Prenatal diagnosis of cleft palate by three-dimensional ultrasound

Chen, Min-Long; Chang, Chiung-Hsin; Yu, Chen-Hsiang; Cheng, Yi–Chen; Chang, Feng-Cheng

doi:10.1016/s0301-5629(01)00403-3

Cited by 52 publications

(34 citation statements)

References 29 publications

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“…We acknowledge that when a 2D image is not obtained, a 3D image might also be difficult to obtain. However, several authors reported that trained or specialized sonographers have an increased ability to diagnose cleft lips and their severity using 3DUS and need significantly shorter time periods to interpret findings [10,11,12,13,14,15,16,17,18]. Despite these benefits, the question of whether or not inexperienced sonographers can obtain similar results compared with experienced operators has never been studied.…”

Section: Discussionmentioning

confidence: 98%

Inexperienced Sonographers Can Successfully Visualize and Assess a Three-Dimensional Image of the Fetal Face Using a Standardized Ultrasound Protocol

Guenot

Baud²,

Lepigeon³

et al. 2013

Fetal Diagn Ther

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Introduction: A standardized three-dimensional ultrasonographic (3DUS) protocol isdescribed that allows fetal face reconstruction. Ability to identify cleft lip with 3DUS using this protocol was assessed by operators with minimal 3DUS experience. Material and Methods: 260 stored volumes of fetal face were analyzed using a standardized protocol by operators with different levels of competence in 3DUS. The outcomes studied were: (1) the performance of post-processing 3D face volumes for the detection of facial clefts; (2) the ability of a resident with minimal 3DUS experience to reconstruct the acquired facial volumes, and (3) the time needed to reconstruct each plane to allow proper diagnosis of a cleft. Results: The three orthogonal planes of the fetal face (axial, sagittal and coronal) were adequately reconstructed with similar performance when acquired by a maternal-fetal medicine specialist or by residents with minimal experience (72 vs. 76%, p = 0.629). The learning curve for manipulation of 3DUS volumes of the fetal face corresponds to 30 cases and is independent of the operator's level of experience. Discussion: The learning curve for the standardized protocol we describe is short, even for inexperienced sonographers. This technique might decrease the length of anatomy ultrasounds and improve the ability to visualize fetal face anomalies.

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Section: Discussionmentioning

confidence: 98%

Inexperienced Sonographers Can Successfully Visualize and Assess a Three-Dimensional Image of the Fetal Face Using a Standardized Ultrasound Protocol

Guenot

Baud²,

Lepigeon³

et al. 2013

Fetal Diagn Ther

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“…It allows for better characterization of the normal anatomy of the fetal face and has increased the diagnostic accuracy of anomalies. [4][5][6][7][8][9][10][11] Threedimensional ultrasonography can also enhance parents' understanding of anomalies and may allow for earlier bonding with their fetuses. It is important for sonologists and sonographers to have an understanding of how to evaluate the fetal face with 3DUS.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11] Three-dimensional ultrasonography enables fetal anatomy to be displayed in 3-orthogonal-plane and parallel-plane formats to allow for improved understanding of fetal anatomy and anomalies. It has become an important tool as an adjunct to 2DUS in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Benefits of a Systematic Approach in the Evaluation of Fetal Facial 3-Dimensional Volumes

Ramos

Kfir

D'Agostini

et al. 2011

Journal of Ultrasound in Medicine

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The benefits of using volume ultrasonography (3-dimensional ultrasonography [3DUS]) have been explored in diagnosing fetal anomalies 1-3 such as cleft lip and palate, 4-11 micrognathia, 12,13 congenital heart diseases, [14][15][16] and skeletal abnormalities. 17,18 However, clinical implementation of this new technology has been challenging for many reasons, including familiarity with the knobology and orientation within a volume of data. Training of physicians to use volume ultrasonography has been limited because of a lack of standardization, display, and manipulation of 3-dimensional (3D) volumes. 19 Abuhamad et al 20 recently showed that the Z technique was a useful method for teaching inexperienced physicians to obtain the coronal plane of the uterus from 3D volGladys A. Ramos, MD, Menashe Kfir, MD, Sujin Lee, MD, Deborah D'Agostini, RDMS, Tanya Wolfson, MA, Anthony Gamst, MD, Dolores H. Pretorius, MD Received November 3, 2010, ORIGINAL RESEARCHObjectives-The purpose of our study was to evaluate the accuracy and efficacy of using a systematic approach to teach maternal-fetal medicine physicians how to display a diagnostic fetal profile and palate using 3-dimensional ultrasonography (3DUS).Methods-Ten maternal-fetal medicine physicians were randomly assigned to 2 groups, A and B, and instructed on basic principles of 3DUS volume manipulation. Physicians in group A were asked to display the fetal profile in 5 volumes, including 1 fetus with abnormalities. Physicians in Group B were asked to display the fetal profile in the same 5 volumes after detailed instruction. The groups were combined, and detailed instruction was repeated. The physicians were asked to review an additional 5 volumes. In a separate session, the physicians were divided into their respective groups, and a similar exercise was repeated. This time, they were asked to display the fetal palate in 3-orthogonal-plane and parallel-plane images. The time required for manipulation was recorded. Images were reviewed for accuracy and clinical utility by 2 blinded experienced sonologists. Data were analyzed with mixed effects models.Results-Fetal profile and parallel-plane palate scores were significantly higher in group B (P < .001) compared to group A. There was no difference between groups in displaying the 3-orthogonal-plane image of the palate or after additional training for either group. The mean times for display did not differ between the groups. The time required for evaluation of the abnormal profiles was longer (P = .02) than that for evaluation of the normal profiles.Conclusions-Detailed instruction in obtaining 3DUS images of fetal profiles and palates improved the image quality obtained by physicians. Teaching physicians in a standardized way may help improve the use of 3DUS in clinical practice.

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“…6). [25][26][27][28] It allows obtaining of true midsagittal plane of the fetal face, important for appropriate evaluation of different facial structures, specially to measure the naso-frontal angle, the assessment of the ocular biometry and the interorbitary distance for the diagnosis of the hyper or hypotelorism, or the assessment of the maxilar and mandible in the diagnosis of micrognathia and retrognathia.…”

Section: Fetal Face Anomaliesmentioning

confidence: 99%

Ultrasonographic Evaluation of Fetal Face by 3D/4D Sonography

Azumendi¹,

Lausin²,

Pooh³

et al. 2008

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Abstract:The evaluation of the fetal face is an important part of every ultrasound examination since detailed facial examination can provide many information alerting the examiner about possible associated anomalies. Face and the brain have the same embryonic origin. By using 2 and 3D ultrasound techniques, it is possible to obtain clear images of different fetal face defects. Incorporation of the 4D ultrasonography made it possible to examine fetal behavior including fetal face movements. In that way using the ultrasound in the examination of the fetal face provides many new information not just about the morphology but also about neurological development and function of the fetal face.

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Prenatal diagnosis of cleft palate by three-dimensional ultrasound

Cited by 52 publications

References 29 publications

Inexperienced Sonographers Can Successfully Visualize and Assess a Three-Dimensional Image of the Fetal Face Using a Standardized Ultrasound Protocol

Inexperienced Sonographers Can Successfully Visualize and Assess a Three-Dimensional Image of the Fetal Face Using a Standardized Ultrasound Protocol

Benefits of a Systematic Approach in the Evaluation of Fetal Facial 3-Dimensional Volumes

Ultrasonographic Evaluation of Fetal Face by 3D/4D Sonography

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