A Systematic Approach to Prenatal Diagnosis of Transposition of the Great Arteries Using 4-Dimensional Ultrasonography With Spatiotemporal Image Correlation

Role of 3-D Ultrasound in Clinical Obstetric Practice: Evolution Over 20 Years

“…In addition, insonation perpendicular to the structures of interest does not image color Doppler signals and should be avoided during volume acquisition (Chaoui et al 2004). Gonçalves et al (2004b) were the first to illustrate that 4-D gray-scale and power Doppler STIC can be used to systematically visualize the abnormal relationship of the outflow tracts in fetuses with transposition of the great arteries, with volume acquisition requiring only clear visualization of the apical four-chamber view during 2-D ultrasonography for 7.5 to 15 s. Yagel et al (2005) confirmed the accuracy of 4-D color Doppler ultrasound using STIC in the assessment of fetal ventricular septal defects. Gonçalves et al (2005b) established the clinical usefulness of STIC 4-D data sets and addressed the necessity for appropriate training in a study evaluating the agreement between two independent observers and the reproducibility of STIC technique to display standard cardiac views of the left and right ventricular outflow tracts by analyzing 20 volume data sets of satisfactory quality.…”

Three- and 4-Dimensional Ultrasonography in the Prenatal Evaluation of Fetal Anomalies Associated With Trisomy 18

“…[27][28][29] With the mutiplanar and TUI options, the 4D volume acquired by STIC could facilitate visualization of these planes and could potentially reduce operator dependence. [30][31][32][33][34][35] Of course, acoustic rib shadows, artifacts from fetal motion, and the lesser resolution were obstacles to gaining desired views from 4D STIC volumes, and even some standard anatomic planes of the fetal heart were captured by Zheng et al 2DUS with better quality and in less time. 36,37 Although the sensitivity for detecting fetal heart defects related to trisomy 18 was not obviously improved by exploring 4D volumes, in our experience it still provided the capability to further show fetal cardiac structures (normal and abnormal) already detected by 2DUS and the possibility to detect additional cardiac anomalies.…”

Improving Detection of Transposition of the Great Arteries in Routine Obstetric Sonographic Screening

“…This allows for dynamic multiplanar slicing and surface rendering of the fetal cardiac structures. 7,8 With B-mode imaging, a diagnosis of TGA depends on the screening sonographer's ability to visualize the outflow tracts crossing normally, but this skill is technically difficult for many sonographers. Goncalves et al 8 have suggested that by using 3D and 4D sonography with STIC, one can bypass the individual technical difficulties that screening sonographers may have: "Four dimensional volume data set acquisition followed by a systematic approach to image the outflow tracts may reduce the operator dependency of prenatal sonography."…”

“…7,8 With B-mode imaging, a diagnosis of TGA depends on the screening sonographer's ability to visualize the outflow tracts crossing normally, but this skill is technically difficult for many sonographers. Goncalves et al 8 have suggested that by using 3D and 4D sonography with STIC, one can bypass the individual technical difficulties that screening sonographers may have: "Four dimensional volume data set acquisition followed by a systematic approach to image the outflow tracts may reduce the operator dependency of prenatal sonography." They also state that "volume acquisition is still operator dependent with current technology but once a good quality volume data set is obtained, the outflow tracts can be systematically imaged by following algorithms developed for B-mode, color and power Doppler imaging."…”

“…They also state that "volume acquisition is still operator dependent with current technology but once a good quality volume data set is obtained, the outflow tracts can be systematically imaged by following algorithms developed for B-mode, color and power Doppler imaging." 8 This technique starts off by achieving visualization of the four-chamber view of the fetal heart. Volumes are obtained in sweeps through the ventricles, atria, and major vessels.…”