Three-dimensional/four-dimensional spatiotemporal image correlation morphology of the ductus arteriosus in fetuses with pulmonary atresia undergoing neonatal ductal stenting.

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Pediatric Cardiology Pub Date : 2023-07-01 Epub Date: 2024-01-05 DOI:10.4103/apc.apc_95_23
Sonia Karapurkar, Aishwarya Gurav, Abish Sudhakar, Navaneetha Sasikumar, Raman Krishna Kumar, Balu Vaidyanathan
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引用次数: 0

Abstract

Background: The value of prenatal identification of morphology of ductus arteriosus in fetuses with congenital heart defects (CHD) with pulmonary atresia and duct-dependent pulmonary circulation (DDPC) in planning neonatal ductal stenting procedure is untested. The aim of the study is to analyze the utility of three-dimensional/four-dimensional (3D/4D) spatiotemporal image correlation (STIC) fetal echocardiography in delineating the morphology of ductus arteriosus in fetuses with DDPC undergoing neonatal ductal stenting.

Methods: In this retrospective study (2017-22), prenatal imaging of pulmonary artery (PA) anatomy, aortic arch sidedness, and morphology of ductus arteriosus (ductal origin was classified as vertical/horizontal and ductal course as tortuous/straight) was done using 3D/4D STIC imaging and volume datasets. Prenatal findings were correlated with angiographic findings during stenting and the degree of agreement was calculated.

Results: We included 27 fetuses with a prenatal diagnosis of CHD with DDPC who underwent neonatal ductal stenting. The accuracy of prenatal assessment of PA anatomy, branch PA stenosis, and arch sidedness was 100%, 92.6%, and 88.9%, respectively. The accuracy of prenatal assessment of ductal origin and course, compared with angiography, was 85.2% and 88.9%, respectively. Prenatal imaging had a diagnostic accuracy of 100% for vertical straight and horizontal tortuous ducts, 84.6% for vertical tortuous, and 67% for horizontal straight ducts. Duct stenting was successful in 25 (92.6%) babies; two died after the procedure from stent occlusion.

Conclusion: Fetal echocardiography using 3D/4D STIC imaging enables accurate delineation of the morphology of ductus arteriosus in fetuses with DDPC, thereby aiding parental counseling and planning neonatal ductal stenting.

接受新生儿动脉导管支架术的肺动脉闭锁胎儿动脉导管的三维/四维时空图像相关形态。
背景:先天性心脏缺陷(CHD)合并肺动脉闭锁和管道依赖性肺循环(DDPC)的胎儿在产前识别动脉导管形态对计划新生儿动脉导管支架植入术的价值尚未得到验证。该研究旨在分析三维/四维(3D/4D)时空图像相关(STIC)胎儿超声心动图在划分接受新生儿动脉导管支架术的DDPC胎儿动脉导管形态中的实用性:在这项回顾性研究(2017-22 年)中,利用三维/四维 STIC 成像和容积数据集对肺动脉(PA)解剖、主动脉弓两侧性和动脉导管形态(导管起源分为垂直/水平,导管走向分为迂曲/笔直)进行了产前成像。将产前检查结果与支架植入术中的血管造影结果进行关联,并计算两者的吻合程度:结果:我们共纳入了27名产前诊断为DDPC合并先天性心脏病的胎儿,他们都接受了新生儿导管支架植入术。产前评估PA解剖结构、PA分支狭窄和弓侧性的准确率分别为100%、92.6%和88.9%。与血管造影相比,产前评估导管起源和走向的准确率分别为 85.2% 和 88.9%。产前成像对垂直直管和水平迂曲导管的诊断准确率为 100%,对垂直迂曲导管的诊断准确率为 84.6%,对水平直管的诊断准确率为 67%。25名婴儿(92.6%)成功进行了导管支架植入术;两名婴儿在术后因支架闭塞而死亡:结论:使用三维/四维 STIC 成像进行胎儿超声心动图检查可准确划分 DDPC 胎儿动脉导管的形态,从而帮助父母进行咨询和计划新生儿动脉导管支架植入术。
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来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
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