Spatiotemporal Image Correlation (STIC)–Assisted Prenatal Ultrasound Diagnosis of Complex intracranial arteriovenous malformations: A Case ReportKe-xiong Niu, Tiantian Feng, Wen-dong Zhang, Tian-gang Li1Department of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital(Gansu Provincial Central Hospital）,Lanzhou, Gansu Province, P. R. China*Corresponding Author: Dr. Tiangang LiDepartment of Ultrasound Diagnosis, Gansu Provincial Maternity and Child-care Hospital(Gansu Provincial Central Hospital）,Lanzhou, Gansu Province, P. R. ChinaTelephone No.: +86-0931-2336818;mail: litiangang1981@126.comAbstractBackground: Fetal intracranial arteriovenous malformations (AVMs) are rare, complex vascular anomalies that present significant diagnostic challenges and can result in severe fetal complications, including cardiomegaly, hydrops fetalis, or intrauterine demise. Spatiotemporal image correlation (STIC) is an advanced ultrasound technique that allows for three-dimensional reconstruction of dynamic vascular structures, potentially improving the diagnosis of complex intracranial AVMs.Objective: This case report aims to illustrate the use of STIC-assisted prenatal ultrasound for diagnosing a complex fetal intracranial AVM, a condition not typically assessed using this technology.Case: A 25-year-old gravida 3, para 2 woman at 26 weeks’ gestation was referred for evaluation of abnormal intracranial vascular flow detected on routine ultrasound. Conventional imaging identified high-flow vascular signals, and STIC was used to visualize the complex vascular anatomy. The STIC volume datasets revealed a shunting channel between the posterior cerebral arteries and the straight sinus, as well as dilated transverse sinuses with arterialized venous waveforms. These findings were consistent with a complex fetal intracranial AVM.Results: STIC provided a time-resolved three-dimensional view of the lesion, enhancing the understanding of its anatomical and hemodynamic features. Multidisciplinary consultation based on STIC findings led to a shared decision regarding pregnancy termination after discussing the high risk of fetal decompensation and adverse outcomes.Conclusion: This case demonstrates that STIC can effectively delineate complex vascular structures in cases of fetal intracranial AVMs, providing valuable insights when conventional ultrasound or MRI is insufficient. STIC enhances diagnostic confidence, facilitates multidisciplinary decision-making, and supports prenatal counseling, especially in resource-limited settings. The integration of STIC into the prenatal evaluation of rare cerebrovascular anomalies may improve risk stratification and management decisions, ultimately influencing fetal outcomes.

Objectives: To investigate the clinical value of fetal heart quantification (fetal HQ) in the evaluation of normal foetal heart size, morphology and cardiac function at different gestational weeks. Materials and methods: A total of 101 pregnant women diagnosed with a healthy foetus by foetal echocardiography from September 2021 to December 2023 were selected and classified into four different periods of gestational weeks: 20-28 weeks (25 cases), 29-32 weeks (26 cases), 33-36 weeks (26 cases), 37-40 weeks (24 cases). Quantitative analyses were performed by automatically tracking the endocardium using fetal HQ software that comes with the Voluson E10 from GE. To investigate the correlation between four-chambered vesicle length end-diastolic (4CV LED), four-chambered vesicle transverse width end-diastolic (4CV TWED), global sphericity index (GSI), ejection fraction (EF), stroke volume (SV), cardiac output (CO) and gestation age (GA), and the variability of normal foetal cardiac morphology and cardiac function at different gestational weeks. Results: A statistically significant difference was observed between 4CV LED and 4CV TWED in normal foetuses at different gestational weeks ( P < 0.05), which exhibited a positive correlation with gestational week. Conversely, no significant correlation was identified between GSI and gestational week ( P > 0.05). The mean GSI of 101 normal foetuses found to be 1.25 ± 0.09. A comparative analysis of EF, SV, and CO in normal foetuses at different gestational weeks revealed statistically significant differences in SV and CO ( P < 0.05), which gradually increased with gestational weeks, whereas there was no statistically significant difference in EF ( P ＞ 0.05). Conclusions: Fetal HQ represents a straightforward and dependable method for evaluating GSI and 24-segment SI of the left and right ventricles, which can provide a certain theoretical basis for the clinical quantitative evaluation of fetal cardiac geometry and cardiac function.

Cantrell syndrome is rare in prenatal diagnosis. The diagnosis of Cantrell syndrome can be made antenatally through the use of ultrasonography, although this is challenging in cases where the defects are minor.We have reported a case diagnosis of imcomplete Cantrell syndrome through sections of the four-chamber view and the left ventricular outflow tract view.

