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Kumar M, Anand R, Jain R, Shukla S, Bhatt C. Prenatal Diagnosis of Short Rib-Polydactyly Type II by Ultrasound in Three Consecutive Pregnancies. J Obstet Gynaecol India 2016; 66:620-622. [PMID: 27803525 DOI: 10.1007/s13224-016-0896-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/12/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Manisha Kumar
- Department of Obstetrics and Gynecology, SSK Hospital, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, India 110001
| | - Rama Anand
- Department of Radiology, SSK Hospital, Lady Hardinge Medical College, New Delhi, India
| | - Reenu Jain
- Department of Obstetrics and Gynecology, SSK Hospital, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, India 110001
| | - S Shukla
- Department of Radiology, SSK Hospital, Lady Hardinge Medical College, New Delhi, India
| | - Chetna Bhatt
- Department of Obstetrics and Gynecology, SSK Hospital, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, India 110001
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Smith A, Chudleigh T, Maxwell D. Incorporating 3D and 4D Ultrasound into Clinical Practice. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2016. [DOI: 10.1179/174313405x27445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
3D ultrasound has been slow to make significant impact in clinical practice. In a large part, this is because 2D ultrasound is of such superior quality that sonographers have not seen any gain in adopting the new technology. More recently, however, diverse application of 3D technology has taken place in many branches of medicine, with obstetrics and gynaecology at the forefront. Several manufacturers now produce machines of remarkable sophistication and utility. Hardware and software have been integrated to allow the release of information from the ultrasound examination that has hitherto not been possible. In addition, virtual real time 3D images (4D ultrasound) have captured the imagination of both public and media. We report our preliminary clinical experience with 3 and 4D ultrasound in a limited clinical environment. While not suitable for wide scale application at present, we believe this technology has inherent advantages that will secure its clinical role and that this role will widen rapidly in the near future.
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Gonçalves LF. Three-dimensional ultrasound of the fetus: how does it help? Pediatr Radiol 2016; 46:177-89. [PMID: 26829949 DOI: 10.1007/s00247-015-3441-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/30/2015] [Accepted: 07/13/2015] [Indexed: 01/20/2023]
Abstract
Three-dimensional ultrasonography (3-D US) was introduced to the field of fetal imaging in the early 1990s. Since then several publications have described potential applications for the diagnosis of congenital malformations as well as organ volumetry. This article reviews basic principles of 3-D US as well as its clinical applicability to prenatal diagnosis of abnormalities involving the face, spine and skeletal system, as well as potential applications of 3-D US for fetal cardiovascular and neuroimaging. Limitations related to motion artifacts, acoustic shadowing and barriers to clinical implementation of 3-D US in clinical practice are addressed.
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Affiliation(s)
- Luis F Gonçalves
- Department of Radiology and Department of Obstetrics & Gynecology, Beaumont Health System,, Divisions of Pediatric Radiology and Fetal Imaging,, 360 W. 13 Mile Road, Royal Oak, MI, 48073, USA.
- Department of Radiology and Department of Obstetrics & Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
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Abstract
In this review, we discuss aspects of the prenatal diagnosis of fetal skeletal malformations, concentrating on the advantages offered by different imaging techniques and the approaches that are of value in evaluating a suspected skeletal dysplasia. We also briefly address the findings in some of the commoner malformations of the fetal skeleton that may be encountered.
