The role of the sagittal view of the ductal arch in identification of fetuses with conotruncal anomalies using 4-dimensional ultrasonography

Jimmy Espinoza, Roberto Romero, Juan Pedro Kusanovic, Francesca Gotsch, Offer Erez, Wesley Lee, Luís F. Gonçalves, Mary Lou Schoen, Sonia S. Hassan

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Objective. Conotruncal anomalies represent one fifth of all congenital heart defects (CHDs) detected in the fetus. However, the spatial relationship of the great vessels is incorrectly defined in about 20% of these cases. The sagittal view of the ductal arch is considered a standard ultrasonographic view in fetal echocardiography and can be easily visualized using 4-dimensional (4D) ultrasonography. This study was designed to determine the role of this ultrasonographic plane for the prenatal diagnosis of conotruncal anomalies. Methods. We reviewed 4D volume data sets, acquired with the spatiotemporal image correlation technique, from fetuses with and without confirmed conotruncal anomalies. The visualization rate of the sagittal view of the ductal arch was compared among groups using standardized multiplanar views. Results. This study included 183 volume data sets from fetuses in the following groups: (1) normal echocardiographic findings (n = 130); (2) conotruncal anomalies (n = 18); and (3) other CHDs (n = 35). Volumes of poor image quality were excluded from analysis (8.2% [15/183]). The visualization rate of the sagittal view of the ductal arch was significantly lower in fetuses with conotruncal anomalies (5.6% [1/18]) than that in fetuses without abnormalities (93.1% [108/116]) and that in fetuses with other CHDs (79.4% [27/34]; P < .01). Absence of visualization of the sagittal view of the ductal arch was associated with a likelihood ratio of 9.44 (95% confidence interval, 5.8-15.5) to have conotruncal anomalies. Conclusions. The sagittal view of the ductal arch may play an important role in the screening and prenatal diagnosis of conotruncal anomalies in 4D ultrasonography.

Original languageEnglish
Pages (from-to)1181-1189
Number of pages9
JournalJournal of Ultrasound in Medicine
Volume26
Issue number9
DOIs
StatePublished - 1 Jan 2007
Externally publishedYes

Keywords

  • 3-dimensional ultrasonography
  • Congenital heart disease
  • Ductus arteriosus
  • Fetal echocardiography
  • Prenatal diagnosis
  • Spatiotemporal
  • Spatiotemporal image correlation

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