Three-dimensional (3D) echocardiographic analysis of congenital heart disease in the fetus: comparison with cross-sectional (2D) fetal echocardiography

Objective We attempted to assess the ability of Doppler-gated three-dimensi onal (3D) fetal echocardiography to reconstruct and display specific cardia c structures in fetuses with cardiac anomalies and to determine whether any advantage is offered by 3D sonographic cardiac examination otter conventio nal fetal echocardiography. Design After 2D fetal echocardiographic examination, 3D cardiac data were c ollected prospectively in 22 fetuses with various congenital heart defects. Their ages ranged from 19 to 35 weeks' gestation, Basic echocardiographic key views of the venoatrial, atrioventricular and ventriculoarterial connec tions were derived from volume data sets and selected for 3D reconstruction and analysis. Comparisons were made with 2D echocardiographic imaging of t he fetal hearts and the diagnostic image quality of visualized structural d etails was evaluated. Results The underlying cardiac malformation was well or satisfactorily visu alized in 20 fetuses using 2D imaging. Gated 3 D volume data sets enabled d iagnostically acceptable visualization of all affected cardiac structures i n 7 of 22 fetuses. High- quality 3D reconstruction of the site and spatial orientation of ventricular septal defects teas obtained in 9 of 13 patients . Two-dimensional imaging remained the principal diagnostic modality in all cases with additional structural detail being obtained by 3D imaging in on ly Two fetuses. Conclusions Three-dimensional imaging of fetal heart disease is feasible fo r a wide range of lesions, and may provide additional information of clinic al value in a small number of cases when compared with 2D imaging.