This Article Full Text Full Text (PDF) Earn FREE CME Credit Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Espinoza, J. Articles by Hassan, S. S. Search for Related Content PubMed PubMed Citation Articles by Espinoza, J. Articles by Hassan, S. S.

The Role of the Sagittal View of the Ductal Arch in Identification of Fetuses With Conotruncal Anomalies Using 4-Dimensional Ultrasonography

Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland/Detroit, Michigan USA (J.E., R.R., J.P.K., F.G., O.E., L.F.G.); Department of Obstetrics and Gynecology (J.E., O.E., L.F.G., M.L.S., S.S.H.) and Center for Molecular Medicine and Genetics (R.R.), Wayne State University, Detroit, Michigan USA; and Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan USA (W.L.).

Address correspondence to Jimmy Espinoza, MD, Roberto Romero, MD, Perinatology Research Branch, NICHD/NIH/DHHS, Wayne State University/Hutzel Women’s Hospital, 3990 John R, Box 4, Detroit, MI 48201 USA. E-mail: espinoz{at}med.wayne.edu, prbchiefstaff{at}med.wayne.edu

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.

Key Words: congenital heart disease • ductus arteriosus • fetal echocardiography • prenatal diagnosis • spatiotemporal • spatiotemporal image correlation • 3-dimensional ultrasonography

Abbreviations: CHD, congenital heart defect • DORV, double-outlet right ventricle • 4D, 4-dimensional • STIC, spatiotemporal image correlation • 3D, 3-dimensional • 2D, 2-dimensional

This article has been cited by other articles:

				P. Jeanty, R. Chaoui, and F. Grochal A Review of Findings in Fetal Cardiac Section Drawings: Part 4: Sagittal and Parasagittal Views J. Ultrasound Med., June 1, 2008; 27(6): 919 - 923. [Abstract] [Full Text] [PDF]

				G. Rizzo, A. Capponi, O. Cavicchioni, M. Vendola, M. E. Pietrolucci, and D. Arduini Application of Automated Sonography on 4-Dimensional Volumes of Fetuses With Transposition of the Great Arteries J. Ultrasound Med., May 1, 2008; 27(5): 771 - 776. [Abstract] [Full Text] [PDF]