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Prenatal diagnosis of transposition of the great arteries: an updated review

Ultrasonography 2020년 39권 4호 p.331 ~ 339
Bravo-Valenzuela Nathalie Jeanne, Peixoto Alberto Borges, Araujo Edward Junior,
소속 상세정보
 ( Bravo-Valenzuela Nathalie Jeanne ) - Federal University of Sao Paulo Paulista School of Medicine Department of Obstetrics
 ( Peixoto Alberto Borges ) - University of Uberaba Mario Palmerio University Hospital
 ( Araujo Edward Junior ) - Federal University of Sao Paulo Paulista School of Medicine Department of Obstetrics

Abstract


Simple transposition of the great arteries (TGA) is a cyanotic heart disease that accounts for 5% to 7% of all congenital heart diseases. It is commonly underdiagnosed in utero, with prenatal detection rates of less than 50%. Simple TGA is characterized by ventriculoarterial discordance, atrioventricular concordance, and a parallel relationship of TGA. The prenatal diagnosis of TGA influences postnatal outcomes and therefore requires planned delivery and perinatal management. For these reasons, it is important to identify the key ultrasound markers of TGA to improve the prenatal diagnosis and consequently provide perinatal assistance. The presence of two vessels instead of three in the three-vessel tracheal view, a parallel course of TGA, and identification of the origin of each of TGA are the key markers for diagnosing TGA. In addition to the classical ultrasound signs, other two-dimensional ultrasound markers such as an abnormal right convexity of the aorta, an I-shaped aorta, and the "boomerang sign" may also be used to diagnose TGA in the prenatal period. When accessible, an automatic approach using four-dimensional technologies such as spatio-temporal image correlation and sonographically-based volume computer-aided analysis may improve the prenatal diagnosis of TGA. This study aimed to review the ultrasound markers that can be used in the antenatal diagnosis of TGA, with a focus on the tools used by ultrasonographers, the obstetric and fetal medicine team, and perinatal cardiologists to improve the diagnosis of this condition.

키워드

Prenatal diagnosis; Ultrasound cardiac screening; Fetal echocardiography; Transposition of the great arteries

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