HDlive Silhouette for Diagnosis of Congenital Dacryocystocele

PICTURE OF THE MONTH

There have been only two reports on three-dimensional (3D) ultrasound evaluation of a congenital dacryocystocele in utero.^1,2 However, these images were only surface-rendering or tomographic slice images. Recently, Castro et al.³ reported 3D reconstruction of a congenital dacryocystocele using magnetic resonance imaging. We could easily understand the dacryocystocele and its surrounding orbital and nasal structures using this technique.

HDlive Silhouette is a recent technology that shows crystal-like images of the fetus and organs and can clearly depict the inside of structures.^4–6 To the best of our knowledge, there has been no report on HDlive Silhouette evaluation of a congenital dacryocystocele in utero. In the current study, we present our experience of diagnosing a unilateral congenital dacryocystocele of the fetus using HDlive Silhouette at 32 weeks and 6 days of gestation.

A right congenital dacryocystocele was noted in a routine third-trimester fetal anomaly scan (Fig. 1). HDlive Silhouette (Voluson E10 BT20; GE Healthcare Japan, Tokyo, Japan) clearly showed the spatial relationships among the dacryocystocele, lens, eyeball, and optic nerve (Fig. 2). We could easily recognize the location of the dacryocystocele on the nose side of the right eyeball. Moreover, the optic nerve could be identified behind the eyeball. HDlive Silhouette may provide additional information for the precise evaluation of fetal orbital and periorbital anatomical structures.

REFERENCES

1. Sepulveda W, Wojakowski AB, Elias D, et al. Congenital dacryocystocele. Prenatal 2- and 3-dimensional sonographic findings. J Ultrasound Med 2005;24(2):225–230. DOI: 10.7863/jum.2005.24.2.225.

2. Lembet A, Bodur H, Selam B, et al. Prenatal two- and three-dimensional sonographic diagnosis of dacryocystocele. Prenat Diagn 2008;28(6):554–555. DOI: 10.1002/pd.2015.

3. Castro PT, Matos AP, Werner H, et al. Evaluation of fetal nasal cavity in bilateral congenital dacryocystocele: 3D reconstruction and virtual navigation by magnetic resonance imaging. Ultrasound Obstet Gynecol 2020;55(1):141–143. DOI: 10.1002/uog.21898.

4. AboEllail MAM, Hanaoka U, Numoto A, et al. HDlive image of giant fetal hemangioma. J Ultrasound Med 2015;34(12):2313–2318. DOI: 10.7863/ultra.15.01070.

5. AboEllail MAM, Tanaka H, Mori N, et al. HDlive silhouette mode in antenatal diagnosis of jejunal atresia. Ultrasound Obstet Gynecol 2016;48(1):131–132. DOI: 10.1002/uog.15737.

6. Hata T, AboEllail MAM, Sajapala S, et al. HDlive silhouette mode with spatiotemporal correlation for assessment of the fetal heart. J Ultrasound Med 2016;35(7):1489–1495. DOI: 10.7863/ultra.15.08061.