All Posts tagged golf ball

Echocardiographic observation and clinical significance of echogenic intracardiac foci in 310 fetuses

23rd World Congress on Ultrasound in Obstetrics and Gynecology

Echocardiographic observation and clinical significance
of echogenic intracardiac foci in 310 fetuses
Y. He, Y. Guo, Y. Zhang, J. Han, Z. Li
Beijing Anzhen Hospital Capital Medical University, Beijing,
China
Objectives:
To assess the clinical meaning of echogenic intracardiac
focus in fetuses by echocardiography.

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Echogenic focus in the fetal left ventricular cavity: Is it a false tendon?

neologoEchogenic focus in the fetal left ventricular cavity: Is it a false tendon?
Nahide Altug a*, A. Nuri Danisman b*
a* Zekai Tahir Burak Maternity Teaching Hospital, Ped. Cardiology Unit, Ankara, Turkey
b* Zekai Tahir Burak Maternity Teaching Hospital, Perinatology Unit, Ankara, Turkey

Early Human Development, Volume 89, Issue 7, July 2013, Pages 479-482

abstract

Keywords: Fetus, False tendon,Echogenic focus,Fetal echocardiography
Objective:
To draw attention to the left ventricular false tendon which can be misinterpreted as echogenic focus in the fetus.
Methods:
The study group consisted of 9 fetuses out of the 161 who had been misdiagnosed for left ventricular false tendon as echogenic focus by obstetricians. Fetal echocardiography and 2-D color Doppler echocardiography were performed in the pre-postnatal period. The standard fetal echocardiographic views (4,5 chamber views, long axis view of the left ventricle, short axis view of the ventricles and great arteries, three vessels and trachea view, long axis views of the duct and aortic arch) were obtained for each case.

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Echocardiographic observation and clinical significance of echogenic intracardiac foci

23rd World Congress on Ultrasound in Obstetrics and Gynecology

Echocardiographic observation and clinical significance
of echogenic intracardiac foci in 310 fetuses
Y. He, Y. Guo, Y. Zhang, J. Han, Z. Li
Beijing Anzhen Hospital Capital Medical University, Beijing,
China
Objectives:
To assess the clinical meaning of echogenic intracardiac
focus in fetuses by echocardiography.
Methods:
The data of 310 fetuses diagnosed as echogenic
intracardiac focus by echocardiography were reviewed. The
ultrasonic characters and clinical data were analysed.
Results:
310 fetuses were all nature pregnancies, and pregnancies
with high risk factors was 41 cases. The solitary EIF cases in left
ventricle were 263 (85% ). The solitary EIF cases in right ventricle
were 1 (3‰). The multiple EIF cases in left ventricle were 44 (14%).
The multiple EIF cases in both ventricles was 2 (6‰). The incidence
of congenital heart disease in the EIF group was 19‰ (6 cases) and
there was no significant difference between the EIF group and the
normal group. Down syndrome cases were 2 (6‰) both of them were
in the high risks group (elderly pregnant woman) 5 women stopped
pregnancy because of fetal malformation. Among the remaining
cases EIF gradually became pale, smaller or disappeared in 281cases
(92%) and 299 (96%) isolated EIF cases had a good clinical outcome
after birth.
Conclusions:
The isolated EIF in fetal heart without complicating
any other abnormalities has no significant clinical meaning. There
were no relationship between the isolated EIF fetal chromosome
abnormality and congenital heart disease

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Golf Balls fetali : Cosa sono ?

ECOCARDIOGRAFIA FETALE
“GOLF BALL” Quale Significato Clinico ?

a cura di S. Gerboni

Negli anni 80,da Allan nel 1986 e Schech et all. nel 1987, è stata descritta durante l’ecocardiografia fetale,la presenza di un focolaio
ecogeno o iperecogeno del muscolo papillare del ventricolo sinistro nel cuore fetale, col termine di golf ball (GB) o palla da golf.
L’eziologia di tale Golf Ball è sconosciuta e la sua incidenza oscilla tra lo 0.5 ed il 20 % ( media 5.6% ).
La localizzazione più frequente è sul muscolo papillare della valvola mitrale (60%), foci multipli nel ventricolo sinistro 16%, ventricolo destro(7%) ed in entrambi i ventricoli (16%).
Inizialmente descritto come un riscontro benigno ha stimolato una ricerca e studi anatomopatologico-ecocardiografico in correlazione ad altre alterazioni cliniche e/o cromosomiche (specialmente in rapporto alla sindrome di Down o trisomia 21). E’ stata segnalata una incidenza del 3% di sindrome di Down in feti con ‘golf ball’ all’ecocardiografia fetale.
In questa sede va però precisato che :

  • la presenza isolata di GB in una gravidanza senza altri marker di patologia va considerata una variante normale senza rilevanza clinica e prognostica.
  • I rilievi neonatali che a volte ripropongono la presenza di tali foci risultano assolutamente benigni e senza
    manifestazioni cliniche.
  • Nella mia esperienza personale, su un numero di 4750 ecocardiografie fetali, l’indicazione all’esame è stata per il 2% dei casi (95 casi) il rilievo da parte dell’ostetrico di golf ball in ventricolo sinistro. In tutti i casi il rilievo è stato isolato senza significato clinico e senza anomalie cromosomiche e con decorso neonatale benigno.
    La Golf Ball può assumere un diverso significato o rappresentare un indicatore di eventuale anomalia associata se viene riscontrata in una gravidanza con altri marker di rischio :

  • età  materna avanzata > di 35 anni con
  • precedente figlio con cromosomopatia o cardiopatia
  • feto a translucenza nucale aumentata
  • presenza di altri marker ecocardiografici di aneuploidia (anomalie dei cromosomi) quali arteria ombelicale singola,
    tri-test positivo etc.

    In conclusione
    tale riscontro non deve essere motivo per generare ansia ed apprensione alla gravida presentandolo terroristicamente come un nuovo marker di possibile anomalia cromosomica fetale, ma va considerato nel suo intrinseco significato clinico e funzionale valutato da un cardiologo fetale.

    Riferimenti:

  • L.D.Allan – Manual of Fetal Echocardiography pg.127 MTP Press Limited 1986
  • Joseph W et al. in Obstetrical & Gynecological Survey 55(5):303-11, 2000
  • Sepulveda W; Romero D in Ultrasound Obstet Gynecol 12: 445-49, 1998 Panorama I Internacional nternacional
  • Simpson J in Prenatal. Diagnosis. 19: 972-975, 1999

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[Echogenic intracardiac structures (golf ball phenomenon)

[Echogenic intracardiac structures (golf ball phenomenon) as predictors of chromosome anomalies]

Bettelheim D, Ulm MR, Deutinger J, Bernaschek G.

Universitatsklinik fur Frauenheilkunde, Abteilung fur Pranatale Diagnostik und Therapie, Wien.

Small echogenic areas in the fetal heart are known as the golf ball phenomenon. These structures are considered by some to be a marker for chromosomal anomalies.

AIM : To prospectively study the relationship of echogenic intracardiac structures and chromosomal aberrations.
METHODS : Over a 15 month period (6/96-9/97) 4500 unselected fetuses between 16-31 weeks were screened for malformations; in each case echogenic intracardiac structures were sought.
RESULTS: In 77 cases (1.17%) single or multiple echogenic punctate intracardiac structures could be diagnosed. In 60 fetuses (78%) chromosome analysis was performed. Two (3.3%) had chromosomal abnormalities–trisomy 21 and 45.XO/46.XX.

CONCLUSION :

  • The golf ball phenomenon appears to be a normal variation in the development of the papillary muscle.
  • This sign is usually easily to identify and if present, should lead to a more detailed screening for anomalies.
  • In the case of other sonographic abnormalities, with advanced maternal age or with a positive triple test, a chromosomal analysis should be performed.
  • PerCarSkype – S.Gerboni Perinatal Cardiologist onLine hr 09.30:11.30


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