Three-dimensional (3-D) ultrasonography for obtaining the four and five-chamber view: comparison with cross-sectional (2-D) fetal sonographic screening.
OBJECTIVE
To assess the ability of Doppler-gated 3-D fetal echocardiography to reconstruct and display specific cardiac structures routinely visualized during antenatal ultrasound in a population at low risk for cardiac anomalies. To determine whether any advantage is offered by 3-D sonographic cardiac examination over conventional sonographic fetal screening techniques.


METHODS
After routine two-dimensional sonographic examination, 3-D cardiac data were collected prospectively in 30 fetuses with gestational ages between 19 and 23 weeks from a low risk patient population. Basic echocardiographic key views were derived from 3-D data and selected for reconstruction and analysis. Four- and five-chamber views were rated and only those views judged to be well visualized were considered as positive results.


RESULTS
The four- and five-chamber views were well visualized in all but one fetus using conventional 2-D imaging. Gated 3-D volume data sets enabled visualization of these structures in only 19 of 30 fetuses but provided additional structural depth and allowed a dynamic 3-D perspective of valvar morphology and ventricular wall motion. The right ventricular outflow tract was available from the 3-D volumes in 16 subjects.


CONCLUSIONS
Considering the versatility of gated 3-D fetal cardiac imaging we believe that it may soon become an important component of fetal screening thus helping to retrieve standard cardiac cross sections when 2-D imaging is limited by lack of sonographer experience or sonographic windows. Diagnostically acceptable echocardiographic views were obtained more consistently with 2-D ultrasound than with 3-D volume data.
Meyer-Wittkopf
M
M
Department of Obstetrics and Perinatal Medicine, Philipps-University of Marburg, Germany.
Rappe
N
N
Sierra
F
F
Barth
H
H
Schmidt
S
S
D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods