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Stereoscopic Evaluation of Fetal Bony Structures

Department of Radiology, University of California, San Diego, La Jolla, California USA (T.R.N., D.H.P.); Department of Electrical Engineering, Oregon State University, Corvallis, Oregon USA (M.J.B.); Department of Radiology, Cha General Hospital, Pochon Cha University, Seoul, Korea (E.K.J.); and Department of Radiology, Ulsan University Hospital, University of Ulsan, Ulsan, Korea (J.H.L.).

Address correspondence to Thomas R. Nelson, PhD, Department of Radiology, 0610, University of California, San Diego, La Jolla, CA 92037–0610 USA. E-mail: tnelson{at}ucsd.edu

Objective. The purpose of this study was to assess the performance of stereoscopic compared with conventional viewing of 3-dimensional ultrasound (3DUS) data for evaluation of fetal bony structures. Methods. A series of 47 human fetuses were evaluated with conventional 3DUS scanning systems. Twenty-five volumes of the fetal head, thorax, and abdomen were acquired. Volume-rendered images of the fetal cranium and spine were displayed interactively on a real-time stereoscopic graphics workstation. Visualization parameters were interactively optimized. Both conventional and stereoscopic images were evaluated for the clarity of structure visualization (0, nonvisualized; 1, nondiagnostic; 2, adequate; and 3, excellent), the ability to identify key anatomic landmarks (eg, sutures, palate, vertebrae, and ribs), artifacts, and evaluation time. Results. Fetal bony structures, especially high-contrast structures, were readily identified with both conventional and stereoscopic. Overall, stereoscopic viewing provided a statistically significant improvement compared with conventional viewing (P < .01), improved conspicuity of complex bony structures, and added structural detail information that assisted in identification of complex anatomy in 14% of the fetal skull and 26% of the fetal spine cases. Overlapping structures were better identified on the volume-rendered stereoscopic display, with stereoscopic viewing improving differentiation of near and far structures. An interactive display and inclusion of a planar slice review further assisted in identification of structures. The evaluation times were comparable for the two methods. Conclusions. The stereoscopic display of rendered 3DUS data adds valuable information that assists in identification of fetal bony structures, such as cranial sutures and spinal vertebrae, particularly in complex formations. The increasing availability of stereoscopic visualization workstations will offer an additional tool for fetal diagnosis and evaluation.

Key Words: fetal • obstetrics • stereoscopic vision • 3-dimensional ultrasound

Abbreviations: LCD, liquid crystal display • MIP, maximum-intensity projection • 3DUS, 3-dimensional ultrasound