Foetal Facial Clefts: Prenatal Evaluation of Lip and Primary Palate by 2D and 3D Ultrasound

Abstract

Introduction: To examine whether three-dimensional ultrasound (3D US) is an accurate diagnostic method of clinical use in the ability to define the location and extent of facial clefting prenatally, compared to two-dimensional ultrasound (2D US). Methods: 18 foetuses suspected or diagnosed to suffer from a facial cleft by 2D US were examined with a targeted 3D US. 2D US and 3D US results were compared with postnatal outcome. Results: Comparison of the number of foetuses with a cleft lip + primary palate diagnosed correctly with 2D US with the results of adjunctive 3D US (true positive + true negative) showed that adjunctive 3D US correctly diagnosed more cleft lips (100 %; 15/15 foetuses vs. 66 %; 12/18 foetuses) and more cleft primary palates (100 %; 12/12 foetuses vs. 58 %; 7/12 foetuses). Conclusion: Interactive review of standardised 3D multiplanar images allows to systematically evaluate lip defects and abnormalities of the maxillary tooth-bearing alveolar ridge. The accuracy of adjunctive 3D ultrasound is superior to 2D ultrasound alone for extensive prenatal diagnosis of cleft lip with or without cleft primary palate.

Zusammenfassung

Einleitung: Ist ein zusätzlich zum 2D-Ultraschall durchgeführter 3D-Ultraschall, in der Diagnose von Lippen- und Lippenkieferspalten, dem 2D-Ultraschall überlegen? Methodik: Bei 18 Feten wurde im 2D der Verdacht oder die Diagnose auf eine Spaltbildung der Lippen oder der Lippen und des Kiefers gestellt. Bei allen Feten wurde zusätzlich eine 3D-US Untersuchung durchgeführt. 2D-US und 3D-US wurden mit dem fetalen Outcome verglichen. Ergebnisse: Vergleicht man die Anzahl der Feten, bei denen eine Lippenspalte + Kieferspalte mittels 2D- vs. additivem 3D-US korrekt diagnostiziert wurde (richtig positiv + richtig negativ), so zeigt sich, dass der 3D-US mehr Lippenspalten (100 %; 15/15 Feten vs. 66 %; 12/18 Feten) und mehr Kieferspalten (100 %; 12/12 Feten vs. 58 %; 7/12 Feten) richtig diagnostizierte. Schlussfolgerung: Die zusätzliche 3D-US Untersuchung ist der alleinigen 2D-US Untersuchung, bei Lippen- und Lippenkieferspalten, überlegen. Die Möglichkeit einer standardisierten interaktiven Untersuchung erlaubt eine systematische Evaluierung der Lippen und des Kiefers.

Prenatal diagnosis - cleft lip - cleft primary palate - two-dimensional ultrasound - three-dimensional ultrasound

Pränatale Diagnostik - Lippenspalte - Kieferspalte - Zweidimensionaler Ultraschall - Dreidimensionaler Ultraschall

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