Three-dimensional sonography in the prenatal diagnosis of aortic arch abnormalities

✍ Scribed by Sifa Turan; Ozhan M. Turan; Peccina Maisel; Peter Gaskin; Chris R. Harman; Ahmet A. Baschat

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 228 KB
• Volume: 37
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.20559

✦ Synopsis

Abstract

Purpose

To assess the added value of 3‐dimensional (3D) echocardiography with spatiotemporal image correlation (STIC) in the diagnosis of aortic arch abnormalities in fetuses with isolated abnormal upper thoracic 3‐vessel view (3VV).

Method

A total of 3,420 women underwent a targeted anatomic survey at 18–22 weeks' gestation in a 1‐year period. An isolated abnormal upper thoracic 3VV detected on 2‐dimensional (2D) imaging was followed up by conventional 2D echocardiography and 3D fetal echocardiography with STIC. Offline reconstruction by a second operator blinded to the suspected diagnosis was performed. Neonatal echocardiography and MRI with 3D reconstruction were performed to verify the prenatal diagnosis.

Result

Of the 3,420 patients referred, 4 had an isolated abnormal 3VV (0.09%). A right‐sided aortic arch (RAA, n = 3) and double aortic arch (DAA, n = 1) were suspected. In all aortic arch abnormalities, 3D fetal echocardiography and STIC correctly identified RAA with aberrant left subclavian artery in 3 cases and DAA in 1 case with a degree of definition that was equal to the confirmatory postnatal echocardiography and 3D MRI.

Conclusion

Although the 2D upper 3VV is a powerful screening tool for isolated aortic arch abnormalities, 3D fetal echocardiography with STIC allows an accurate prenatal characterization of the abnormality to a degree that is typically attainable only by post partum imaging. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2009