Three-vessel view of the fetal upper mediastinum: an easy means of detecting abnormalities of the ventricular outflow tracts and great arteries during obstetric screening

Authors

  • Dr S. -J. Yoo,

    Corresponding author
    1. Department of Ultrasound, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, Korea
    2. Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, Korea
    3. Department of Radiology, Sejong Heart Institute, Kyunggi-do, Korea
    • No. 42–102 Kaenari Apt., 716-1 Yorksam-dong, Kangnam-ku, Seoul, 135-082, Korea
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  • Y.-H. Lee,

    1. Department of Ultrasound, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, Korea
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  • E. S. Kim,

    1. Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, Korea
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  • H. M. Ryu,

    1. Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, Korea
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  • M. Y. Kim,

    1. Department of Obstetrics and Gynecology, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, Korea
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  • H.-K. Choi,

    1. Department of Diagnostic Radiology, Asan Medical Center/The University of Ulsan College of Medicine, Seoul, Korea
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  • K. S. Cho,

    1. Department of Diagnostic Radiology, Asan Medical Center/The University of Ulsan College of Medicine, Seoul, Korea
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  • A. Kim

    1. Department of Obstetrics and Gynecology, Asan Medical Center/The University of Ulsan College of Medicine, Seoul, Korea
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Abstract

The three-vessel view is a transverse view of the fetal upper mediastinum is as simple to obtain as the four-chamber view. It demonstrates the main pulmonary artery, ascending aorta and superior vena cava in cross- or oblique sections. The purposes of this study were to describe the normal anatomy of the three-vessel view and to analyze what anatomical changes would occur in this view when there are lesions of the ventricular outflow tracts and/or great arteries. Sonograms of 29 fetuses with lesions involving the ventricular outflow tracts and/or great arteries were reviewed. Three-vessel views were evaluated in terms of vessel size, number, arrangement and alignment.

Twenty-eight of 29 fetuses showed an abnormal three-vessel view that included abnormal vessel size (n = 12), abnormal alignment (n = 8), abnormal arrangement (n = 7) and abnormal vessel number (n = 3). The vessel size was abnormal in obstructive lesions of the right (n = 4) or the left (n = 8) side of the heart. An abnormal alignment was seen in tetralogy of Fallot (n = 6) and double-outlet right ventricle (n = 2) that showed anterior displacement of the aorta. An abnormal arrangement was seen in complete (n = 4) and corrected (n = 1) transpositions, double-outlet right ventricle (n = 1) and pulmonary atresia with ventricular septal defect (n = 1). Only two vessels were seen in truncus arteriosus (n = 1). Four vessels were seen in persistent left superior vena cava (n = 2). A fetus with pulmonary atresia and intact ventricular septum showed a normal three-vessel view.

In conclusion, most of the lesions involving the ventricular outflow tracts and/or great arteries showed an abnormal three-vessel view. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology

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