Three-dimensional (3-D) ultrasonography for obtaining the four and five-chamber view: comparison with cross-sectional (2-D) fetal sonographic screening

Objectives To assess the ability of Doppler-gated 3-D fetal echocardiograph y to reconstruct and display specific cardiac structures routinely visualiz ed during antenatal ultrasound in a population at low risk for cardiac anom alies. To determine whether any advantage is offered by 3-D sonographic car diac examination over conventional sonographic fetal screening techniques. Design After routine two-dimensional sonographic examination, 3-D cardiac d ata were collected prospectively in 30 fetuses with gestational ages betwee n 19 and 23 weeks from a low risk patient population. Basic echocardiograph ic key views were derived from 3-D data and selected for reconstruction and analysis. Four- and five-chamber views were rated and only those views jud ged to be well visualized were considered as positive results. Results The four- and five-chamber views were well visualized in all but on e fetus using conventional 2-D imaging. Gated 3-D volume data sets enabled visualization of these stuctures in only 19 of 30 fetuses but provided addi tional structural depth and allowed a dynamic 3-D perspective of valvar mor phology and ventricular wall motion. The right ventricular outflow tract wa s available from the 3-D volumes in 16 subjects. Conclusions Considering the versatility of gated 3-D fetal cardiac imaging we believe that it may soon become an important component of fetal screenin g thus helping to retrieve standard cardiac cross sections when 2-D imaging is limited by lack of sonographer experience or sonographic windows. Diagn ostically acceptable echocardiographic views were obtained more consistentl y with 2-D ultrasound than with 3-D volume data.