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First-Trimester Sonographic Evaluation of Palatine Clefts: A Novel Diagnostic Approach.
J Ultrasound Med. 2017 Jul; 36(7):1397-1414.JU

Abstract

OBJECTIVES

Sonographic evaluation of the palate is a difficult task, and most palatine clefts are diagnosed in the neonatal period because of the limitations of 2-dimensional (2D) sonography. The objective is to describe a sonographic technique based on 2D markers for screening of palatine clefts during the nuchal translucency scan and to assess the ability of 3-dimensional (3D) sonography in imaging the normal and abnormal palate.

METHODS

A total of 2014 women who enrolled for first-trimester screening were included in this prospective study. Screening for palatine clefts was done by 2D evaluation of bony landmarks of the palate, which were the appearance of the palatal line in the sagittal view, retronasal triangle in the coronal view, and alveolar ridge of the maxilla in the axial view followed, by 3D evaluation in suspicious cases. All cases included in the study were followed by second-trimester anomaly scans and evaluated postnatally. Additionally, in 100 consecutive normal cases, 3D evaluation of the palate was done.

RESULTS

Visualization of 2D landmarks could be done in all, and 3D assessment was feasible in 94% of cases. Fourteen cases, of which 5 were unilateral, 4 bilateral, and 2 median cleft lip and palate, 2 median cleft palate, and 1 atypical palatine cleft were identified. There were no false-positives results reported, and 1 case of a bifid uvula was missed.

CONCLUSIONS

The study demonstrates that evaluation of the palate can be done at the 11 to 14 week scan based on 2D markers and can also be assessed with 3D sonography. The inclusion of 2D markers in all 3 planes increases the sensitivity for detection of palatine clefts.

Authors+Show Affiliations

Shri Lakshmi Scan Center, Kaveripattinam, India.Department of Conservative Dentistry and Endodontics, Rajah Muthiah Dental College, Annamalai University, Chidambaram, India.Shri Lakshmi Scan Center, Kaveripattinam, India.Department of Radiology, Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals, Salem, India.Department of Radiology, Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals, Salem, India.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

28417474

Citation

Lakshmy, Selvaraj Ravi, et al. "First-Trimester Sonographic Evaluation of Palatine Clefts: a Novel Diagnostic Approach." Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, vol. 36, no. 7, 2017, pp. 1397-1414.
Lakshmy SR, Deepa S, Rose N, et al. First-Trimester Sonographic Evaluation of Palatine Clefts: A Novel Diagnostic Approach. J Ultrasound Med. 2017;36(7):1397-1414.
Lakshmy, S. R., Deepa, S., Rose, N., Mookan, S., & Agnees, J. (2017). First-Trimester Sonographic Evaluation of Palatine Clefts: A Novel Diagnostic Approach. Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 36(7), 1397-1414. https://doi.org/10.7863/ultra.16.05084
Lakshmy SR, et al. First-Trimester Sonographic Evaluation of Palatine Clefts: a Novel Diagnostic Approach. J Ultrasound Med. 2017;36(7):1397-1414. PubMed PMID: 28417474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - First-Trimester Sonographic Evaluation of Palatine Clefts: A Novel Diagnostic Approach. AU - Lakshmy,Selvaraj Ravi, AU - Deepa,Selvaraj, AU - Rose,Nity, AU - Mookan,Senthilkumar, AU - Agnees,Joy, Y1 - 2017/04/18/ PY - 2016/05/29/received PY - 2016/09/15/accepted PY - 2017/4/19/pubmed PY - 2018/3/24/medline PY - 2017/4/19/entrez KW - 2- and 3-dimensional sonography KW - cleft lip KW - cleft palate KW - first-trimester screening KW - obstetric ultrasound KW - orofacial clefts KW - prenatal diagnosis SP - 1397 EP - 1414 JF - Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine JO - J Ultrasound Med VL - 36 IS - 7 N2 - OBJECTIVES: Sonographic evaluation of the palate is a difficult task, and most palatine clefts are diagnosed in the neonatal period because of the limitations of 2-dimensional (2D) sonography. The objective is to describe a sonographic technique based on 2D markers for screening of palatine clefts during the nuchal translucency scan and to assess the ability of 3-dimensional (3D) sonography in imaging the normal and abnormal palate. METHODS: A total of 2014 women who enrolled for first-trimester screening were included in this prospective study. Screening for palatine clefts was done by 2D evaluation of bony landmarks of the palate, which were the appearance of the palatal line in the sagittal view, retronasal triangle in the coronal view, and alveolar ridge of the maxilla in the axial view followed, by 3D evaluation in suspicious cases. All cases included in the study were followed by second-trimester anomaly scans and evaluated postnatally. Additionally, in 100 consecutive normal cases, 3D evaluation of the palate was done. RESULTS: Visualization of 2D landmarks could be done in all, and 3D assessment was feasible in 94% of cases. Fourteen cases, of which 5 were unilateral, 4 bilateral, and 2 median cleft lip and palate, 2 median cleft palate, and 1 atypical palatine cleft were identified. There were no false-positives results reported, and 1 case of a bifid uvula was missed. CONCLUSIONS: The study demonstrates that evaluation of the palate can be done at the 11 to 14 week scan based on 2D markers and can also be assessed with 3D sonography. The inclusion of 2D markers in all 3 planes increases the sensitivity for detection of palatine clefts. SN - 1550-9613 UR - https://www.unboundmedicine.com/medline/citation/28417474/First_Trimester_Sonographic_Evaluation_of_Palatine_Clefts:_A_Novel_Diagnostic_Approach_ L2 - https://doi.org/10.7863/ultra.16.05084 DB - PRIME DP - Unbound Medicine ER -