Key result
Comprehensive prenatal ultrasound achieves ~98% sensitivity for fetal aortic arch branch abnormalities vs single 3VT.
Why the study?
Fetal aortic arch branch abnormalities have complex classifications, requiring evaluation of the diagnostic efficacy of a comprehensive prenatal ultrasound protocol, fetal cardiac magnetic resonance imaging, and their combination for accurate prenatal identification and sub-typing.
Does a comprehensive prenatal ultrasound protocol and supplementary fetal cMRI improve the diagnostic accuracy for fetal aortic arch branch abnormalities in pregnant patients with suspected FAABAs compared to a single 3VT ultrasound view?
Cohort (n=180)
Yes
Does a comprehensive prenatal ultrasound protocol and supplementary fetal cMRI improve the diagnostic accuracy for fetal aortic arch branch abnormalities in pregnant patients with suspected FAABAs compared to a single 3VT ultrasound view?
A comprehensive prenatal ultrasound protocol integrating 3VT, coronal sections, and 4D STIC-HD significantly improves sensitivity for diagnosing fetal aortic arch branch abnormalities, with fetal cMRI serving as an effective complementary tool.
Answers are grounded in this paper and cite their sources.
May enhance prenatal detection of fetal aortic arch abnormalities with comprehensive protocols; leaves open prospective validation and cMRI integration.
Background: Fetal aortic arch branch abnormalities (FAABAs) are characterized by complex classifications. Accurate prenatal identification and precise sub-typing are of great value for clinical counseling and pregnancy management. This study aimed to assess the diagnostic efficacy of a comprehensive prenatal ultrasound (US) protocol integrating three-vessel and trachea (3VT) view, aortic arch and descending aortic coronal sections (CSs), and four-dimensional (4D) spatiotemporal image correlation combined with high-definition (STIC-HD) live flow imaging. It also compared prenatal US, fetal cardiac magnetic resonance imaging (cMRI), and combined US + cMRI for diagnosing FAABAs. Method: This prospective dual-center study recruited 180 pregnant patients with suspected FAABAs from 2019 to 2021. All underwent three described US examinations, and 33 cases received supplementary fetal cMRI. Postpartum imaging, surgery, and autopsy results were defined as the gold standard. Diagnostic efficiency was validated using sensitivity, specificity, predictive values, F-score, Youden index, and Cohen’s kappa analysis. Results: Gold standard verification identified 165 FAABAs cases (91.7%), including 55.8% left aortic arch, 32.1% right aortic arch, and 12.1% double aortic arch, plus 15 normal cases. The combined 3VT + CS view and comprehensive US protocol yielded a sensitivity of 98.2%, significantly higher than that of single 3VT view (73.5%, P<0.001). The US + cMRI combination achieved the optimal overall diagnostic efficacy (sensitivity: 97.0%, P<0.05). Conclusions: The comprehensive US protocol is the preferred prenatal imaging method for FAABAs diagnosis and classification. Fetal cMRI is a reliable complementary modality, particularly for cases with suboptimal acoustic windows.
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Chen et al. (2026) conducted a cohort in Suspected fetal aortic arch branch abnormalities (FAABAs) (n=180). Comprehensive prenatal ultrasound protocol (integrating 3VT view, aortic arch and descending aortic coronal sections, and 4D STIC-HD live flow imaging) and supplementary fetal cMRI vs. Single three-vessel and trachea (3VT) ultrasound view; verified against gold standard (postpartum imaging, surgery, and autopsy) was evaluated on Diagnostic sensitivity for fetal aortic arch branch abnormalities (FAABAs) (p=<0.001). A comprehensive prenatal ultrasound protocol yielded 98.2% sensitivity for diagnosing fetal aortic arch branch abnormalities compared to 73.5% for a single 3VT view (P<0.001).
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