,822 fetuses underwent first-trimester echocardiography during the study period. Ten cases of congenital absence of the aortic valve were diagnosed, for an overall incidence rate of 0.019%. The earliest gestational age at diagnosis was 11 weeks 6 days. The mean crown-lump length was 61.9 mm; mean gestational age was 12 weeks; and mean maternal body mass index ± SD was 21.2 ± 3.9 kg/m(2). Nine fetuses had increased nuchal translucency ranging from 2.4 to 12.4 mm (mean ± SD, 6.4 ± 3.6 mm). Color Doppler flow imaging revealed biphasic bidirectional flow in the ascending aorta and aortic arch and reversed flow in the ductus venosus during atrial systole in all cases. Reversed diastolic flow was present in the umbilical arteries and thoracic aorta. All cases had complex cardiac malformations as well as extracardiac abnormalities. CONCLUSIONS: Our study confirms that absence of the aortic valve is a rare cardiac defect that can be diagnosed by first-trimester fetal echocardiography. A "to-and-fro" flow pattern or biphasic bidirectional flow in the great arteries is a key echocardiographic feature in fetuses with absence of the aortic valve.


Assuntos
Valva Aórtica/anormalidades , Valva Aórtica/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/epidemiologia , Primeiro Trimestre da Gravidez , Ultrassonografia Pré-Natal/estatística & dados numéricos , China/epidemiologia , Ecocardiografia/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Mortalidade Fetal , Humanos , Incidência , Gravidez , Resultado da Gravidez/epidemiologia , Prognóstico , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
8.
Prenat Diagn ; 36(2): 117-26, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26573084

RESUMO

OBJECTIVE: We aim to determine the accuracy of first-trimester ultrasonography in detecting fetal limb abnormalities. METHODS: This is a retrospective study of all women undergoing fetal nuchal translucency (NT) assessment and detailed fetal anatomic survey in the first trimester at a single tertiary-care referral center in China. Fetal anatomy scans were repeated in the second trimester. Detection of fetal limb abnormalities was compared between first and second trimester anatomy scans and confirmed at delivery or at autopsy. RESULTS: Analyzed were 9438 fetuses from 9197 women (241 twin pairs). The incidence of fetal limb abnormalities was 0.38% (36/9438). Of these, 28 (77.8%) were diagnosed prenatally: 23 (63.9%) on first trimester scan and 5 (13.9%) on second trimester scan. Limb reduction defects (usually transverse limb deficiencies) were the most common limb defects identified in the first trimester (n = 12), followed by clubfoot (n = 4), skeletal dysplasia (n = 3), sirenomelia (n = 1), limb dysplasia (n = 1), malposition (n = 1), and syndactyly (n = 1). Nine fetuses with isolated limb abnormalities had normal NT, while 74.1% (20/27) of limb abnormalities that were associated with other abnormalities had increased NT. CONCLUSIONS: This study demonstrates that the majority of limb abnormalities detected prenatally [23/28 (82%)] can be identified in the first trimester, especially major limb defects; however, our numbers are small and still need larger cases for further investigation.


Assuntos
Deformidades Congênitas dos Membros/diagnóstico por imagem , Primeiro Trimestre da Gravidez , Ultrassonografia Pré-Natal/métodos , Adolescente , Adulto , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , China , Pé Torto Equinovaro/diagnóstico por imagem , Ectromelia/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Translucência Nucal , Gravidez , Estudos Retrospectivos , Sensibilidade e Especificidade , Sindactilia , Centros de Atenção Terciária , Adulto Jovem
9.
Nan Fang Yi Ke Da Xue Xue Bao ; 35(12): 1770-4, 2015 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-26714914

RESUMO

OBJECTIVE: To investigate the prenatal ultrasonic manifestations of fetal gray matter heterotopias (FGMH) and evaluate the optimal method its prenatal diagnosis. METHODS: The prenatal and postnatal ultrasound images and MRI images were analyzed for a fetus with a definitive diagnosis of FGMH. The detection rates of FGMH by prenatal ultrasound and MRI reported in literature were compared. RESULTS: We identified 11 reports of FGMH from 1998 to 2015, involving 43 cases with prenatal diagnoses. Of the total of 44 cases (including our case), 32 that had been confirmed postpartum had prenatal ultrasound and MRI data, which showed a significantly lower detection rates of FGMH by prenatal ultrasound than by MRI (43.8% vs 93.8%, P<0.001). CONCLUSION: Prenatal ultrasound can only detect subependymal heterotopia with characteristic manifestations, and the detection of other types of FGMH relies on MRI, which is currently the best option for prenatal diagnosis of FGMH.


