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DETECTING CONGENITAL HEART DEFECTS IN THE WOMB

June 8, 2020

Leiden University Medical Centre (LUMC) in Leiden has a strong specialist team, program and follow-up program in fetal medicine and surgery and performs all these specialist procedures for the whole of the Netherlands. It is a world-leader in certain conditions. It has found that the outstanding clinical precision, high image quality, reliability and speed of Canon Medical’s Aplio-i series ultrasound, as well as options, such as speckle tracking, increase diagnostic confidence in detecting fetal abnormalities.
High quality images

An increasing number and range of fetal abnormalities can be detected with advanced technology and the improved visibility obtainable from imaging equipment. However, it is not always easy to ascertain what these abnormalities really mean for the life of the fetus, especially in areas like brain defects. Making an accurate prognosis is the challenge. The more information that can be gained on the abnormality, the easier this is.

Ultrasound is the first choice modality in fetal imaging and good equipment with the latest technology is key. The fetal unit at LUMC has three Aplio i800 systems, which it has used for the past three years – A decision they have never regretted. In particular, the team finds the system’s image quality superb, especially in use for challenging patients. For example, in obese mothers-to-be, from which obscured images are often obtained. Image quality during the intricate procedures involved in fetal surgery is crucial and determines how long the procedures take. With the Aplio i-series, more patients can be examined in a reduced time, a clear benefit in fetal surgery.

Additional innovations

Innovation in ultrasound is welcome. New technologies like speckle tracking, are extremely useful in detecting heart defects, in addition to standard 2D and Doppler ultrasound. Canon was one of the first to offer excellent speckle tracking. Myocardial Performance Index (MPI) and Wall Motion Tracking (WMT) are especially interesting to explore in fetuses with conditions that affect one chamber of the heart. They may, for example, be able to help predict which fetuses will develop fibrotic heart disease, and which will end up with a preserved left ventricle of the heart.

Another useful technique on the Aplio i-series is Superb Micro-Vascular, which expands the range of visible blood flow and provides visualization of low micro-vascular flow. Benefits compared to conventional Doppler technologies are high frame rates, high resolution, high sensitivity and fewer motion artefacts, offering clinicians new means to reveal minute vessels when evaluating fetal brain, kidneys or any other tiny vessels.

Huge decisions can result from tiny indications

The need for precision, high quality and reliability are of particular importance in fetal healthcare, in which lives are often at stake. There is a huge psychological impact when reporting fetal abnormalities, and technology that helps provide more accuracy is essential. Diagnosis can lead to pregnancy termination, so accuracy is essential.

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Text contributions and editing:
Mélisande Rouger - Independent Journalist (full article)

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