Premium
Clinical Trial of Multiplanar Real‐time 4‐ Versus 2‐Dimensional Sonographic Guidance for Transcervical Chorionic Villus Sampling
Author(s) -
Adeniji Beni,
Williams John,
Solt Ido,
Morales Carlos,
Alanakian Artemis,
Rotmensch Siegfried
Publication year - 2011
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2011.30.3.309
Subject(s) - medicine , chorionic villus sampling , wilcoxon signed rank test , sampling (signal processing) , chorionic villi , catheter , radiology , nuclear medicine , pregnancy , prenatal diagnosis , fetus , mann–whitney u test , computer science , genetics , filter (signal processing) , computer vision , biology
Objectives Real‐time 4‐dimensional (4D) sonography can visualize the location of a chorionic villus sampling (CVS) catheter simultaneously in 3 dimensions. We determined the utility of 4D versus 2‐dimensional (2D) sonographic guidance for transcervical CVS. Methods Chorionic villus sampling was performed on 40 patients at 10 to 13 weeks' gestation (20 in each study group). Primary outcomes were as follows: (1) time in seconds needed to complete the procedure; (2) procedure failure, defined as the inability to obtain an adequate sample by a single catheter insertion or a necessity to switch to the alternative imaging modality; and (3) acquisition of a sample of chorionic villi sufficient for cytogenetic analysis. Wilcoxon rank sum and Fisher exact tests were used for categorical and continuous variables, respectively.A , Two‐dimensional guidance of the transcervical chorionic villus sampling procedure. Arrows indicate the chorionic villus sampling catheter. B , Multiplanar 3‐dimensional guidance of the procedure.Results The procedure time was significantly longer in the 4D group than the 2D group (161.4 versus 80.4 seconds, respectively; P = .001). The success rate at first introduction of the catheter was higher for 2D guidance (90%) than 4D guidance (70%) but was not statistically significant with the study group sizes. Adequate sample sizes were obtained in all patients. The main limiting factor in 4D guidance was a low frame rate. Conclusions Our findings show the feasibility of 4D guidance for transcervical CVS, although at the expense of a prolonged procedure time when compared to 2D sonographic guidance. The value of 4D guidance for less experienced operators remains to be determined.