Journal of clinical ultrasound : JCU · 2026
The Value of the Vertical Vein Stenosis Site, Proximal Flow Velocity, and Their Ratio in Prenatal Ultrasound Diagnosis and Prognostic Assessment of Fetal TAPVC With PVO.
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Zeng Yuzhou, Wang Hongying, Zeng Shilin, Yang Wanying, Liu Jinrong, Huang Danping, Zhang Rui, Zhou Huiling, Wu Hengying
Аннотация
OBJECTIVE: To evaluate the potential value of peak velocity at the vertical vein obstruction site (Vmax), proximal vertical vein velocity (Vp), and their ratio (Vmax/Vp) in the prenatal diagnosis of fetal total anomalous pulmonary venous connection (TAPVC) with pulmonary venous obstruction (PVO) and in early neonatal risk assessment.
METHODS: This was a retrospective cohort study. A total of 8 fetuses with TAPVC and PVO (14 examinations), 6 fetuses with TAPVC without PVO (11 examinations), and 50 normal fetuses were enrolled. Peak velocities of the vertical vein (or pulmonary vein) were compared across the three groups. In the PVO group, the correlations between indicators such as Vmax, Vmin, Vmean, PVVI, Vp, and Vmax/Vp and clinical outcomes (including neonatal acidosis, hypoxemia, severity of pulmonary hypertension, and death) were analyzed.
RESULTS: Vmax was higher in the PVO group than in the TAPVC without PVO and normal groups (p < 0.001). Vp was lower in the PVO group than the corresponding pulmonary venous velocity in normal fetuses (p < 0.001). Vmax was not significantly correlated with Vmax/Vp (rs = 0.43, p = 0.126), suggesting that the ratio may provide additional hemodynamic information beyond Vmax alone. Lower Vp was associated with acidosis, hypoxemia, more severe pulmonary hypertension, more severe obstruction, and mortality (all p ≤ 0.03). Vmax/Vp was associated with the severity of pulmonary hypertension (p = 0.045).
CONCLUSION: In this small exploratory cohort, Vp and Vmax/Vp appeared to provide complementary information to Vmax in fetuses with TAPVC and PVO. These preliminary findings suggest that combined assessment of proximal and stenotic-site velocities may help identify atypical obstruction and support prenatal risk stratification.
METHODS: This was a retrospective cohort study. A total of 8 fetuses with TAPVC and PVO (14 examinations), 6 fetuses with TAPVC without PVO (11 examinations), and 50 normal fetuses were enrolled. Peak velocities of the vertical vein (or pulmonary vein) were compared across the three groups. In the PVO group, the correlations between indicators such as Vmax, Vmin, Vmean, PVVI, Vp, and Vmax/Vp and clinical outcomes (including neonatal acidosis, hypoxemia, severity of pulmonary hypertension, and death) were analyzed.
RESULTS: Vmax was higher in the PVO group than in the TAPVC without PVO and normal groups (p < 0.001). Vp was lower in the PVO group than the corresponding pulmonary venous velocity in normal fetuses (p < 0.001). Vmax was not significantly correlated with Vmax/Vp (rs = 0.43, p = 0.126), suggesting that the ratio may provide additional hemodynamic information beyond Vmax alone. Lower Vp was associated with acidosis, hypoxemia, more severe pulmonary hypertension, more severe obstruction, and mortality (all p ≤ 0.03). Vmax/Vp was associated with the severity of pulmonary hypertension (p = 0.045).
CONCLUSION: In this small exploratory cohort, Vp and Vmax/Vp appeared to provide complementary information to Vmax in fetuses with TAPVC and PVO. These preliminary findings suggest that combined assessment of proximal and stenotic-site velocities may help identify atypical obstruction and support prenatal risk stratification.