Three-dimensional sonography in the prenatal diagnosis of aortic arch abnormalities.
OBJECTIVE
To assess the added value of 3-dimensional (3D) echocardiography with spatiotemporal image correlation (STIC) in the diagnosis of aortic arch abnormalities in fetuses with isolated abnormal upper thoracic 3-vessel view (3VV).


METHODS
A total of 3,420 women underwent a targeted anatomic survey at 18-22 weeks' gestation in a 1-year period. An isolated abnormal upper thoracic 3VV detected on 2-dimensional (2D) imaging was followed up by conventional 2D echocardiography and 3D fetal echocardiography with STIC. Offline reconstruction by a second operator blinded to the suspected diagnosis was performed. Neonatal echocardiography and MRI with 3D reconstruction were performed to verify the prenatal diagnosis.


RESULTS
Of the 3,420 patients referred, 4 had an isolated abnormal 3VV (0.09%). A right-sided aortic arch (RAA, n = 3) and double aortic arch (DAA, n = 1) were suspected. In all aortic arch abnormalities, 3D fetal echocardiography and STIC correctly identified RAA with aberrant left subclavian artery in 3 cases and DAA in 1 case with a degree of definition that was equal to the confirmatory postnatal echocardiography and 3D MRI.


CONCLUSIONS
Although the 2D upper 3VV is a powerful screening tool for isolated aortic arch abnormalities, 3D fetal echocardiography with STIC allows an accurate prenatal characterization of the abnormality to a degree that is typically attainable only by post partum imaging.
Turan
Sifa
S
Obstetrics, Gynecology and Reproductive Sciences, University of Maryland, Baltimore, MD 21201, USA.
Turan
Ozhan M
OM
Maisel
Peccina
P
Gaskin
Peter
P
Harman
Chris R
CR
Baschat
Ahmet A
AA
D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000196:embryology; D019560:Echocardiography, Three-Dimensional; D005260:Female; D005333:Fetus / Q000002:abnormalities; D006801:Humans; D011247:Pregnancy; D016037:Single-Blind Method; D016216:Ultrasonography, Prenatal / Q000379:methods*; D054079:Vascular Malformations / Q000000981:diagnostic imaging* / Q000196:embryology