The diagnostic value and prognostic assessment of three-dimensional ultrasound for fetal vein of Galen aneurysmal malformation
Objective To measure the volume of fetal vein of Galen aneurysmal malformations(VGAM)using three-dimensional ultrasound Virtual Organ Computer-Aided Analysis(VOCAL)and,in combination with clinical follow-up data,explore the prognostic value of VOCAL technology in assessing VGAM.Methods Ten singleton primigravida patients diagnosed prenatally with VGAM at Shiyan Maternal and Child Health Hospital from June 2019 to August 2023 were selected as study subjects.Ultrasound follow-up observations were conducted every two weeks,using both traditional measurement methods and VOCAL technology to obtain VGAM volumes V1 and V2.Fetal cardiovascular conditions,the status of the thoracoabdominal and pericardial cavities,and umbilical artery spectral data were also recorded.Results In nine cases with larger VGAM,follow-up revealed an increased cardiothoracic ratio and greater tricuspid regurgitation.Some of these cases also showed varying degrees of effusion in the thoracic,abdominal,or pericardial cavities,with reversed or absent diastolic blood flow in the umbilical artery spectrum.VGAM volume increased with gestational age,and traditional measurement values(V1)were consistently lower than the three-dimensional VOCAL measurements(V2),showing statistically significant differences(t values between 2.88 and 24.86,P＜0.05).All nine cases underwent induction of labor.In one case with a smaller VGAM volume,the prognosis was better;the cardiac abnormalities did not progress during follow-up,VGAM volume increased more slowly with gestational age,and the difference between V1 and V2 was not statistically significant(P＞0.05).After birth,this infant received interventional treatment with a favorable outcome.Conclusion The size of VGAM affects the prognosis of children and leads to extracranial abnormalities as the disease progresses.Three-dimensional ultrasound VOCAL technology is valuable for assessing the extent of intracranial VGAM lesions,providing important guidance for early clinical intervention and long-term treatment.
ultrasoundvirtual organ computer-aided analysisprenatal diagnosisvein of Galen aneurysmal nalformationinterventional treatment
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