{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:47:30Z","timestamp":1782276450981,"version":"3.54.5"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2022YFF0606301"],"award-info":[{"award-number":["2022YFF0606301"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to evaluate the feasibility of direct visualization of a normal fetal palate and detect cleft palate in the first trimester with a novel three-dimensional ultrasound (3D US) technique, Crystal and Realistic Vue (CRV) rendering technology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two-dimensional (2D) images and 3D volumes of healthy and cleft palate fetuses at 11\u201313<jats:sup>+6<\/jats:sup> weeks were obtained prospectively. 2D ultrasound views included the coronal view of the retronasal triangle and the midsagittal view of the face. 3D-CRV views were analyzed by multiplanar mode display. The pregnancy outcomes of all fetuses were determined during the follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our study, 124 fetuses were recruited, including 100 healthy fetuses and 24 cleft palate fetuses. The cleft palate with lip was observed in 23 fetuses (bilateral in 15, unilateral in 6, median in 2), and one cleft palate was only found in the abnormal group. The bilateral (<jats:italic>n<\/jats:italic>\u2009=\u200912) and median (<jats:italic>n<\/jats:italic>\u2009=\u20092) cleft palates with lips and the cleft palate alone (<jats:italic>n<\/jats:italic>\u2009=\u20091) were associated with other anatomical or chromosomal abnormalities, and one unilateral cleft palate with cleft lip had concomitant NT thickening. In the cleft palate fetus group, 16 fetuses suffered intrauterine death, which was associated with other structural or chromosomal abnormalities in 14 fetuses, seven cases were terminated after consultation, and one was delivered at term. The coronal view of the retronasal triangle and the midsagittal view was easily obtained in all fetuses. 3D-CRV images of palatal parts were clearly obtained in all cases. Unilateral, bilateral, and median cleft palates with cleft lips were visually demonstrated and classified by the 3D-CRV technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is feasible to identify the palate by 3D-CRV in the first trimester in both healthy and cleft palate fetuses. Together with 2D ultrasonography as a complementary diagnostic tool, 3D-CRV is helpful in classifying the cleft palate with a reasonable degree of certainty.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1199965","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T20:03:10Z","timestamp":1689364990000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Cleft palate in fetuses: feasibility of early diagnosis by Crystal and Realistic Vue rendering 3D ultrasound technology in the first trimester"],"prefix":"10.3389","volume":"11","author":[{"given":"Zhihong","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxuan","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhong","family":"Leng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuemei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengli","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"B1","first-page":"248","volume-title":"Callen\u2019s ultrasonography in obstetrics and gynecology","author":"Mary","year":"2019"},{"key":"B2","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.jormas.2021.05.008","article-title":"Global prevalence of cleft palate, cleft lip and cleft palate and lip: a comprehensive systematic review and meta-analysis","volume":"123","author":"Salari","year":"2022","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1016\/j.molmed.2011.07.007","article-title":"Breakthroughs in the genetics of orofacial clefting","volume":"17","author":"Mangold","year":"2011","journal-title":"Trends Mol Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"108373","DOI":"10.1016\/j.mrrev.2021.108373","article-title":"Orofacial clefts embryology, classification, epidemiology, and genetics","volume":"787","author":"Nasreddine","year":"2021","journal-title":"Mutat Res Rev Mutat Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1111\/j.1601-0825.2009.01577.x","article-title":"The genetics of isolated orofacial clefts: from genotypes to subphenotypes","volume":"15","author":"Jugessur","year":"2009","journal-title":"Oral Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1002\/pd.5794","article-title":"Prenatal ultrasound diagnosis of cleft palate without cleft lip, the new ultrasound semiology","volume":"40","author":"Faure","year":"2020","journal-title":"Prenat Diagn"},{"key":"B7","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1002\/1097-0223(200011)20:11%3C870::AID-PD940%3E3.0.CO;2-J","article-title":"Evaluation of prenatal diagnosis of cleft lip with or without cleft palate and cleft palate by ultrasound: experience from 20 European registries","volume":"20","author":"Clementi","year":"2000","journal-title":"Prenat Diagn"},{"key":"B8","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1002\/uog.5280","article-title":"Prenatal ultrasound detection of facial clefts: a prospective study of 49,314 deliveries in a non-selected population in