Use of Energy Color Doppler in Visualizing Fetal Pulmonary Vascularization to Predict the Absence of Severe Pulmonary Hypoplasia

Roth, P.; Agnani, G.; Arbez-Gindre, Francine; Pauchard, Jean-Yves; Burguet, A.; Schaal, J.-P.; Maillet, R

doi:10.1159/000010023

Cited by 10 publications

(6 citation statements)

References 20 publications

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“…In essence, color Doppler is also based on this principle, even though the number of pulses is relatively few per investigated beam (usually [4][5][6][7][8][9][10][11][12][13][14][15][16], and the signal processing is different from the spectral Doppler. Here, not the entire frequency spectrum is analysed by means of Fourier analysis, but only the mean Doppler shift in small sample volumes along the beam by employing what is referred to as the autocorrelation algorithm.…”

Section: Power Doppler Ultrasound (Pdu)mentioning

confidence: 99%

“…Pooh et al [15] showed the vascular pattern of fetal brain using transvaginal PDU from 12 to 30 weeks of gestation. Roth et al [16] were the first to correlate the absence of fetal lung vascularization, investigated with PDU, and lung hypoplasia. Dubiel et al [17] described fetal lung blood movements after 28 weeks of gestation.…”

Section: Power Doppler Ultrasound (Pdu)mentioning

confidence: 99%

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Fractional Moving Blood Volume Measurement Using Power Doppler Ultrasound as an Estimation of Fetal Organ Blood Perfusion

Hernández‐Andrade¹,

Jansson²,

Maršál

2006

CMIR

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Fractional moving blood volume (FMBV) estimated using power Doppler ultrasound (PDU) is a sensitive technique to detect slow blood movement. However, several factors as; depth, attenuation and blood characteristics can affect the PDU signals. The aim of this study was to standardized and validate the FMBV measurement compensating for the factors that can affect the final results, in order to accurate estimate blood movement in a specific region of interest (ROI) of fetal organs as an estimation of blood perfusion.FMBV measurement for the fetal lung blood perfusion was standardized in 29 healthy fetuses at 35-37 weeks of gestation. Clear definition of the ROI in both fetal lungs was proposed. FMBV values were in the range of 27-42% (mean 36.2%) and showed a coefficient of variation of 0.14. No significant differences between the FMBV values obtained from the left and the right lungs, or between cardiac systole and diastole were observed. A phantom experimental study showed good sensitivity for slow blood movement.FMBV was then compared with blood perfusion measurements evaluated with radioactive labeled microspheres (RMS) in the adrenal gland of 5 fetal lambs exposed to severe asphyxia. There was a high correlation between FMBV and RMS (r=0.90, range 0.43-0.99).The reproducibility and agreement analyses showed an intraclass correlation coefficient of 0.92 (95% confidence intervals [CI] 0.78-0.96), and a mean difference between observers of 0.06 (SD, 3.7).Conclusion. The estimation of the fractional moving blood volume measurement using power Doppler ultrasound can be reliable correlated with true fetal organ blood perfusion. FMBV is a reproducible method that can offer valuable information about adaptive fetal blood flow changes in the presence of pregnancy associated complications.

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Section: Power Doppler Ultrasound (Pdu)mentioning

confidence: 99%

Section: Power Doppler Ultrasound (Pdu)mentioning

confidence: 99%

Fractional Moving Blood Volume Measurement Using Power Doppler Ultrasound as an Estimation of Fetal Organ Blood Perfusion

Hernández‐Andrade¹,

Jansson²,

Maršál

2006

CMIR

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“…These studies showed that comparable to the assessment of pulmonary vessels in healthy fetuses, identification of the proximal fetal pulmonary vessels is primarily possible by the use of 2D power Doppler. 29,30 In line with abbreviations given in the selected articles, the parameters assessed in the pulmonary vessels ipsilateral or contralateral to the diaphragmatic defect are described as "ipsilateral [parameter]" or "contralateral [parameter]" respectively. All reported findings concern left-sided CDH (LCDH) fetuses, if it concerns right-sided CDH (RCDH), this is reported specifically.…”