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Affiliation(s)
- Ann-Edwidge Noel
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Richard N Brown
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
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Eleftheriades M, Iavazzo C, Manolakos E, Hassiakos D, Botsis D, Petersen M, Konstantinidou A. Recurrent short rib polydactyly syndrome. J OBSTET GYNAECOL 2012; 33:14-6. [DOI: 10.3109/01443615.2012.698334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ulla M, Aiello H, Cobos MP, Orioli I, García-Mónaco R, Etchegaray A, Igarzábal ML, Otaño L. Prenatal diagnosis of skeletal dysplasias: contribution of three-dimensional computed tomography. Fetal Diagn Ther 2011; 29:238-47. [PMID: 21212631 DOI: 10.1159/000322212] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 10/20/2010] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To describe the contribution of 3-dimensional computed tomography (3D-CT) in the prenatal diagnosis of skeletal dysplasias (SD) in a cohort of patients with inconclusive diagnosis by ultrasound (US). METHODS Between May 2007 and February 2010, six pregnant women with suspected fetal SD on US examination but with no specific diagnosis were studied with 3D-CT. The images were evaluated by a multidisciplinary team who proposed a likely diagnosis. Further postnatal workup included clinical and radiological evaluation in all cases. Prenatal and postnatal diagnoses were compared. RESULTS The use of 3D-CT provided a precise diagnosis confirmed postnatally in 5/6 patients. These included osteogenesis imperfecta type II (n = 2), osteogenesis imperfecta type III (n = 1), chondrodysplasia punctata (n = 1) and thanatophoric dysplasia type I (n = 1). A precise diagnosis could not be made in 1 case - either pre- or postnatally. CONCLUSION Prenatal 3D-CT contributed to the diagnosis of the specific fetal SD in the majority of these cases. 3D-CT may have a complementary role to US where fetal SD is suspected, but no specific diagnosis can be made using US alone. Further studies on clinical performance and risk-benefit analysis are needed.
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Affiliation(s)
- Marina Ulla
- Department of Radiology, Hospital Italiano de Buenos Aires, Universidad de Buenos Aires, Argentina. marina.ulla @ hospitalitaliano.org.ar
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Yamada T, Nishimura G, Nishida K, Sawai H, Omatsu T, Kimura T, Nishihara H, Shono R, Shimada S, Morikawa M, Mizushima M, Yamada T, Cho K, Tanaka S, Shirato H, Minakami H. Prenatal diagnosis of short-rib polydactyly syndrome type 3 (Verma-Naumoff type) by three-dimensional helical computed tomography. J Obstet Gynaecol Res 2010; 37:151-5. [DOI: 10.1111/j.1447-0756.2010.01324.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Suspected fetal skeletal malformations or bone diseases: how to explore. Pediatr Radiol 2010; 40:1046-51. [PMID: 20432024 DOI: 10.1007/s00247-010-1598-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 01/24/2010] [Indexed: 01/30/2023]
Abstract
Skeletal dysplasias are a heterogeneous and complex group of conditions that affect bone growth and development and result in various anomalies in shape and size of the skeleton. Although US has proved reliable for the prenatal detection of skeletal abnormalities, the precise diagnosis of a dysplasia is often difficult to make before birth (especially in the absence of a familial history) due to their various phenotypic presentations, the variability in the time at which they manifest and often, the lack of precise molecular diagnosis. In addition to the accuracy of the antenatal diagnosis, it is very important to establish a prognosis. This is a clinically relevant issue as skeletal dysplasias may be associated with severe disability and may even be lethal. We will therefore describe the respective role of two-dimensional (2-D) US, three-dimensional (3-D) US and CT in the antenatal assessment of skeletal malformations.
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Prager RW, Ijaz UZ, Gee AH, Treece GM. Three-dimensional ultrasound imaging. Proc Inst Mech Eng H 2010; 224:193-223. [PMID: 20349815 DOI: 10.1243/09544119jeim586] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This review is about the development of three-dimensional (3D) ultrasonic medical imaging, how it works, and where its future lies. It assumes knowledge of two-dimensional (2D) ultrasound, which is covered elsewhere in this issue. The three main ways in which 3D ultrasound may be acquired are described: the mechanically swept 3D probe, the 2D transducer array that can acquire intrinsically 3D data, and the freehand 3D ultrasound. This provides an appreciation of the constraints implicit in each of these approaches together with their strengths and weaknesses. Then some of the techniques that are used for processing the 3D data and the way this can lead to information of clinical value are discussed. A table is provided to show the range of clinical applications reported in the literature. Finally, the discussion relating to the technology and its clinical applications to explain why 3D ultrasound has been relatively slow to be adopted in routine clinics is drawn together and the issues that will govern its development in the future explored.
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Affiliation(s)
- R W Prager
- Department of Engineering, University of Cambridge, Cambridge, UK.
