Segmentary fetal branch pulmonary artery blood flow velocimetry: <i>in utero</i> Doppler study

Sivan, Eyal; Rotstein, Zeev; Lipitz, Shlomo; Sevillia, J.; Achiron, Reuven

doi:10.1046/j.1469-0705.2000.00268.x

Cited by 20 publications

(10 citation statements)

References 11 publications

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“…22,23 These studies established that at least 3 levels of bifurcation of pulmonary vessels were imaged in normal fetuses, leading us to consider this simple morphologic criterion for evaluating pulmonary arterial vasculature in fetuses with CDH.…”

Section: Discussionmentioning

confidence: 99%

“…The level of the section was chosen to obtain the largest possible cross-sectional image of the lung. The power Doppler angiogram was considered normal when the 3 distinct segments of the pulmonary vasculature 22,23 were clearly identified, that is, when at least 3 levels of bifurcation of the pulmonary vessels were imaged ( Figure 1A). The pulmonary angiogram was otherwise considered poor ( Figure 1, B and C) or absent ( Figure 1D).…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of Fetal Pulmonary Vasculature by Power Doppler Imaging in Congenital Diaphragmatic Hernia

Michelet

Aubry

Sayed

et al. 2004

J of Ultrasound Medicine

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Objective. To evaluate the feasibility of prenatal power Doppler imaging of pulmonary arteries in congenital diaphragmatic hernia and to study its potential to predict outcome. Methods. A prospective observational study was conducted. Forty-two cases of congenital diaphragmatic hernia (32 left and 10 right) without associated anomalies were analyzed. Qualitative evaluation of pulmonary vasculature was based on power Doppler imaging performed at 26 to 38 weeks. The pulmonary arteries were studied in the lung contralateral to the hernia. Pulmonary Doppler angiography was considered satisfactory when 3 levels of bifurcation defining 3 distinct segments of the pulmonary arteries were imaged and was otherwise considered poor. We also recorded the gestational age at diagnosis, side of the hernia, abdominal circumference below the third percentile, amniotic fluid volume, lung/thoracic area ratio, left/right ventricle ratio, and, in left-sided hernias, stomach position, and we carried out a multivariate analysis to determine the contribution of each factor to predict neonatal mortality. Results. More than 3 divisions of the fetal pulmonary arteries were imaged in 20 cases; 1 or 2 divisions or none were imaged in 22. Neonatal mortality was significantly greater when fewer than 3 divisions of the pulmonary arteries were imaged (18 [82%] of 22) than when 3 divisions could be identified on power Doppler imaging (5 [25%] of 20; P = .0005). However, the lung/thoracic area ratio was the only factor that remained significantly associated with mortality in the multivariate analysis. Conclusions. An altered pulmonary power Doppler image is associated with neonatal mortality, but estimation of the lung area remains the best predictor of neonatal outcome. Key words: congenital diaphragmatic hernia; lung/head ratio; lung/thorax ratio; power Doppler imaging; prenatal diagnosis; pulmonary hypoplasia; sonography. ongenital diaphragmatic hernia (CDH) diagnosed in utero has a neonatal mortality rate of 50% to 80%, 1-7 death being mainly due to pulmonary hypoplasia. Predicting the neonatal outcome prenatally remains a challenge. Moreover, prenatal staging of CDH is becoming increasingly important as new intrauterine therapeutic interventions emerge, including minimally invasive fetal surgery.8 So far, research on prenatal prediction of pulmonary hypoplasia has focused on using sonography or magnetic resonance imaging to assess the size of the lungs, 7,9-14 the degree of herniation of abdominal organs, 6,15,16 and the consequences of fetal hemodynamic changes on left ventricular size. 17,18 In CDH, however, pulmonary hypoplasia is associated with alterations of the pulmonary vasculature, accounting for potentially lethal postnatal pulmonary hypertension.19

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluation of Fetal Pulmonary Vasculature by Power Doppler Imaging in Congenital Diaphragmatic Hernia

Michelet

Aubry

Sayed

et al. 2004

J of Ultrasound Medicine

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“…With the advent of high‐resolution ultrasound technology, coupled with sophisticated Doppler and power Doppler angiography, it is now possible to evaluate fetal arterial62 and venous systems63. We therefore adopted Clements and Warner's classification system with modifications, based on 2D and Doppler ultrasound, and applied it to fetal findings.…”

Section: A Unified Concept For Congenital Lung Malformation and Its Cmentioning

confidence: 99%

Fetal lung lesions: a spectrum of disease. New classification based on pathogenesis, two‐dimensional and color Doppler ultrasound

Achiron

Hegesh

Yagel

2004

Ultrasound in Obstet & Gyne

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“…By contrast, the proximal branch is clearly identified, and it can be insonated at a consistent location with small angles on virtually all occasions. Furthermore, reference values throughout gestation are available for the parameters used in this study22, 31 and this allows the use of Z ‐scores for gestational age21, 32.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival following delayed presentation and resection of colorectal liver metastases (Br J Surg 2011: 98: 1309–1317)

Garden

2011

British Journal of Surgery

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Der Stellenwert von Wasserstoffbrücken und π‐Stapelung in isolierten „kalten“ Komplexen aus 2‐Pyridon (2PY) und 1,2,4,5‐Tetrafluorbenzol (4FB), Pentafluorbenzol (5FB) sowie Hexafluorbenzol (6FB) wurde untersucht. Lediglich für 2PY⋅6FB in der Gasphase wurde eine π‐Stapelung und ein breites UV‐Spektrum beobachtet, die übrigen 2PY⋅nFB‐Komplexe zeigten die für Dimere mit zwei Wasserstoffbrücken charakteristischen, gut aufgelösten Absorptionsspektren (siehe Bild).

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Segmentary fetal branch pulmonary artery blood flow velocimetry: in utero Doppler study

Cited by 20 publications

References 11 publications

Evaluation of Fetal Pulmonary Vasculature by Power Doppler Imaging in Congenital Diaphragmatic Hernia

Evaluation of Fetal Pulmonary Vasculature by Power Doppler Imaging in Congenital Diaphragmatic Hernia

Fetal lung lesions: a spectrum of disease. New classification based on pathogenesis, two‐dimensional and color Doppler ultrasound

Long-term survival following delayed presentation and resection of colorectal liver metastases (Br J Surg 2011: 98: 1309–1317)

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