Flow Viewer enhances color flow Doppler and aids in diagnosis of a fetal renal abnormality

While a variety of renal abnormalities are commonly noted on 2D ultrasound, the prenatal diagnosis of malformations remains challenging. Differentiating the wide variety of diagnoses present in the fetal kidneys is incredibly important for the clinician involved with counseling the parents, as different anomalies portend a broadly ranging prognosis and outcome.¹

The ultrasound evaluation demonstrated a breech female fetus with a normal estimated fetal weight. The fetal anatomic survey identified anhydramnios and bilateral multicystic dysplastic kidneys (Figures 1 and 2). Microflow Imaging High Definition (MFI-HD) was used to obtain color flow imaging only of the left renal artery (Figure 3).

Traditional color flow imaging was suboptimal, however supported no evidence of renal arteries (Figure 4). Using Flow Viewer, the fetal aorta was more easily identified and clearly demonstrated bilateral absence of the renal arteries (Figure 5). The patient was informed of the findings of bilateral renal agenesis, which included a discussion regarding the lack of specific treatment outside of research protocols and the poor prognosis.

In this patient’s case, the fetal diagnosis was not fully conclusive with the use of 2D imaging and traditional color flow imaging on the C5-1 transducer. Our diagnosis of bilateral renal agenesis, which progressed from an initial finding of bilateral multicystic dysplastic kidneys, was aided using Flow Viewer. This color Doppler imaging modality allowed for superior imaging of the fetal aorta and the ability to definitively demonstrate complete and bilateral absence of the fetal renal arteries. In this case, the fetal diagnosis was made with greater accuracy using Flow Viewer advanced color Doppler ultrasound technology, which provided the clinician and the patient a greater degree of confidence in the true diagnosis of bilateral renal agenesis in the fetus.

The latest Philips update to color flow Doppler is the innovative imaging modality Flow Viewer. Flow Viewer is a significant improvement over traditional color Doppler ultrasonography alone (Figures 6, 7 8). In both routine obstetric and complex perinatal care, the availability of Flow Viewer for color flow Doppler ultrasound has remarkable potential to change the healthcare of the pregnant patient and for prenatal diagnosis and management of the fetus. Flow Viewer continues to demonstrate the impressive capabilities of ultrasound through high-quality flow imaging, clearly defined fetal vasculature and cardiac anatomy as well as an enhanced 3D-like realistic image.