Does a new ultrasound flow modality improve visualization of neonatal pulmonary veins?

Blood flow imaging is a new ultrasound modality that supplements color Doppler imaging with angle-independent information of flow direction that is not influenced by velocity aliasing. This is done by visualizing the blood speckle movement superimposed on the color Doppler images. This study aimed to investigate whether this method improves the visualization of the pulmonary veins in neonates.

Twenty-six neonates with suspected congenital heart disease were prospectively examined with echocardiography and blood flow imaging of the pulmonary veins after parental consent. For each patient, blood flow imaging and color Doppler imaging cine loops were presented to four observers (pediatric cardiologist/cardiologists) in a random order. Questions regarding the pulmonary venous connections and the overall quality of the pulmonary vein imaging were evaluated on a visual analogue scale from 0 (worst) to 100 (best). The methods were compared within each observer using the Wilcoxon's exact signed-rank test.

Blood flow imaging (color Doppler imaging combined with the blood speckle movement) was consistently ranked as better than conventional color Doppler imaging for visualization of the pulmonary veins for all observers (all P-values < 0.002).

Blood flow imaging may improve the visualization of the pulmonary veins in neonates.