Real-time three-dimensional fetal echocardiography: initial feasibility study.

Abstract

Real‐time three‐dimensional echocardiography acquires data as a volume rather than as a series of planar images, thereby obviating cardiac or respiratory gating and limiting artifacts generated by random motion. This study was undertaken to evaluate the feasibility of using real‐time three‐dimensional echocardiography to evaluate fetal cardiac anatomy and function. Ten human fetuses were evaluated in utero, four of whom had congenital heart disease. Freehand transabdominal scanning was performed on each pregnant woman using a real‐time three‐dimensional echocardiography system. Four volume clips at 20 volumes/s of duration 1.5 s each were obtained on each fetal heart and stored for off‐line analysis. Data were displayed immediately as a series of four simultaneous planes, with the ability for the observer to manipulate the position of each plane within the acquired volume data set. Cardiac motion could be slowed, stopped, or viewed at its original speed. Most structures and views, as well as cardiac function, could be visualized consistently. Abnormal structures could be detected readily. Off‐line analysis was rapid and easy. We conclude that fetal real‐time three‐dimensional echocardiography is a feasible, facile, and rapid new technique.

Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): A systematic study of standard cardiac views assessed by different observers

“…Three-dimensional [45][46][47][48][49][50][51] and, more recently, four-dimensional ultrasonography of the fetal heart [52][53][54][55][56][57][58] have the potential for making the examination less operator-dependent. Once a volume dataset is acquired, the heart can be examined using multiple planes of section, some of which are unobtainable with two-dimensional ultrasound.…”

Real-time 3-Dimensional Fetal Echocardiography With an Instantaneous Volume-Rendered Display

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Rapid and facile, 3D imaging allows the acquisition of a volume data set in a matter of seconds, in comparison with the more prolonged interval typically required for conventional fetal cardiac imaging. Thus, whereas conventional fetal cardiac imaging requires a great deal of expertise, acquisition of volume data sets appears far less dependent on operator expertise.…”

“…Unlike reconstructive approaches to 3D fetal cardiac imaging, real-time 3D fetal cardiac imaging avoids the need for cardiac gating. 12,13,15 Gating the fetal heart, because of the lack of a fetal electrocardiogram, brings added complexity and the potential for artifacts to 3D imaging. More importantly, 3D reconstructive approaches require the sweep of a plane of ultrasound over the fetal heart, usually over 5 to 15 seconds or more.…”

“…12,13,15 Previous investigations have shown instantaneous high-quality reformatted planar displays. 12,15 However, rendered displays have involved cumbersome, time-consuming offline processing and have had poor image quality. 13 Recently, a high-resolution real-time 3D sonographic imaging platform was developed that provides instantaneous rendered displays.…”

“…12,13,15 Although reconstructive techniques acquire a series of planar images over several seconds, real-time approaches acquire entire volumes (rather than single planes) instantaneously, using specialized 2D matrix, phased array transducers. As a result, real-time imaging avoids the need for cardiac gating and avoids artifacts related to arbitrary fetal motion during the acquisition.…”