HDlive rendering images of cyclopia and a proboscis in a fetus with normal chromosomes at 32 weeks of gestation.
HDlive rendering images of cyclopia and a proboscis in a fetus with normal chromosomes at 32 weeks of gestation.
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妊娠 32 周时染色体正常的胎儿的独眼和长鼻的 HDlive 渲染图像。
DOI：
10.1007/s10396-013-0466-z
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Mashima M.
中科院分区：
文献类型：
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作者：
Hata T;Hanaoka U;Mashima M.
HDlive 渲染模式兼具可调节照明和新的类肤颜色，使胚胎和胎儿具有自然且解剖学上真实的外观，并且已经有一些关于胎儿表面异常的产前 3D HDlive 渲染图像的报道 [1]。我们首次展示了使用 3D HDlive 渲染模式重建的妊娠 32 周时染色体正常的胎儿的独眼和长鼻的经验。一名 34 岁女性，妊娠 4，第 3 段，在妊娠 32 周时因胎儿前脑无裂畸形、胎儿长鼻、疑似膈疝、疑似胎儿生长受限 (FGR) 和羊水过多而被转诊至我们的超声诊所。由于患有2型糖尿病，她在本次怀孕期间从怀孕21周开始接受胰岛素注射。二维 (2D) 超声检查（Voluson E8，GE Healthcare，密尔沃基，威斯康星州，美国）显示胎儿前脑无裂畸形、独眼、长鼻、膈疝、室间隔缺损、FGR [估计胎儿体重为 1,418 g (-1.6 SD)] 和羊水过多。 3D HDlive 渲染模式（Voluson E8，GE Healthcare，密尔沃基，威斯康星州，美国；弯曲阵列经腹换能器，2-8MHz）清晰地描绘了独眼和长鼻（图 1）。 32周4天羊膜穿刺，染色体分析显示46XY。孕36周，阴道分娩男婴，体重2140g，脐动脉pH值为7.431，1min、8min阿普加评分分别为4、2。婴儿在产后2小时后死亡。父母未同意进行尸检。然而，新生儿尸检证实存在独眼和长鼻（图2）。胎儿面部的 3D HDlive 渲染图像比传统 3D 超声检查获得的图像更容易辨别，因为 3D HDlive 渲染模式提供的胎儿面部图像异常逼真，几乎无法区分实际照片和 HDlive 扫描 [2]。在本例中，3D HDlive 渲染模式显示了相同的解剖学逼真图像，以及独眼和长鼻的宏观发现。 3D HDlive 渲染模式有潜力补充传统 2D 超声在胎儿面部异常诊断中的作用，并且可以帮助产前了解复杂胎儿面部异常的诊断挑战[1]。
The HDlive rendering mode with both adjustable lighting and new skin-like colors gives the embryo and fetus a natural and anatomically realistic appearance, and there have been a few reports on antenatal 3D HDlive rendering images of fetal superficial abnormalities [1]. We present our first experience of cyclopia and a proboscis in a fetus with normal chromosomes at 32weeks of gestation reconstructed employing the 3D HDlive rendering mode. A 34-year-old woman, gravida 4, para 3, was referred to our ultrasound clinic at 32 weeks of gestation because of fetal holoprosencephaly, fetal proboscis, suspected diaphragmatic hernia, suspected fetal growth restriction (FGR), and hydramnios. She had received insulin injections since 21 weeks of gestation during this pregnancy because of type 2 diabetes. Two-dimensional (2D) sonography (Voluson E8, GE Healthcare, Milwaukee, WI, USA) revealed fetal alobar holoprosencephaly, cyclopia, a proboscis, diaphragmatic hernia, ventricular septal defect, FGR [estimated fetal weight was 1,418 g (-1.6 SD)], and hydramnios. The 3D HDlive rendering mode (Voluson E8, GE Healthcare, Milwaukee, WI, USA; curved array transabdominal transducer, 2–8MHz) clearly depicted cyclopia and a proboscis (Fig. 1). Amniocentesis was performed at 32 weeks and 4 days, and chromosome analysis showed 46XY.At 36 weeks of gestation, a male infant weighing 2,140 g was delivered vaginally, with an umbilical artery pH of 7.431, and Apgar scores of 4 and 2 at 1 and 8 min, respectively. The baby died 2 h after delivery. Permission to conduct an autopsy was not granted by the parents. However, postmorten examination of the neonate confirmed the presence of cyclopia and a proboscis (Fig. 2). The 3D HDlive rendering images of the fetal face are more readily discernible than those obtained by conventional 3D sonography because the 3D HDlive rendering mode provides such extraordinarily realistic imaging of the fetal face that it is almost impossible to differentiate between actual photographs and HDlive scans [2]. In the present case, the 3D HDlive rendering mode showed the same anatomically realistic images with macroscopic findings of cyclopia and a proboscis. The 3D HDlive rendering mode has the potential to supplement conventional 2D ultrasound in diagnosing fetal facial anomalies, and it can assist in the prenatal understanding of the diagnostic challenges of complicated fetal facial anomalies [1].