title: A systematic approach to the use of the multiplanar display in evaluation of abnormal vascular connections to the fetal heart using 4-dimensional ultrasonography.
abstract: OBJECTIVE
  The multiplanar display is a modality that allows the simultaneous visualization of 3 orthogonal planes from volume data sets obtained with 3- and 4-dimensional ultrasonography. Simultaneous display of standard views used in fetal echocardiography and their orthogonal planes may provide novel ultrasonographic views for examination of the fetal heart and its vascular connections. This study was designed to determine the clinical utility of the multiplanar display in the examination of abnormal vascular connections to the fetal heart.
  
  
  METHODS
  We reviewed 4-dimensional volume data sets, acquired with the spatiotemporal image correlation technique, from patients with abnormal vascular connections to the fetal heart. Multiplanar views of the fetal heart were used to simultaneously display standard planes used in fetal echocardiography and their corresponding orthogonal planes.
  
  
  RESULTS
  This study included 4 volume data sets from fetuses with confirmed abnormal vascular connections to the heart, including: (1) an interrupted inferior vena cava with azygos or hemiazygos vein continuation; (2) a persistent left superior vena cava draining into a dilated coronary sinus; and (3) a dilated superior vena cava associated with a thoracic lymphangioma. Simultaneous visualization of orthogonal planes displaying abnormal vascular connections to the fetal heart facilitated identification of the abnormal vessels and their spatial relationships with other vascular structures.
  
  
  CONCLUSIONS
  Multiplanar imaging can be used to assess abnormal vascular connections to the fetal heart and may provide novel ultrasonographic planes for fetal echocardiography using 3- and 4-dimensional ultrasonography.
authors.affiliation: Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA. jespinoz@med.wayne.edu
authors.forename: Jimmy
authors.initials: J
authors.lastname: Espinoza
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
authors.forename: Francesca
authors.initials: F
authors.lastname: Gotsch
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Wesley
authors.initials: W
authors.lastname: Lee
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
authors.forename: Luís F
authors.initials: LF
authors.lastname: Gonçalves
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Schoen
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
mesh_terms: D003626:Data Display; D019560:Echocardiography, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000295:instrumentation / Q000379:methods*; D014584:User-Computer Interface; D054079:Vascular Malformations / Q000000981:diagnostic imaging*