Document Type : Original Article
Department of Radiology, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
Department of Pediatric Heart Disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Department of Pediatric Rheumatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Faculty of Medicine, Mashhad Medical Sciences ,Islamic Azad University, Mashhad, Iran
Radiology clinic of Nasl-e-Omid
Background: The prenatal diagnosis of coarctation of aorta (CoA) remains a major challenge, as the false-positive diagnosis is fairly common. The purpose of this study was to find some useful prenatal sonographic markers compatible with the postnatal diagnosis of CoA.
Methods: The study included fetuses suspected of CoA in the second and third-trimester ultrasound tests. All cases were examined by fetal echocardiography at a single ultrasound clinic between 2019 and 2020. The proportion of right and left ventricular size was assessed and ductal/isthmus diameter ratio was measured. A comparison was drawn between the results of neonates with neonatal CoA and neonates without CoA.
Results: Of 20 fetuses with suspected prenatal CoA, 3 (15%) had neonatal CoA. The mean ductal/isthmus ratio was significantly higher in the neonates with CoA (1.96 vs. 1.46; p< 0.001). The diagnostic power of ductal/isthmus ratio to detect CoA with a cut point of 1.53 had a sensitivity and specificity of 100% and 70.6%, respectively, a positive and negative predictive value of 37.5% and 100%, respectively, and an overall accuracy of 75%.
Conclusion: The ductal/isthmus ratio diameter and ventricular disproportion are significant sonographic markers for the prenatal diagnosis of CoA, and the ductal/isthmus ratio has high sensitivity and specificity compared to postnatal findings.