Feasibility of Transabdominal Real-time CDFI and HDFI Techniques for Fetal Pulmonary Vein Display in the First Trimester

Abstract

Objective: This study aimed to assess the feasibility and usefulness of transabdominal color Doppler flow imaging (CDFI) technology and the high-definition flow imaging (HDFI) technique in detecting fetal pulmonary veins (PVs) in the first trimester (11-13₊₆ weeks).

Methods: From December 2018 to October 2019, 328 pregnant women with 328 normal singleton fetuses (crown-rump length: 45-84 mm) who had undergone CDFI and HDFI scans for fetal heart and vessel examination were enrolled in this study. The cases were divided into three groups according to the gestational age: group A, 11⁺⁰ -11⁺⁶ weeks; group B, 12⁺⁰ -12⁺⁶ weeks; and group C, 13⁺⁰ -13⁺⁶ weeks. Baseline sonograms and CDFI and HDFI images were analyzed by two senior radiologists independently and blindly. The abilities of CDFI and HDFI to display PVs were compared.

Results: Successful PV display rates via CDFI and HDFI were 2.3% and 68.2% (P<0.01), 22.4% and 82.4% (P<0.01), 41.5% and 91.2% (P<0.01) for group A, group B, and group C, respectively. The total successful display rates for the two methods were 28.9% (CDFI) and 84.8% (HDFI) (P<0.01).

Conclusions: The HDFI technique is more valuable than CDFI for detecting PVs in early pregnancy (11-13⁺⁶ weeks). HDFI can detect at least one PV in all cases and may be used to detect pulmonary venous anomalies early.

Keywords: color Doppler flow imaging; first trimester; high-definition flow imaging; prenatal sonography; pulmonary vein.