Three-dimensional ultrasound in the evaluation of fetal anomalies

Objectives To determine the additional information and clinical impact prov ided by three-dimensional ultrasound (3D US) imaging of fetal anomalies com pared to conventional 2-dimensional ultrasound (2D US). Materials and methods Sixty-three patients with 103 anomalies were scanned prospectively with both 2D and 3D US. Each anomaly was reviewed by one or m ore fetal imaging specialists to determine whether the 3D US data were adva ntageous, equivalent, or disadvantageous when compared with 2D US images. C linical impact and pathologic or clinical outcome were determined in all ca ses. Results The 3D US images provided additional information in 53 anomalies (5 1%), were equivalent to 2D US images in 46 anomalies (45%), and were disadv antageous in four anomalies (4%). The 3D US was most helpful in evaluating fetuses with facial anomalies, hand and foot abnormalities and axial spine and neural tube defects. Planar images derived from 3D US volume data sets generally were more helpful for diagnostic purposes, whereas rendered 3d US images were more useful as a point of reference and were better appreciate d by patients in understanding fetal abnormalities. Additional information provided by 3D US images impacted clinical management in 5% of patients. Th e 3D US images were disadvantageous in two fetuses with multiple anomalies and two with cardiac anomalies. Conclusion The 3D US offered diagnostic advantages in about one-half of the selected cases studied and had effect on patient management in 5% of cases . This modality can be a powerful adjunctive tool to 2D US in providing a m ore comprehensible, 3D US impression of congenital anomalies. Thus, 3D US i s currently most helpful as a targeted study complementing 2D US.