Section: Main Findingsmentioning

confidence: 99%

Prenatal assessment of pulmonary vasculature development in fetuses with congenital diaphragmatic hernia: A literature review

et al. 2023

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Pathophysiological studies have shown that pulmonary vascular development is impaired in fetuses with a congenital diaphragmatic hernia (CDH), leading to a simplified vascular tree and increased vascular resistance. Multiple studies have described prenatal ultrasound parameters for the assessment of the pulmonary vasculature, but none of these parameters are used in daily clinical practice. We provide a comprehensive review of the literature published between January 1990 and February 2022 describing these parameters, and aim to explain the clinical relevance of these parameters from what is known from pathophysiological studies. Prenatal detection of a smaller diameter of the contralateral (i.e. contralateral to the diaphragmatic defect) first branch of the pulmonary artery (PA), higher pulsatility indices (PI), higher peak early diastolic reverse flow values, and a lower vascularization index seem of added value for the prediction of survival and, to a lesser extent, morbidity. Integration within the routine evaluation is complicated by the lack of uniformity of the methods used. To address the main components of the pathophysiological changes, we recommend future prenatal studies in CDH with a focus on PI values, PA diameters and pulmonary vascular branching.

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“…Magnetic resonance imaging lung volume measurements may be helpful, especially if oligohydramnios hampers ultrasound, but MRI was not superior to oligohydramnios in predicting outcome in the only published study . Studies of pulmonary perfusion either by conventional Doppler ultrasound or after maternal hyperoxygenation have also not included renal survivors. Meta-analysis could not confirm that the amniotic lecithin to sphingomyelin ratio predicts lung maturity …”

Section: Prenatal Assessmentmentioning

confidence: 99%

Perinatal Diagnosis, Management, and Follow-up of Cystic Renal Diseases

et al. 2018

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IMPORTANCEPrenatal and neonatal cystic kidney diseases are a group of rare disorders manifesting as single, multiple unilateral, or bilateral cysts or with increased echogenicity of the renal cortex without macroscopic cysts. They may be accompanied by grossly enlarged kidneys, renal oligohydramnios, pulmonary hypoplasia, extrarenal abnormalities, and neonatal kidney failure. The prognosis is extremely variable from trivial to very severe or even uniformly fatal, which poses significant challenges to prenatal counseling and management.OBJECTIVE To provide a clinical practice recommendation for fetal medicine specialists, obstetricians, neonatologists, pediatric nephrologists, pediatricians, and human geneticists by aggregating current evidence and consensus expert opinion on current management of cystic nephropathies before and after birth.METHODS After 8 systematic literature reviews on clinically relevant questions were prepared (including 90 studies up to mid-2016), recommendations were formulated and formally graded at a consensus meeting that included experts from all relevant specialties. After further discussion, the final version was voted on by all members using the Delphi method. The recommendations were reviewed and endorsed by the working groups on inherited renal disorders of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) and European Society for Paediatric Nephrology (ESPN); the German Society of Obstetrics and Gynecology (DGGG), German Society of Perinatal Medicine (DGPM), and German Society of Ultrasound in Medicine (DEGUM); and the alliance of patient organizations, PKD International. RECOMMENDATIONSThe group makes a number of recommendations on prenatal and postnatal imaging by ultrasound and magnetic resonance imaging, genetic testing, prenatal counseling, in utero therapeutic interventions, and postnatal management of prenatal and neonatal cystic kidney diseases, including provision of renal replacement therapy in neonates. In addition to detailed knowledge about possible etiologies and their prognosis, physicians need to be aware of recent improvements and remaining challenges of childhood chronic kidney disease, neonatal renal replacement therapy, and intensive pulmonary care to manage these cases and to empower parents for informed decision making.

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Use of Energy Color Doppler in Visualizing Fetal Pulmonary Vascularization to Predict the Absence of Severe Pulmonary Hypoplasia

Cited by 10 publications

References 20 publications

Fractional Moving Blood Volume Measurement Using Power Doppler Ultrasound as an Estimation of Fetal Organ Blood Perfusion

Fractional Moving Blood Volume Measurement Using Power Doppler Ultrasound as an Estimation of Fetal Organ Blood Perfusion

Prenatal assessment of pulmonary vasculature development in fetuses with congenital diaphragmatic hernia: A literature review

Perinatal Diagnosis, Management, and Follow-up of Cystic Renal Diseases

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