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Prenatal examination of the area and morphology of the atrioventricular valves using four‐dimensional ultrasound in normal and abnormal hearts
Author(s) -
Adriaanse B. M. E.,
Uittenbogaard L. B.,
Tromp C. H. N.,
Schaefer S. S.,
Heymans M. W.,
Vugt J. M. G.,
Haak M. C.
Publication year - 2015
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4569
Subject(s) - atrioventricular valve , medicine , tricuspid valve , cardiology , fetus , fetal echocardiography , diastole , ultrasound , mitral valve , systole , anatomy , prenatal diagnosis , pregnancy , ventricle , radiology , blood pressure , biology , genetics
Abstract Objective Our aim is to evaluate the feasibility to examine the morphology and area of the atrioventricular (AV) valves in normal fetuses and fetuses with cardiac defects using spatiotemporal image correlation (STIC). Methods Atrioventricular valves were analyzed longitudinally in STIC volumes of 74 normal fetuses between the 15th and 36th week of pregnancy. The valve area was measured in a rendered view in diastole, the number of valve leaflets in systole. Longitudinal data analysis was performed using linear mixed models. Fifty fetuses with cardiac defects were examined. Results Examination of 355 STIC volumes of normal fetuses showed in 82.5% sufficient quality. The tricuspid valve leaflets were seen in 200 (68.3%) volumes and the mitral valve leaflets in 219 (74.7%) volumes. The tricuspid valve showed in 61.1% a round, 29.0% rectangle, and 8.9% elliptical shape and the mitral valve in 60.1% round, 28.0% rectangle, and 10.9% elliptical. Regression analysis revealed a positive relationship of the valve area with gestational age ( p < 0.0001). Most heart defects with stenosis showed an area below the 5th percentile. Conclusion Prenatal examination of the morphology and area of the AV valves using four‐dimensional ultrasound is feasible. A rectangular valve opening is normal, which was visualized in about one third of the normal fetuses. © 2015 John Wiley & Sons, Ltd.