Norway","volume":"31","author":"Offerdal","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1002\/uog.24888","article-title":"ISUOG practice guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan","volume":"59","author":"Salomon","year":"2022","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1097\/GCO.0000000000000852","article-title":"Understanding the distinction between cleft lip and cleft palate: a critical step for successful prenatal detection","volume":"35","author":"Minor","year":"2023","journal-title":"Curr Opin Obstet Gynecol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1002\/pd.5189","article-title":"The 2D axial transverse views of the fetal face: a new technique to visualize the fetal hard palate; methodology description and feasibility","volume":"37","author":"Fuchs","year":"2017","journal-title":"Prenat Diagn"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1111\/aogs.13418","article-title":"A score-based method for quality control of fetal hard palate assessment during routine second-trimester ultrasound examination","volume":"97","author":"Fuchs","year":"2018","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B13","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1002\/uog.7484","article-title":"Retronasal triangle: a sonographic landmark for the screening of cleft palate in the first trimester","volume":"35","author":"Sepulveda","year":"2010","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1002\/uog.21931","article-title":"Absent \u2018superimposed-line\u2019 sign: novel marker in early diagnosis of cleft of fetal secondary palate","volume":"56","author":"Lakshmy","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.7863\/ultra.16.05084","article-title":"First-trimester sonographic evaluation of palatine clefts: a novel diagnostic approach","volume":"36","author":"Lakshmy","year":"2017","journal-title":"J Ultrasound Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1002\/pd.4242","article-title":"Sonographic assessment of fetal secondary palate between 12 and 16 weeks of gestation using three-dimensional ultrasound","volume":"33","author":"Zajicek","year":"2013","journal-title":"Prenat Diagn"},{"key":"B17","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/uog.10139","article-title":"First-trimester diagnosis of cleft lip and palate using three-dimensional ultrasound","volume":"40","author":"Martinez-Ten","year":"2012","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1002\/uog.15800","article-title":"Crystal Vue technique for imaging fetal spine and ribs","volume":"47","author":"Dall\u2019Asta","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.ajog.2018.11.1088","article-title":"How to obtain diagnostic planes of the fetal central nervous system using three-dimensional ultrasound and a context-preserving rendering technology","volume":"220","author":"Dall\u2019Asta","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1755","DOI":"10.1080\/14767058.2018.1526899","article-title":"Prenatal diagnosis of fetal multiple hemivertebrae: the importance of 3D ultrasound assessment","volume":"33","author":"Volpe","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1002\/uog.20221","article-title":"Sonographic demonstration of fetal esophagus using three-dimensional ultrasound imaging","volume":"54","author":"Dall\u2019Asta","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1002\/uog","article-title":"Evaluation of tramline sign for prenatal diagnosis of abnormally invasive placenta using three-dimensional ultrasound and Crystal Vue rendering technology","volume":"52","author":"Dall\u2019Asta","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1002\/uog.17346","article-title":"Qualitative evaluation of crystal vue rendering technology in assessment of fetal lip and palate","volume":"49","author":"Dall\u2019Asta","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1002\/uog.3954","article-title":"Prenatal ultrasound examination of the secondary palate","volume":"29","author":"Campbell","year":"2007","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1002\/uog.3877","article-title":"A novel technique for visualization of the normal and cleft fetal secondary palate: angled insonation and three-dimensional ultrasound","volume":"29","author":"Pilu","year":"2007","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1002\/uog.22123","article-title":"Prospective ultrasound diagnosis of orofacial clefts in the first trimester","volume":"58","author":"Wu","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1046\/j.0960-7692.2001.00575.x","article-title":"Fetal cleft lip and palate: sonographic diagnosis, chromosomal abnormalities, associated anomalies and post natal outcome in 70 fetuses","volume":"18","author":"Berge","year":"2001","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1199965\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T20:03:14Z","timestamp":1689364994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1199965\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,14]]},"references-count":27,"alternative-id":["10.3389\/fped.2023.1199965"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1199965","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,14]]},"article-number":"1199965"}}