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Journal of Ultrasound in Medicine, Vol 17, Issue 6 341-348, Copyright © 1998 by American Institute of Ultrasound in Medicine
Three-dimensional ultrasonography of normal fetal heart: comparison with two-dimensional imaging
M. Levental, D. H. Pretorius, M. S. Sklansky, N. E. Budorick, T. R. Nelson and K. Lou
Department of Radiology, McGill University, Jewish General Hospital, Montreal, Quebec, Canada.
Thirty-one high-risk patients (16 to 35 weeks' gestation) underwent
two-dimensional and three-dimensional ultrasonography to compare
two-dimensional and non-cardiac-gated three-dimensional ultrasonography of
the normal fetal heart. After normal two-dimensional studies,
three-dimensional sonographic volumes were acquired without cardiac gating
in transverse and longitudinal planes. Standard cardiac views were derived
from three-dimensional data, analyzed, and rated as follows: (1) not
identifiable, (2) identifiable but inadequate for diagnosis, (3) adequate,
and (4) excellent. Two-dimensional ultrasonography demonstrated better
yields of diagnostically acceptable images of basic echocardiographic views
(four-chamber view, 100% for two-dimensional sonography versus 10 to 71%
for three-dimensional sonography; right ventricular outflow tract, 42% for
two-dimensional versus 6 to 26% for three-dimensional ultrasonography; left
ventricular outflow tract, 71% for two-dimensional versus 13 to 45% for
three-dimensional sonography). In one subject three-dimensional
ultrasonography was superior to two-dimensional sonography in demonstrating
an outflow tract. Aortic and ductal arches were not imaged with the
two-dimensional technique but were available from the acquired
three-dimensional volumes in 3 to 32% and 23%, respectively. False-positive
and false-negative findings were observed on three-dimensional
ultrasonograms. Overall, compared to two-dimensional ultrasonography,
non-cardiac-gated three-dimensional sonography yielded inadequate
reconstructed image quality of basic echocardiographic views (four-chamber
view, right ventricular outflow tract, left ventricular outflow tract).
Three-dimensional ultrasonography, however, shows potential for allowing
nonechocardiographers to acquire some diagnostically acceptable views of
the aortic and ductal arches.
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