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Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound 30/45MHZ System
Published on: May 5, 2018
Vascular ring: prenatal diagnosis and prognostic management based on sequential cross-sectional scanning by
Yi Zhou1, Yuanyuan Zhou1, Tingting Yu1
1Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, China.
Insights
Sequential cross-sectional observation (SCS) accurately diagnoses fetal vascular rings, improving prenatal care. This method aids in predicting respiratory symptoms based on ring shape and airway proximity.
Area of Science:
- Cardiology
- Pediatric Surgery
- Medical Imaging
Background:
- Vascular rings are congenital anomalies compressing the trachea or esophagus.
- Accurate prenatal diagnosis is crucial for timely treatment.
- Current prenatal diagnosis methods have high missed and misdiagnosis rates.
Purpose of the Study:
- To investigate the accuracy of prenatal diagnosis of vascular rings using SCS.
- To evaluate the prognosis of vascular rings based on ring shape and airway distance.
Main Methods:
- 37,875 fetuses underwent prenatal ultrasound from 2019-2021.
- Fetal echocardiography combined with dynamic sequential cross-sectional observation (SCS) was used.
- Vascular ring shape and airway proximity (Grades I-III) were assessed; monitoring occurred prenatally and postnatally.
Main Results:
- 418 cases of vascular rings were detected with no missed or misdiagnoses using SCS.
- Vessel shapes varied, influencing prognosis.
- Grade I, " and "O" rings indicated poor prognosis and higher respiratory symptom risk.
Conclusions:
- SCS provides accurate prenatal diagnosis of vascular rings.
- Ring morphology and airway proximity assessment guide prenatal monitoring.
- This approach aids in predicting and managing postnatal airway compression.
Background:
In terms of embryonic origin, vascular ring is a congenital anomaly in which the aortic arch and its branches completely or incompletely encircle and compress the trachea or esophagus. Early and accurate diagnosis of a vascular ring is the key to treatment. Prenatal diagnosis mainly relies on fetal echocardiography, but the rate of missed diagnosis and misdiagnosis is still very high, and the prognosis has not been evaluated. The aim of this study was to investigate the accuracy of prenatal diagnosis and to evaluate the prognosis semi-quantitatively according to the shape of the ring and the distance between the vessel and the trachea.
Methods:
From 2019 to 2021, 37,875 fetuses underwent prenatal ultrasound examination in our center. All fetal cardiac examinations were performed using the fetal echocardiography method proposed by the American Institute of Ultrasound in Medicine (AIUM) combined with dynamic sequential cross-sectional observation (SCS). For SCS, the standard abdominal section was taken as the initial section, and the probe was moved cephalically along the long axis of the body until the superior mediastinum had disappeared. If a vascular ring was found, the shape of the ring and the distance of the branch to the airway were observed. The distance relationship with the airway was divided into three grades: I-III; the closer the distance, the lower the grade. The vascular rings were monitored every 4 weeks before birth. All were monitored before surgery or 1 year after birth.
Results:
A total of 418 cases of vascular rings were detected. There was no missed diagnoses or misdiagnoses by SCS. The vessels formed different shaped rings according to their origin and route. Grade I, "" and "O" rings have a poor prognosis and are associated with the highest risk of respiratory symptoms.
Conclusions:
SCS can accurately diagnose vascular rings before delivery, evaluate the shape and size of the rings to conduct prenatal monitoring of children until birth, which plays a guiding role in airway compression after birth.
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