Three-dimensional ultrasonographic technology to assess and compare echodensity of fetal bowel, bone, and liver in the second trimester of pregnancy.

Khandelwal, Meena; Silva, J; Chan, Linda S.; Reece, E. Albert

doi:10.7863/jum.1999.18.10.691

Cited by 7 publications

(2 citation statements)

References 11 publications

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“…However, 13% of participants also stated they made comparisons to other fetal structures, such as liver and lung, concurring with previous studies. [11][12][13][14] These participants did not offer any additional detail on how this occurred in practice.…”

Section: Discussionmentioning

confidence: 99%

Fetal echogenic bowel: Is there a national consensus on identification and reporting?

Sevens

Chudleigh

2023

Ultrasound

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Introduction: Saving Babies’ Lives Care Bundle Version 2 highlights the importance of correct identification and reporting of echogenic bowel to improve maternal and newborn outcomes. Yet there is no national consensus to guide sonographers in identifying and reporting fetal echogenic bowel. This two-phase study aims to develop a national consensus to guide sonographers on the identification, classification and reporting of fetal echogenic bowel during the Fetal Anomaly Screening Programme (FASP) second trimester anomaly scan. Phase 1 results are presented capturing the national current practice of sonographers in its identification. Methods: An online questionnaire survey was deployed to capture numerical and free text data. Data analysis was by descriptive statistics. Participants were recruited via social media and through professional networks and organisations. Results: A total of 95 participants completed the questionnaire during an 11-week period. Common practice across England included sonographers using a subjective method for identifying fetal echogenic bowel and making comparisons to fetal bone. However, there was wide variance in the fetal bone used and the transducer frequency typically used to assess bowel echogenicity. Confirmation of echogenic bowel was made at the 20-week scan in 58% of cases, 32% following fetal medicine department review with the remaining 10% unsure when confirmation occurred. Conclusion: While there is common practice in identifying and report echogenic fetal bowel in some areas, there remains disparity within sonographer practice in England’s national screening service. This study allowed baseline data to be collated, providing the first steps towards development of guidance for sonographers in identifying and reporting this appearance.

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Section: Discussionmentioning

confidence: 99%

Fetal echogenic bowel: Is there a national consensus on identification and reporting?

Sevens

Chudleigh

2023

Ultrasound

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“…The subjective assessment does not appear to depend on sonographer experience 12 . Khandelwal et al 13 attempted to objectively measure the echogenicity of the fetal bowel, comparing it to the echogenicity of the liver and bone using a grayscale distribution (0–255), and found that the echogenicity of the liver, bone, and bowel was constant during weeks 15 to 24 of gestation, and it varied widely after 26 weeks. Despite this objective measurement, the normal range was still wide, making the diagnosis of fetal bowel echogenicity difficult.…”

Section: Discussionmentioning

confidence: 99%

Effect of B‐Mode Optimization Techniques on Fetal Bowel Echogenicity Using Computerized Image Analysis

Karayanni-Ammuri

Ohel

Degani

et al. 2013

J of Ultrasound Medicine

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chogenic bowel, first described by Nyberg et al in 1990, 1,2 refers to the sonographic finding of hyperechoic bowel or bowel echogenicity similar to that of fetal bone. 3 The incidence of this finding ranges between 0.2% and 1.4% (1% on average) in the second trimester of pregnancy. [4][5][6] Although usually a normal variant in the early second trimester, 7 it has been associated with pathologic conditions, including aneuploidy, cystic fibrosis , congenital fetal bowel obstruction, intra-amniotic bleeding, congenital infections, intrauterine growth restriction, and intrauterine fetal death. 4,[6][7][8] The diagnosis of echogenic bowel is problematic because of the subjective nature of the diagnosis. [4][5][6]9,10 High-frequency probes, harmonic imaging, and speckle reduction imaging may increase the contrast of the sonogram image and result in an examiner's impresRasha Karayanni-Ammuri, MD, Gonen Ohel, MD, Shimon Degani, MD, Amer Zreik, MD, Marwan Odeh, MD, Israel Shapiro, MD, Zvi Leibovitz, MD Received September 14, 2012, ORIGINAL RESEARCHObjectives-The purpose of this study was to provide and compare measurable parameters for normal fetal bowel echogenicity under predefined B-mode scanning presets.Methods-Forty healthy fetuses underwent 14-to 17-week ultrasound scans, and 40 underwent 21-to 25-week scans. Sagittal, coronal, and axial fetal abdominal images were tested using predefined B-mode presets. The presets differed from fundamental imaging by isolated activation of harmonic imaging, compound resolution imaging, speckle reduction imaging, focus and frequency composite imaging, and coded excitation imaging features. A transabdominal probe was used in all fetuses, and transvaginal images were added for the 14-to 17-week scans. The images were studied with customdeveloped software, which provided a grayscale analysis of the pixels in the region of interest within the image. The mean brightness of the pixels from the fetal bowel area was calculated.Results-The 14-to 17-week transabdominal scans showed significantly higher mean brightness on harmonic imaging compared to fundamental imaging (P < .01). Activation of coded excitation and compound resolution imaging in these scans resulted in a significant decrease in the mean brightness compared to fundamental imaging. Mean bowel brightness values on the 21-to 25-week transabdominal scans did not differ significantly with the use of the different imaging presets compared to fundamental imaging.Conclusions-Transabdominal harmonic imaging in the early second trimester may significantly increase the mean brightness of the fetal bowel tissue. Contrarily, compound resolution imaging and coded excitation imaging produce the opposite effect on bowel echogenicity.

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Ultraschallscreening im 2. Trimenon

Hackelöer

Hecher

2002

Gynäkologe

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Three-dimensional ultrasonographic technology to assess and compare echodensity of fetal bowel, bone, and liver in the second trimester of pregnancy.

Cited by 7 publications

References 11 publications

Fetal echogenic bowel: Is there a national consensus on identification and reporting?

Fetal echogenic bowel: Is there a national consensus on identification and reporting?

Effect of B‐Mode Optimization Techniques on Fetal Bowel Echogenicity Using Computerized Image Analysis

Ultraschallscreening im 2. Trimenon

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