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

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Abstract
Objectives To assess the ability of Doppler‐gated 3‐D fetal echocardiography to reconstruct and display specific cardiac structures routinely visualized during antenatal ultrasound in a population at low risk for cardiac anomalies. To determine whether any advantage is offered by 3‐D sonographic cardiac examination over conventional sonographic fetal screening techniques. Design After routine two‐dimensional sonographic examination, 3‐D cardiac data were collected prospectively in 30 fetuses with gestational ages between 19 and 23 weeks from a low risk patient population. Basic echocardiographic 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 judged to be well visualized were considered as positive results. Results The four‐ and five‐chamber views were well visualized in all but one 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 additional structural depth and allowed a dynamic 3‐D perspective of valvar morphology and ventricular wall motion. The right ventricular outflow tract was 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 screening thus helping to retrieve standard cardiac cross sections when 2‐D imaging is limited by lack of sonographer experience or sonographic windows. Diagnostically acceptable echocardiographic views were obtained more consistently with 2‐D ultrasound than with 3‐D volume data. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology