Reference range of fetal thorax using two-dimensional and three-dimensional ultrasound VOCAL technique and application in fetal thoracic malformations

Author:

Lian Xihua,Xu Zhenhong,Zheng Liping,Zhu Zhixing,Ejiwale Tofunmi,Kumar Ayush,Cai Peiya,He Shaozheng,Liu Shunlan,Zhang Ying,Lyu GuorongORCID

Abstract

Abstract Background To establish the normal reference range of fetal thorax by two-dimensional (2D) and three-dimensional (3D) ultrasound VOCAL technique and evaluate the application in diagnosing fetal thoracic malformations. Methods A prospective cross-sectional study was undertaken involving 1077 women who have a normal singleton pregnancy at 13–40 weeks gestational age (GA). 2D ultrasound and 3D ultrasound VOCAL technique were utilized to assess fetal thoracic transverse diameter, thoracic anteroposterior diameter, thoracic circumference, thoracic area, lung volume, thoracic volume and lung-to-thoracic volume ratio. The nomograms of 2D and 3D fetal thoracic measurements were created to GA. 50 cases were randomly selected to calculate intra- and inter-observer reliability and agreement. In addition, the case groups including congenital skeletal dysplasia (SD) (15), congenital diaphragmatic hernia (CDH) (30), pulmonary sequestration (PS) (25) and congenital cystic adenomatoid malformation (CCAM) (36) were assessed by the nomograms and followed up subsequently. Results Both 2D and 3D fetal thoracic parameters increased with GA using a quadratic regression equation. The intra- and inter-observer reliability and agreement of each thoracic parameter were excellent. 2D fetal thoracic parameters could initially evaluate the fetal thoracic development and diagnose the skeletal thoracic deformity, and lung volume, thoracic volume and lung-to-thorax volume ratio were practical to diagnose and differentiate CDH, PS and CCAM. Conclusion We have established the normal fetal thoracic reference range at 13–40 weeks, which has a high value in diagnosing congenital thoracic malformations.

Funder

the key Clinical Specialty Discipline Construction Program of Fujian, P.R.C

the Research Project of Science and Technology Department of Fujian Province, China

the Youth Research Project of Health and Family Planning Commission of Fujian Province, China

the Quanzhou Science and Technology Project

the Research Project of Collaborative Innovation Center for Maternal and Infant Health Service Application Technology

Publisher

Springer Science and Business Media LLC

Subject

Radiology Nuclear Medicine and imaging

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