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Evaluation of Fetal Cardiac Function in Twin-twin Transfusion Syndrome by Color Doppler Ultrasonography and Two-dimensional Strain Imaging

Author: ZhaoSheng
Tutor: DengYouBin
School: Huazhong University of Science and Technology
Course: Medical Imaging and Nuclear Medicine
Keywords: Two-dimensional strain Twin-twin transfusion syndrome Echocardiography Fetus twin-twin transfusion syndrome echocardiography Twin-twin transfusion syndrome
CLC: R714.5
Type: PhD thesis
Year: 2011
Downloads: 21
Quote: 0
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Abstract


PART I Assessment of right ventricular function in recipient fetus of twin-twin transfusion syndrome with two-dimensional strain imagingObjective To evaluate the value of two-dimensional strain imaging in assessing right ventricular function of recipient fetus in TTTS pregnancies.Methods This study included 16 TTTS pregnancies and 19 normal monochorionic diamniotic pregnancies(controls). Doppler studies of the umbilical artery, umbilical vein, ductus venosus, middle cerebral artery, atrioventricular valve and semilunar value were recorded in both fetus, and myocardial performance index of both ventricles was calculated. Longitudinal peak systolic strain of right ventricular were calculated and compared between recipient fetus and other fetus.Results (1) Cardiothoracic ratio and myocardial performance index of right ventricular showed significant differences between recipient fetus and controls. (2) Right ventricular strain was decreased in recipient fetus compared with controls.Conclusions Two-dimensional strain imaging can be uesed to evaluate right ventricular myocardial function in the recipient fetus of TTTS. PART II Assessment of cardiac function in recipient twin of twin-twin transfusion syndrome with color Doppler ultrasoundObjective To evaluate the value of color Doppler in assessing cardiac function of recipient twin in twin-twin transfusion syndrome (TTTS) pregnancies.Methods This study included 17 TTTS pregnancies. Doppler studies of the umbilical artery, umbilical vein, ductus venosus, middle cerebral artery, atrioventricular valve and semilunar value were recorded in both fetus, and cardiothoracic ratio, heart rate, myocardial performance index of both ventricles were calculated.Results (1)The estimated fetal weight, Cardiothoracic ratio, myocardial performance index of right ventricle in recipient twins were significant higher than that of donor twin. (2)The incidence of abnomal Doppler findings in umbilical vein, ductus venosus and tricuspid valve of recipient twin were all significantly higher than that of donor twin. (3)There were two recipient twin manifesting right ventricular outflow tract obstruction in this study.Conclusions Color Doppler imaging can be used to evaluate cardiac dysfunction in the recipient twin. PARTâ…¢Assessment of cardiovascular function in donor fetus of twin-twin transfusion syndrome with color Doppler ultrasonographyObjective To evaluate the value of 2D and color Doppler ultrasonography in assessing cardiac function of donor fetus in twin-twin transfusion syndrome (TTTS) pregnancies.Methods 17 TTTS pregnancies and 19 normal monochorionic diamniotic pregnancies(controls) were including in this study. To observe the cardiac funtion of donor fetus, Doppler patterns of the umbilical artery, umbilical vein, ductus venosus and myocardial performance index of both ventricles were assessed in all fetus.Results Absent or reversed diastolic blood flow in umbilical artery were found in 7 donor fetus. One donor fetus showed increased cardiothoracic ratio and pericardial effusion. Pulsatility index of the ductus venosus in donor fetus were significant higher than that of controls.Conclusions Mild cardiovascular abnormalities were found in donor fetus, and follow-up examination were helpful in assess the severity of this disease.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Fetus
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