3-DIMENSIONAL ULTRASOUND EXAMINATION OF THE FETAL HANDS - NORMAL AND ABNORMAL

Purpose To assess particular features of fetal hand evaluation using t hree-dimensional ultrasound, and to determine whether any advantage is offered by three-dimensional over two-dimensional ultrasound in fetal hand evaluation. Methods Three-dimensional fetal data were collected prospectively from 44 hands in 40 fetuses from a predominantly high-ri sk patient population. All had a concurrent two-dimensional ultrasound examination of the hands. Diagnoses from two- and three-dimensional u ltrasound examinations were compared and additional information from t he three-dimensional volume assessment was noted. Three-dimensional as sessment of distal forearm bones, wrist position, finger configuration and number of metacarpals and digits was recorded. Results Hands were appropriately identified as normal (32/32) or abnormal (12/12) by bot h two- and three-dimensional ultrasound. Three-dimensional ultrasound provided additional information when compared to two-dimensional ultra sound in both normal and abnormal hands, including the provision of th ree orthogonal planes with one volume acquisition, allowing rotation o f the volume so that hands could be evaluated in planes not possible d uring two-dimensional imaging, assessment of a hand with loosely curle d fingers as normal, the ability to evaluate thumb and fingers simulta neously, and improved assessment of abnormal hands. Conclusions Three- dimensional ultrasound offers the potential to provide greater informa tion in fetal hand evaluation for both normal and abnormal hands.