title: Four-dimensional sonography with B-flow imaging and spatiotemporal image correlation for visualization of the fetal heart.
abstract: OBJECTIVE
  To use B-flow imaging with 4-dimensional (4D) sonography and spatiotemporal image correlation (STIC) in the evaluation of normal fetal heart and congenital heart disease during pregnancy.
  
  
  METHODS
  Volume data sets of the fetal heart were acquired with automated transverse and longitudinal sweeps of the anterior chest wall. We studied 13 normal fetuses and 2 fetuses with congenital heart disease (1 double-outlet right ventricle and 1 hypoplastic left heart syndrome) at gestation ages ranging from 13 to 39 weeks using transabdominal 4D B-flow sonography with STIC (4D BF-STIC).
  
  
  RESULTS
  4D BF-STIC demonstrated dynamic angiographic features in both normal and abnormal fetal hearts. 4D BF-STIC images could not be obtained in 2 normal fetuses at 18.1 and 33.1 weeks because of the high fetal heart rate and inappropriate fetal position. In normal fetal heart, characteristic hemodynamic changes in both atria and ventricles were clearly demonstrated in systole and diastole. 4D BF-STIC also allowed visualization of the relationship, size, and course of the outflow tracts, thus helping the examiner to better understand the relationships between the vessels. In a case of hypoplastic left heart syndrome, dramatic hemodynamic changes including the right atrium, right ventricle, and pulmonary artery were evident. In a case of double-outlet right ventricle with ventricular septal defect, left-to-right shunt flow through a ventricular septal defect was clearly shown, as were great arteries originating in parallel from the right ventricle.
  
  
  CONCLUSIONS
  4D BF-STIC provides a means of real-time 3-dimensional evaluation of fetal intracardiac and extracardiac hemodynamics in the second and third trimesters. This novel technique assists in the evaluation of fetal cardiac hemodynamics and may play an important role in future fetal cardiac research and in the evaluation of congenital heart disease in the fetus.
authors.affiliation: Department of Perinatology and Gynecology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hata
authors.forename: Shu-Yan
authors.initials: SY
authors.lastname: Dai
authors.forename: Eisuke
authors.initials: E
authors.lastname: Inubashiri
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanenishi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yanagihara
authors.forename: Seiko
authors.initials: S
authors.lastname: Araki
mesh_terms: D003326:Coronary Circulation; D019561:Echocardiography, Four-Dimensional; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging* / Q000196:embryology*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third