title: Three-vessel view of the fetal upper mediastinum: an easy means of detecting abnormalities of the ventricular outflow tracts and great arteries during obstetric screening.
abstract: The three-vessel view is a transverse view of the fetal upper mediastinum is as simple to obtain as the four-chamber view. It demonstrates the main pulmonary artery, ascending aorta and superior vena cava in cross- or oblique sections. The purposes of this study were to describe the normal anatomy of the three-vessel view and to analyze what anatomical changes would occur in this view when there are lesions of the ventricular outflow tracts and/or great arteries. Sonograms of 29 fetuses with lesions involving the ventricular outflow tracts and/or great arteries were reviewed. Three-vessel views were evaluated in terms of vessel size, number, arrangement and alignment. Twenty-eight of 29 fetuses showed an abnormal three-vessel view that included abnormal vessel size (n = 12), abnormal alignment (n = 8), abnormal arrangement (n = 7) and abnormal vessel number (n = 3). The vessel size was abnormal in obstructive lesions of the right (n = 4) or the left (n = 8) side of the heart. An abnormal alignment was seen in tetralogy of Fallot (n = 6) and double-outlet right ventricle (n = 2) that showed anterior displacement of the aorta. An abnormal arrangement was seen in complete (n = 4) and corrected (n = 1) transposition, double-outlet right ventricle (n = 1) and pulmonary atresia with ventricular septal defect (n = 1). Only two vessels were seen in truncus arteriosus (n = 1). Four vessels were seen in persistent left superior vena cava (n = 2). A fetus with pulmonary atresia and intact ventricular septum showed a normal three-vessel view. In conclusion, most of the lesions involving the ventricular outflow tracts and/or great arteries showed an abnormal three-vessel view.
authors.affiliation: Department of Ultrasound, Samsung Cheil Hospital, Seoul, Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Yoo
authors.forename: Y H
authors.initials: YH
authors.lastname: Lee
authors.forename: E S
authors.initials: ES
authors.lastname: Kim
authors.forename: H M
authors.initials: HM
authors.lastname: Ryu
authors.forename: M Y
authors.initials: MY
authors.lastname: Kim
authors.forename: H K
authors.initials: HK
authors.lastname: Choi
authors.forename: K S
authors.initials: KS
authors.lastname: Cho
authors.forename: A
authors.initials: A
authors.lastname: Kim
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008482:Mediastinum / Q000098:blood supply / Q000000981:diagnostic imaging / Q000196:embryology*; D011247:Pregnancy; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal / Q000379:methods*