Three- and four-dimensional ultrasound: new methods for evaluating fetal thoracic anomalies
Article first published online: 11 JUN 2008
Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 32, Issue 1, pages 36–43, July 2008
How to Cite
Achiron, R., Gindes, L., Zalel, Y., Lipitz, S. and Weisz, B. (2008), Three- and four-dimensional ultrasound: new methods for evaluating fetal thoracic anomalies. Ultrasound Obstet Gynecol, 32: 36–43. doi: 10.1002/uog.5308
- Issue published online: 19 JUN 2008
- Article first published online: 11 JUN 2008
- Manuscript Accepted: 11 DEC 2007
- fetal thoracic anomalies;
- prenatal diagnosis;
- prenatal ultrasound
To study three- (3D) and four-dimensional (4D) ultrasound applications for the evaluation of fetal thoracic anomalies.
Volume datasets of 23 fetuses with thoracic anomalies were acquired with static 3D and cine 4D ultrasound, i.e. spatiotemporal image correlation (STIC) mode. The volumes were analyzed and displayed by multiplanar and tomographic ultrasound imaging (TUI) modes and static volume contrast imaging (VCI). Color Doppler was added to the volumes acquired, and various rendering modes were used to display the volume datasets.
The mean gestational age at evaluation was 22 (range, 14–34) weeks. The anomalies were identified as: diaphragmatic hernia (n = 5), lung dysplasia (n = 11), skeletal dysplasia with small thorax/thanatophoric dysplasia (n = 2), abnormal situs (n = 2), hydrothorax (n = 2) and esophageal atresia (n = 1). The TUI mode achieved optimal display of the thorax, thereby aiding the diagnosis of diaphragmatic hernia and lung dysplasia. In right diaphragmatic hernias, the VCI mode proved invaluable as it distinguished liver from lung tissue. High-definition color Doppler with glass-body rendering significantly contributed to the detection of abnormal vascularization in lung dysplasia. Maximal transparent mode with a transvaginal transducer provided accurate diagnosis of skeletal dysplasia in the first trimester. Situs abnormalities were best viewed with a minimal transparent mode, in which abnormal organs and positions of vessels were clearly identified. Pleuroamniotic shunt localization was monitored precisely by 3D in a fetus with hydrothorax, and inversion mode added important information regarding the size of an esophageal pouch in a fetus with esophageal atresia.
The 3D-4D technique is a novel, useful sonographic tool for evaluating the fetal thorax. It enhances precise diagnosis and provides better spatial visualization of the anomalies involved. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.