Three‐dimensional assessment of umbilical vein deviation angle for prediction of liver herniation in left‐sided congenital diaphragmatic hernia

Abstract

In fetuses with CDH, umbilical vein bowing may be quantified by measuring the UVDA using three-dimensional ultrasound. This sonographic marker seems to be an accurate predictor of liver herniation in left-sided CDH. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Expected small left heart size in the presence of congenital diaphragmatic hernia: Fetal values and Z-scores for infants confirmed to have no heart disease postnatally

“…Our findings are based on single-center data, which may limit generalizability. However, experienced ultrasonographers may be required for the consistent ascertainment of important fetal markers of CDH severity, with strong agreement between expert evaluators ( 5 , 8 , 27 , 44 – 47 ). Our prior work demonstrated acceptable interobserver variability for the measurements in the current study ( 25 , 44 ).…”

Predicting Perinatal Outcomes in Fetuses with Congenital Diaphragmatic Hernia Using Ultrasound and Magnetic Resonance Imaging

“…Liver herniation is commonly interpreted as a binary variable; hence, either “up” (in the thorax) or “down” (confined within the abdomen) 15–18 . Cases of CDH with a herniated liver have the following features upon ultrasound examination 19 : (1) coursing of the lateral segmental portal vessels toward or above the diaphragmatic ridge; (2) bowing of the umbilical segment of the portal vein (portal sinus) to the left mid-line, which can be quantified by measuring the umbilical vein deviation angle using three-dimensional ultrasound 20 ; (3) identification of a posteriorly positioned stomach within the fetal hemithorax (indirect criterion); and (4) the gallbladder and hepatic or umbilical veins may be abnormally located within the abdomen, which can be scaphoid 15 . Other considerations include a smaller than expected abdominal circumference for gestational age, and the gallbladder may be occasionally seen in the chest, a potential key diagnostic finding for right-sided CDH.…”

How to obtain diagnostic planes of the fetal central nervous system using three-dimensional ultrasound and a context-preserving rendering technology

“…Several Authors have focused on 3D US as a complementary tool in the evaluation of the secondary palate (25)(26)(27)(28)(29)(30)(31)(32) or the fetal mandible (24,33), and recent reports have suggested that the subjective (34)(35)(36)(37)(38)(39)(40) or semiautomated (41) detection of facial dysmorphisms using 3D US can contribute in the identification of highly suggestive features of genetic syndromes. Also skeletal (42)(43)(44), cardiac (45)(46)(47)(48)(49)(50)(51)(52)(53) and thoracoabdominal (54,55) imaging may benefit from 3D US assessment, while more recent advances in 3D imaging have focused on the implementation of intelligent software for the automated data extraction from 3D volume datasets for clinical purposes. Within this scenario, fetal intelligent navigation (56)(57)(58)(59) and the 5D CNS+ (60) software have been designed with the aim to provide the clinicians valuable and reliable tools capable to simplify the ultrasound assessment of the fetal heart and brain, respectively.…”