Low-frequency high-definition power Doppler in visualizing and defining fetal pulmonary venous connections.
OBJECTIVE
The use of low-frequency high-definition power Doppler in assessing and defining pulmonary venous connections was investigated.


METHODS
Study A included 260 fetuses at gestational ages ranging from 18 to 36 weeks. Pulmonary veins were assessed by performing two-dimensional B-mode imaging, color Doppler flow imaging (CDFI), and low-frequency high-definition power Doppler. A score of 1 was assigned if one pulmonary vein was visualized, 2 if two pulmonary veins were visualized, 3 if three pulmonary veins were visualized, and 4 if four pulmonary veins were visualized. The detection rate between Exam-1 and Exam-2 (intra-observer variability) and between Exam-1 and Exam-3 (inter-observer variability) was compared. In study B, five cases with abnormal pulmonary venous connection were diagnosed and compared to their anatomical examination.


RESULTS
In study A, there was a significant difference between CDFI and low-frequency high-definition power Doppler for the four pulmonary veins observed (P < 0.05). The detection rate of each pulmonary vein when employing low-frequency high-definition power Doppler was higher than that when employing two-dimensional B-mode imaging or CDFI. There was no significant difference between the intra- and inter-observer variabilities using low-frequency high-definition power Doppler display of pulmonary veins (P > 0.05). The coefficient correlation between Exam-1 and Exam-2 was 0.844, and the coefficient correlation between Exam-1 and Exam-3 was 0.821. In study B, one case of total anomalous pulmonary venous return and four cases of partial anomalous pulmonary venous return were diagnosed by low-frequency high-definition power Doppler and confirmed by autopsy.


CONCLUSIONS
The assessment of pulmonary venous connections by low-frequency high-definition power Doppler is advantageous. Pulmonary venous anatomy can and should be monitored during fetal heart examination.
Department of Ultrasound, Henan Province Hospital, Zhengzhou, 450002, China.
Lin
L
Liu
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. yihuahecn@126.com.
Yihua
Y
He
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Zhian
Z
Li
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Xiaoyan
X
Gu
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Ye
Y
Zhang
Department of Ultrasound, Henan Province Hospital, Zhengzhou, 450002, China.
Lianzhong
L
Zhang
D015150:Echocardiography, Doppler / Q000379:methods*; D005333:Fetus; D005865:Gestational Age; D006801:Humans; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000196:embryology*; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal / Q000379:methods*
Fetal echocardiography; Low-frequency high-definition power Doppler; Pulmonary veins; Pulmonary venous connections; Visualization rate