Assuntos
Lissencefalias Clássicas e Heterotopias Subcorticais em Banda/diagnóstico , Doenças Fetais/diagnóstico , Substância Cinzenta/patologia , Diagnóstico Pré-Natal , Feminino , Feto , Humanos , Imagem por Ressonância Magnética , Gravidez , Ultrassonografia Pré-Natal
10.
Prenat Diagn ; 35(2): 103-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25201035

RESUMO

OBJECTIVE: To describe the incidence, prenatal diagnosis, and perinatal outcome in fetuses with congenital dacryocystocele. METHODS: All cases of congenital dacryocystocele diagnosed by prenatal ultrasound were identified using an established perinatal database. Prenatal ultrasound images were reviewed, and perinatal outcome was abstracted from the medical records. The correlation between the cyst size, gestational age, and prenatal and neonatal outcome was analyzed. RESULTS: The overall incidence of fetal dacryocystocele was 0.016% (75/456,202). Fifty-three cases (70.7%) had unilateral, and 22 (29.3%) had bilateral lesions. Lesions were seen more commonly among female fetuses with a female : male ratio 1.48 : 1. The average diameter of cysts size was 6.9 ± 1.9 mm (3.3-11 mm). There was a direct correlation between cyst size and gestational age. Among the 75 cases, 8 were lost to follow-up, 3 underwent elective termination of pregnancy. 58 resolved spontaneously before birth, and 6 were confirmed at birth. Two developed neonatal infection requiring antibiotic treatment. All 6 cases confirmed at birth resolved without surgical resection. CONCLUSIONS: Congenital dacryocystocele can be diagnosed by prenatal ultrasound. Such lesions typically resolve spontaneously in utero or in the early neonatal period. Thus, it should be considered as a developmental variant rather than a structural birth defect.


Assuntos
Cistos/diagnóstico por imagem , Doenças Fetais/diagnóstico por imagem , Obstrução dos Ductos Lacrimais/complicações , Adulto , China/epidemiologia , Cistos/congênito , Cistos/epidemiologia , Feminino , Doenças Fetais/epidemiologia , Doenças Fetais/etiologia , Humanos , Incidência , Obstrução dos Ductos Lacrimais/congênito , Obstrução dos Ductos Lacrimais/epidemiologia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal , Adulto Jovem
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 34(8): 1092-7, 2014 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-25176073

RESUMO

OBJECTIVE: To detect structural changes in the brain in fetuses with agenesis of the corpus callosum (ACC) and holoprosencephaly (HPE) in the first trimester. METHODS: The ultrasound data were analyzed retrospectively in 620 normal singleton fetuses between 11 and 13(+6) gestational weeks, 5 fetuses diagnosed to have ACC, and 13 fetuses with HPE. The midbrain diameter (MD) and falx diameter (FD) were measured and their ratio (MD/FD) was calculated for comparative analysis. RESULTS: No significant difference was found in the MD, FD, and MD/FD ratio between fetuses with ACC and HPE (P>0.05). Compared to the normal fetuses, all the fetuses with ACC and HPE showed significantly increased mean MD and MD/FD ratio (P<0.05); 4 (80%) fetuses with ACC and 11 (84.6%) with HPE had a reduced FD. All the fetuses with ACC and HPE had MD/FD ratios greater than 1, which were below 1 in all the normal fetuses. CONCLUSION: In the first trimester, fetuses with ACC and HPE have measurable abnormalities in the midbrain and falx area of the brain, and these changes, represented by abnormal midsagittal MD, FD and their ratio, can be of value in detecting ACC or HPE in fetuses in the first trimester.


Assuntos
Agenesia do Corpo Caloso/diagnóstico , Corpo Caloso/diagnóstico por imagem , Ultrassonografia Pré-Natal , Feminino , Feto , Idade Gestacional , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Estudos Retrospectivos
12.
Nan Fang Yi Ke Da Xue Xue Bao ; 34(7): 950-5, 2014 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-25057062

RESUMO

OBJECTIVE: To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13⁺6 gestational weeks and explore their clinical value in screening open spina bifida (OSB). METHODS: Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13⁺6 weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges. RESULTS: In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL; the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1. CONCLUSION: The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to fourth ventrical-cisterner magena anteroposterior diameter ratio greater than 1 can be indicative of OSB at 11 to 13⁺6 gestational weeks.


