Abstract
Objective: To evaluate whether abnormal atrial morphology, which is well recognized in autopsy series, is detectable by fetal echocardiographic examination of the four-chamber view, and can therefore be utilized to differentiate left from right isomerism in heterotaxy syndromes. Methods: This study was a retrospective review of 30 cases with prenatally diagnosed heterotaxy syndromes. Ultrasound video recordings and still images were reviewed with respect to atrial morphology in the four-chamber view. In 25 cases the morphology of both atria was sufficiently well visualized on the recordings to be evaluated and only these were included in the study. Results: Two types of atrial morphology were distinguished in our cohort: a sickle-shape with the tip pointing laterally and apically, and a blunt shape resembling the usual atrial appearance in the four-chamber view. Nineteen out of the 25 cases (76%) presented with isomerism of the atria in the four-chamber view. Thirteen had bilateral sickle-shaped atrial morphology, all associated with left isomerism. Six had bilateral blunt-shaped atrial morphology, all associated with right isomerism. The atria of the remaining six cases were not isomeric, the right atrium being sickle-shaped and the left blunt-shaped. Five of the latter cases were associated with left and one with right isomerism. Conclusions: The majority of prenatally diagnosed heterotaxy syndromes seem to present with isomeric atrial morphology in the four-chamber view. In these cases a differentiation between left and right isomerism can be based on the two distinct types of atrial morphology. This may further enhance the prenatal differentiation of these syndromes.
Original language | English (US) |
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Pages (from-to) | 538-545 |
Number of pages | 8 |
Journal | Ultrasound in Obstetrics and Gynecology |
Volume | 26 |
Issue number | 5 |
DOIs | |
State | Published - Oct 2005 |
Externally published | Yes |
Keywords
- Atrial morphology
- Echocardiography
- Fetus
- Heterotaxy
- Isomerism
- Prenatal diagnosis
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
- Reproductive Medicine
- Radiology Nuclear Medicine and imaging
- Obstetrics and Gynecology