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Fetal cleft lip and palate detection by three-dimensional ultrasonography.
Ultrasound Obstet Gynecol. 2000 Sep; 16(4):314-20.UO

Abstract

OBJECTIVES

To demonstrate a standardized approach for the evaluation of cleft lip and palate by three-dimensional (3D) ultrasonography.

DESIGN

This was a retrospective study of seven fetuses with confirmed facial cleft anomalies. Post-natal findings were compared to a blinded review of 3D volume data from abnormal fetuses with seven other normal fetuses that were matched for gestational age. Upper lip integrity was examined by 3D multiplanar imaging. Sequential axial views were used to evaluate the maxillary tooth-bearing alveolar ridge contour and anterior tooth socket alignment. Alveolar ridge disruption suggested cleft palate. Premaxillary protrusion, either by multiplanar imaging or surface rendering, indicated bilateral cleft lip and palate.

RESULTS

Post-natal findings confirmed bilateral cleft lip and palate (four cases), unilateral cleft lip and palate (one case), and unilateral cleft lip (two cases). Multiplanar review identified all three fetuses with unilateral cleft lip, three of four fetuses with bilateral cleft lip, one fetus with unilateral cleft palate, and three of four fetuses with bilateral cleft palate. Surface rendering correctly identified all cleft lips, with the exception of one fetus, who was thought to have a unilateral cleft lip and palate, despite the actual presence of a bilateral lesion. One cleft palate defect was directly visualized by 3D surface rendering. No false-positives occurred.

CONCLUSION

Interactive review of standardized 3D multiplanar images allows one to evaluate labial defects, abnormalities of the maxillary tooth-bearing alveolar ridge, and presence of premaxillary protrusion for detecting cleft lip and palate anomalies. Surface rendering may increase diagnostic confidence for normal or abnormal studies. This technology provides an array of visualization tools that may improve the prenatal characterization of facial clefts, particularly of the palate.

Authors+Show Affiliations

Division of Fetal Imaging, Department of Obstetrics and Gynecology, William Beaumont Hospital, 3601 West Thirteen Mile Road, Royal Oak, MI 48073-6769, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11169306

Citation

Lee, W, et al. "Fetal Cleft Lip and Palate Detection By Three-dimensional Ultrasonography." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 16, no. 4, 2000, pp. 314-20.
Lee W, Kirk JS, Shaheen KW, et al. Fetal cleft lip and palate detection by three-dimensional ultrasonography. Ultrasound Obstet Gynecol. 2000;16(4):314-20.
Lee, W., Kirk, J. S., Shaheen, K. W., Romero, R., Hodges, A. N., & Comstock, C. H. (2000). Fetal cleft lip and palate detection by three-dimensional ultrasonography. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 16(4), 314-20.
Lee W, et al. Fetal Cleft Lip and Palate Detection By Three-dimensional Ultrasonography. Ultrasound Obstet Gynecol. 2000;16(4):314-20. PubMed PMID: 11169306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fetal cleft lip and palate detection by three-dimensional ultrasonography. AU - Lee,W, AU - Kirk,J S, AU - Shaheen,K W, AU - Romero,R, AU - Hodges,A N, AU - Comstock,C H, PY - 2001/2/13/pubmed PY - 2001/5/1/medline PY - 2001/2/13/entrez SP - 314 EP - 20 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 16 IS - 4 N2 - OBJECTIVES: To demonstrate a standardized approach for the evaluation of cleft lip and palate by three-dimensional (3D) ultrasonography. DESIGN: This was a retrospective study of seven fetuses with confirmed facial cleft anomalies. Post-natal findings were compared to a blinded review of 3D volume data from abnormal fetuses with seven other normal fetuses that were matched for gestational age. Upper lip integrity was examined by 3D multiplanar imaging. Sequential axial views were used to evaluate the maxillary tooth-bearing alveolar ridge contour and anterior tooth socket alignment. Alveolar ridge disruption suggested cleft palate. Premaxillary protrusion, either by multiplanar imaging or surface rendering, indicated bilateral cleft lip and palate. RESULTS: Post-natal findings confirmed bilateral cleft lip and palate (four cases), unilateral cleft lip and palate (one case), and unilateral cleft lip (two cases). Multiplanar review identified all three fetuses with unilateral cleft lip, three of four fetuses with bilateral cleft lip, one fetus with unilateral cleft palate, and three of four fetuses with bilateral cleft palate. Surface rendering correctly identified all cleft lips, with the exception of one fetus, who was thought to have a unilateral cleft lip and palate, despite the actual presence of a bilateral lesion. One cleft palate defect was directly visualized by 3D surface rendering. No false-positives occurred. CONCLUSION: Interactive review of standardized 3D multiplanar images allows one to evaluate labial defects, abnormalities of the maxillary tooth-bearing alveolar ridge, and presence of premaxillary protrusion for detecting cleft lip and palate anomalies. Surface rendering may increase diagnostic confidence for normal or abnormal studies. This technology provides an array of visualization tools that may improve the prenatal characterization of facial clefts, particularly of the palate. SN - 0960-7692 UR - https://www.unboundmedicine.com/medline/citation/11169306/Fetal_cleft_lip_and_palate_detection_by_three_dimensional_ultrasonography_ L2 - https://doi.org/10.1046/j.1469-0705.2000.00181.x DB - PRIME DP - Unbound Medicine ER -