Assuntos
Primeiro Trimestre da Gravidez , Espinha Bífida Cística/diagnóstico por imagem , Ultrassonografia Pré-Natal , Tronco Encefálico , Cerebelo , Cisterna Magna , Fossa Craniana Posterior , Feminino , Quarto Ventrículo , Idade Gestacional , Humanos , Medição da Translucência Nucal , Gravidez , Valores de Referência
13.
J Clin Ultrasound ; 40(5): 301-5, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21952985

RESUMO

Diastematomyelia is a rare congenital disorder in which the spinal cord is divided longitudinally for part of its length. It can be accurately identified in the prenatal period by detailed sonographic examination of the spine. We report a case of diastematomyelia localized to spinal levels T6-T9 diagnosed prenatally at 31 weeks' gestation and review the existing literature on the diagnosis and management of this condition during pregnancy.


Assuntos
Defeitos do Tubo Neural/diagnóstico , Medula Espinal/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Aborto Terapêutico , Adulto , Diagnóstico Diferencial , Feminino , Idade Gestacional , Humanos , Imagem por Ressonância Magnética , Gravidez , Medula Espinal/anormalidades
14.
Nan Fang Yi Ke Da Xue Xue Bao ; 31(6): 987-90, 2011 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-21690051

RESUMO

OBJECTIVE: To evaluate the perinatal management and outcome of different types of fetal arrhythmia. METHODS: A retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a single institution between October 2003 and December 2010. RESULTS: A total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia during pregnancy was extrasystole (n=59), followed by bradycardia (n=23), tachycardia (n=16), atrial flutter (AF, n=3), atrioventricular block (AVB, n=12) and other arrhythmia (n=17). The overall incidence of cardiac anomalies (commonly fetal bradycardia) was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia (P=0.024), presence of congenital heart defect (CHD, P=0.000) and fetal hydrops (P=0.008) were significant risk factors associated with termination of pregnancy. CONCLUSION: Fetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination.


Assuntos
Arritmias Cardíacas/diagnóstico por imagem , Doenças Fetais/diagnóstico por imagem , Adulto , Arritmias Cardíacas/classificação , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Humanos , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Retrospectivos , Ultrassonografia Doppler em Cores , Ultrassonografia Pré-Natal , Adulto Jovem
15.
Prenat Diagn ; 31(4): 334-46, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21280058

RESUMO

OBJECTIVE: To describe the sonographic features and perinatal outcome of congenital vascular rings diagnosed prenatally at a single tertiary care institution. METHODS: All cases of congenital vascular rings diagnosed by prenatal ultrasound between July 2005 and December 2009 were identified at a single referral center using an established perinatal database. The diagnosis was confirmed by postnatal echocardiography for live-born infants or autopsy for terminated cases. RESULTS: The overall incidence of vascular ring during this 5-year period was 0.086% (81 cases among 94 321 women undergoing perinatal ultrasound examination). Forty-four cases had complete O-shaped (n = 3) or U-shaped (n = 41) vascular rings, and 37 cases had incomplete C-shaped vascular rings (vascular slings). The most common type of vascular ring seen in 50.6% (41/81) of cases was a right aortic arch with aberrant left subclavian artery. The second most common type was a left aortic arch with an aberrant right subclavian artery [39.5% (32/81)]. Chromosomal analysis was performed prenatally in 46 pregnancies, and six cases (13.0%) of fetal aneuploidy were identified. CONCLUSIONS: Congenital vascular rings can be diagnosed with prenatal ultrasound using the three-vessel trachea view and subsequent fetal echocardiography with particular attention to the relationship of the aortic arches, ductal arches, and the trachea.


Assuntos
Resultado da Gravidez/epidemiologia , Ultrassonografia Pré-Natal , Malformações Vasculares/diagnóstico por imagem , Aneurisma/diagnóstico por imagem , Aneurisma/patologia , Síndromes do Arco Aórtico/diagnóstico por imagem , Síndromes do Arco Aórtico/patologia , Anormalidades Cardiovasculares/diagnóstico por imagem , Anormalidades Cardiovasculares/patologia , Estudos de Casos e Controles , Estudos de Coortes , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/patologia , Feminino , Humanos , Recém-Nascido , Modelos Biológicos , Fenótipo , Gravidez , Prognóstico , Estudos Retrospectivos , Artéria Subclávia/anormalidades , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/patologia , Ultrassonografia Pré-Natal/estatística & dados numéricos , Malformações Vasculares/classificação , Malformações Vasculares/epidemiologia , Malformações Vasculares/patologia
16.
Rev Obstet Gynecol ; 4(3-4): 99-102, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22229061

RESUMO

Pulmonary hypoplasia is a rare congenital disorder; most cases occur in association with other congenital abnormalities, including congenital diaphragmatic hernia, oligohydramnios, and/or skeletal deformities. The authors report a case of unilateral pulmonary hypoplasia diagnosed prenatally and confirmed at autopsy.

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