Does 3D imaging of the fetal spine improve confidence in interpreting images in the second trimester?

Abstract

IntroductionThis study investigated the addition of 3D ultrasound imaging to 2D ultrasound imaging when assessing the fetal spine in the second trimester in relation to: the diagnostic confidence of image assessors in interpretation, sonographer perceptions of the challenges in acquiring 3D images, and the additional time required to acquire 3D images.MethodsSix image assessors rated their diagnostic confidence when assessing 2D and 3D images of the fetal spine images acquired from second trimester morphology scans. Sonographer perceptions were investigated using a questionnaire assigned to eight sonographers. The mean time required to take 3D images of the fetal spine was retrospectively calculated using the time stamps from the ultrasound images of 100 second trimester morphology scans.ResultsCommon reasons for assessor's lack of confidence in reporting were poor quality or insufficient images of the upper spine (cervical/thoracic), the scapulae and/or the ribs. Diagnostic confidence of image assessors increased significantly (<.001) when 3D imaging was added to 2D imaging. All sonographers who completed the questionnaire stated that they found 3D ultrasound of the fetal spine useful in addition to 2D. 87.5% of these sonographers sometimes found 3D ultrasound challenging, mostly due to fetal position, or maternal obesity. The mean additional time required to perform 3D ultrasound to assess the fetal spine was 2 minutes and 19 seconds.ConclusionAdding 3D ultrasound of the fetal spine to a 2D second trimester obstetric morphology scan increased the diagnostic confidence of image assessors with only a small additional time requirement.