Objectives: This study aims to explore the clinical value of prenatal ultrasonography in the diagnosis of the common arterial trunk (CAT) classification and associated deformities. Materials and methods: The two-dimensional ultrasound images spatiotemporal image correlations (STICs) and clinical data of 108 foetuses diagnosed with CAT malformations were retrospectively analysed, their CAT types were classified, and the correlations between these different types and foetal malformations and pregnancy outcomes were analysed. Results: Among the 108 foetuses, there were 47 cases (43.5%) of type A1, 51 cases (47.3%) of type A2, 9 cases (8.3%) of type A3 and 1 case of type A4 (0.9%), of which 22 cases (20.4%) were isolated CAT, 56 cases (51.8%) had complex intra-cardiac structural abnormalities, 30 cases (27.8%) had intra-cardiac or extra-cardiac structural abnormalities, 17 cases had 1 other system abnormality, and 5 cases had 2 other system abnormalities. Four cases were combined with 3 other system abnormalities, while 4 cases were combined with 4 other system abnormalities, among which the facial and physical abnormalities had the highest incidence (40.0%). The STIC images were completely displayed in 88 cases (81.5%). Isolated CAT and CAT combined with other malformations were significantly correlated with foetal pregnancy outcomes ( P < 0.05). Conclusions: Prenatal ultrasonography had a high clinical application value for classifying CAT. Pregnancy outcomes were highly correlated with the classification and combined intra-cardiac and extra-cardiac structural malformations. The early assessment of foetal prognosis before birth has great value for clinical intervention.

IntroductionFetal persistent hyperplastic primary vitreous (PHPV) and retinoblastoma (Rb) is rare congenital abnormal development of the vitreous body1,2. According to related manifestations after delivery, PHPV is clinically called “white pupil.” It mainly manifests as vision loss and lens opacity and, in severe cases, as intravitreal hemorrhage and eyeball atrophy. The disease is possibly isolated or associated with congenital syndromes, such as Walker–Warburg syndrome and Norrie disease. Rb is the most common intraocular malignancy of childhood. The role of prenatal ultrasound screening for Rb has been discussed3. Here, we present a case of persistent primary hyperplasia vitreous diagnosed in the second trimester using prenatal ultrasonography. An echogenic band with an irregular surface was detected between the lens and the posterior wall of the left eye. No other system abnormalities were present in the fetus.

Fetal ventricular aneurysm is a rare congenital cardiac malformation that can occur in various cardiac cavities and often exists in isolation without other malformations. Modern ultrasound technology can assist the prenatal diagnosis of ventricular aneurysm. Herein, we will present a rare case of a giant left ventricular aneurysm detected by prenatal ultrasonography.

Vascular rings(VRs) are defined as congenital abnormalities of the aortic arch and its branches. The most common vascular rings include right aortic arch (RAA) and double aortic arches(DAA). Vascular rings can form a ring that may compress the esophagus and trachea ,which likely result feeding difficulties and respiratory distress. We have reported three cases about diagnosis of vascular rings using High-definition flow(HD-flow) render mode and spatiotemporal image correlation(STIC). In addition ,we have evaluated the postnatal imaging features of vascular rings.

Objectives: To investigate the incidence of single umbilical artery (SUA), malformation, and postpartum outcomes in a retrospective analysis of 781 fetuses with SUA. Methods: A retrospective analysis of 781 pregnant women with singleton fetuses with SUA were diagnosed in the Gansu Provincial Maternal and Child-care Hospital from 2013 to 2019. Detailed data on maternal and fetal characteristics and postpartum outcomes were obtained. Results: A total of 624 (79.9%) fetuses were diagnosed with isolated SUA, whereas 157 (20.1%) fetuses had SUA with other structural and/or chromosomal abnormalities. The highest incidence of malformations was found in the urinary system, followed by the cardiovascular system and the digestive system. The incidence of SUA on the right side was 59.1% and life side was 40.9% respectively. Fetuses with SUA and other abnormalities showed a trend to be small for gestational age (3061 g vs 3201 g, p < 0.01) but not be delivered preterm. Conclusions: After a diagnosis of SUA, structural observation of the fetus is required. The urinary, cardiovascular, and digestive systems should be the focus of observation. If relevant malformations are found, genetic testing must be performed. With isolated SUA, it is recommended to dynamically monitor biological indicators to be alert for SGA, but genetic testing is not recommended.