Four-dimensional sonography with spatiotemporal image correlation and tomographic ultrasound imaging in the prenatal diagnosis of anomalous pulmonary venous connections.

OBJECTIVES

To determine whether the use of 4-dimensional (4D) sonography with spatiotemporal image correlation (STIC) and tomographic ultrasound imaging (TUI) can provide additional information with respect to 2-dimensional (2D) echocardiography in the prenatal diagnosis of anomalous pulmonary venous connections.

METHODS

The study population consisted of 10 cases that were initially suspected to have total or partial anomalous pulmonary venous connections by prenatal 2D echocardiography between January 2008 and April 2011. All 10 cases were further examined and analyzed by 4D sonography with STIC-TUI. Detailed postnatal surgery or autopsy was performed on all 10 fetuses.

RESULTS

Total anomalous pulmonary venous connections were found in 5 cases, and a partial connection was diagnosed in 1 fetus postnatally. The remaining 4 cases were confirmed to have normal pulmonary venous connections. Four of the 5 fetuses with anomalous pulmonary venous connections had an additional major cardiac defect; 1 fetus had an isolated connection. Anomalous drainage was supracardiac to the superior vena cava in 2 cases, cardiac to the coronary sinus in 3, and partially infracardiac to the portal vein in remaining case. The pulmonary venous connections were completely and correctly visualized with 2D echocardiography in 2 of the 10 cases, partially identified in 4, and not distinguished completely in 4. Four-dimensional sonography imaging with STIC-TUI clearly visualized the connections in 9 of the 10 cases, and the remaining case was partially identified.

CONCLUSIONS

Four-dimensional sonography with STIC-TUI facilitates visualization of pulmonary venous connections, thus supplying additional information with respect to 2D echocardiography in the prenatal diagnosis of anomalous pulmonary venous connections.