{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T22:04:55Z","timestamp":1751580295795,"version":"3.37.3"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T00:00:00Z","timestamp":1514332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The \u201cY sign\u201d at the level of the 3\u2010vessel and trachea view corresponds to thinning of main pulmonary artery and arterial duct and a dilated transverse aortic arch. The purpose of this study was to evaluate the Y sign for the diagnosis of aortic dextroposition anomalies at the time of the first\u2010trimester scan and to assess the screening performance of only the Y sign, only abnormal left axis deviation (axis sign), and their combination for the diagnosis of aortic dextroposition anomalies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective evaluation of 6025 pregnant women undergoing first\u2010trimester ultrasonography was conducted. The cardiac axis was measured in all examined patients and considered abnormal (positive axis sign) at greater than 57\u2009\u00b0. The frequency of the Y sign and the axis sign was assessed for this population, and their screening performance for the diagnosis of aortic dextroposition anomalies was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5775 patients fulfilled the inclusion criteria. Aortic dextroposition anomalies were diagnosed in 17 cases (tetralogy of Fallot in 8 and Fallot\u2010like double\u2010outlet right ventricle in 9). The Y sign was found in 18 of 5775 (0.3%) fetuses examined, of which 7 of 18 were confirmed with tetralogy of Fallot, 9 of 18 with a Fallot\u2010like double\u2010outlet right ventricle, and 2 of 18 with pulmonary stenosis. A positive axis sign of greater than 57\u2009\u00b0 was found in 20 fetuses, including 4 with normal heart anatomy. The sensitivity values of the Y sign, the axis sign, and their combination were 94%, 76%, and 94%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Visualization of the Y sign should increase the suspicion of aortic dextroposition anomalies in the late first trimester. The screening performance of the Y sign alone and in combination with an abnormal cardiac axis was high and may aid in the early diagnosis of aortic dextroposition anomalies in the fetus.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.14533","type":"journal-article","created":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T09:21:11Z","timestamp":1514366471000},"page":"1869-1880","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["\u201cY Sign\u201d at the Level of the 3\u2010Vessel and Trachea View: An Effective Fetal Marker of Aortic Dextroposition Anomalies in the First Trimester"],"prefix":"10.1002","volume":"37","author":[{"given":"Marcin","family":"Pasternok","sequence":"first","affiliation":[{"name":"Center for Prenatal Diagnostics Opole Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Nocun","sequence":"additional","affiliation":[{"name":"Dobreusg Ultrasound Group Practice Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Knafel","sequence":"additional","affiliation":[{"name":"Departments of Gynecology and Obstetrics Jagiellonian University Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariusz","family":"Grzesiak","sequence":"additional","affiliation":[{"name":"Polish Mother's Memorial Hospital Research Institute Lodz Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Orzechowski","sequence":"additional","affiliation":[{"name":"Profemi Private Practice Krotoszyn Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Konarska","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Cardiology Jagiellonian University Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artur","family":"Ludwin","sequence":"additional","affiliation":[{"name":"Dobreusg Ultrasound Group Practice Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inga","family":"Ludwin","sequence":"additional","affiliation":[{"name":"Dobreusg Ultrasound Group Practice Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Zymroz","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Frederic Chopin Clinical District Hospital No. 1 Rzeszow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Parzynska","sequence":"additional","affiliation":[{"name":"Departments of Gynecology and Obstetrics Jagiellonian University Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0656-6614","authenticated-orcid":false,"given":"Marcin","family":"Wiechec","sequence":"additional","affiliation":[{"name":"Dobreusg Ultrasound Group Practice Krakow Poland"},{"name":"Departments of Gynecology and Obstetrics Jagiellonian University Krakow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,12,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3783"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.34.4.585"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2014.08.010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90754-X"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.22657"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000608"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.882"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8814"},{"key":"e_1_2_6_10_1","first-page":"255","article-title":"Normal fetal heart axis and position","volume":"70","author":"Comstock CH","year":"1987","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.10020090.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12478"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(94)00328-B"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2006.25.4.560"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9026"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4023"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2710"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2001.00385.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3949"},{"key":"e_1_2_6_20_1","first-page":"59","article-title":"Sonoanatomie des fetalen Herzens","volume":"6","author":"Chaoui R","year":"1991","journal-title":"Ultraschall Klin Prax"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.09030173.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00801.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5067"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3948"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2404"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13274"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13419"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(88)90100-3"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(75)90034-X"},{"key":"e_1_2_6_30_1","first-page":"157","article-title":"The pathogenesis of tetralogy of Fallot","volume":"73","author":"Winn KJ","year":"1973","journal-title":"Am J Pathol"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/15513818809042970"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12342"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12403"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(94)00350-M"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7614"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.304095158"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12517"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2803"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15866"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjum.14533","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.14533","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T10:13:12Z","timestamp":1695031992000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.14533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,27]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1002\/jum.14533"],"URL":"https:\/\/doi.org\/10.1002\/jum.14533","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"type":"print","value":"0278-4297"},{"type":"electronic","value":"1550-9613"}],"subject":[],"published":{"date-parts":[[2017,12,27]]},"assertion":[{"value":"2017-08-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-10-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}