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Abstract
PURPOSE OF REVIEW Several technological advances have greatly improved three-dimensional sonography, which have improved acquisition and display capabilities. This review describes these technical changes as well as current applications of 3D sonography in prenatal diagnosis. RECENT FINDINGS Recently published papers have emphasized the potential of getting a precise 'any plane of choice' from a three-dimensional volume, as a new way of scanning, based on the off-line analysis of a volume dataset. Surface mode has been used to demonstrate malformations and genetic diseases. The maximum rendering mode, which highlights bones, has great potential for imaging the nasal bones and the frontal bones with the metopic suture. Organ volume can be measured, but the utility of this in clinical practice remains to be determined. Three-dimensional ultrasound needs to be standardized. SUMMARY Three-dimensional ultrasonography is the most rapidly developing technique in fetal imaging. New features will permit the transition from the era of 'sonography in two-dimensional planes' to 'volume ultrasound'.
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Affiliation(s)
- Rabih Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany.
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Timor-Tritsch IE, Monteagudo A. Three and four-dimensional ultrasound in obstetrics and gynecology. Curr Opin Obstet Gynecol 2007; 19:157-75. [PMID: 17353685 DOI: 10.1097/gco.0b013e328099b067] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Developments in ultrasound in general, but even more so in three-dimensional ultrasound, parallel the growth in computing power and speed of computer technology. It is not surprising, therefore, that three-dimensional ultrasound technology is constantly evolving at a fast pace. The purpose of this article is to provide enhanced diagnostic capabilities for the obstetrical and gynecologic provider. RECENT FINDINGS The most recent advances in three-dimensional ultrasound have to do with two main features. First, an increasingly fast acquisition speed, enabling quick sequences of fast moving organs such as the heart to be captured. Second, the increasing number of different display modalities, making understanding and analysis of normal anatomy and pathology easier for clinicians. SUMMARY This article highlights a selected number of clinical situations in which three-dimensional ultrasound meaningfully enhances the contribution of this fast evolving diagnostic imaging tool.
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Affiliation(s)
- Ilan E Timor-Tritsch
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York 10016, USA.
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Teele RL. A guide to the recognition of skeletal disorders in the fetus. Pediatr Radiol 2006; 36:473-84. [PMID: 16525770 DOI: 10.1007/s00247-005-0087-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Revised: 11/30/2005] [Accepted: 12/02/2005] [Indexed: 10/24/2022]
Abstract
The discovery of fetal skeletal abnormality on prenatal US mandates an extended study of the fetus. This extended examination includes specific views and measurements of the fetal skeleton. Lethality can be predicted if severe pulmonary hypoplasia is present. Specific diagnosis of a fetal osteochondrodysplasia is difficult; a collaborative approach among obstetric, neonatal and genetic services is necessary to provide the parents with all available information regarding the pregnancy. Pediatric radiologists who have experience in radiologic assessment of osteochondrodystrophies of infants and children can provide expertise in this area.
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Affiliation(s)
- Rita L Teele
- Starship Children's Hospital and National Women's Ultrasound Department, Grafton, Auckland, New Zealand.
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Solerte L. Three-dimensional multiplanar ultrasound in a limb-body wall complex fetus: clinical evidence for counseling. J Matern Fetal Neonatal Med 2006; 19:109-12. [PMID: 16581607 DOI: 10.1080/14767050400028840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A rare dysmorphologic fetal anomaly at the 17th week of gestation was suspected during a second trimester routine scan for fetal and maternal screening data. First findings were significant for a severe abdominal wall defect, limb and foot compromised positions. Fetal biometry was appropriate in biparietal diameter and head circumference measurements; the long upper bones were normal both for length and development. The patient was referred to a prenatal unit to complete the sonographic diagnosis. Two- and three-dimensional sonographic investigations were performed and techniques were complementary for fetal maldevelopment specification. Limb-body wall complex with lumbosacral spine torsion and lower limbs with severely abnormal features were identified. With 2D color Doppler, a heart defect was confirmed and the umbilical cord was missing from the amniotic cavity. An invasive procedure by amniocentesis was made to ascertain alpha-fetoprotein levels and fetal karyotype. Following parental counseling, pregnancy was terminated and feto-pathological examination confirmed the sonographic diagnosis. The 17-week fetus affected by limb-body wall complex is reported herein; 2D and 3D scans of the fetus identified organ displacement due to a combination of very early events.
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Affiliation(s)
- Laura Solerte
- Department of Obstetrics and Gynaecology, Prenatal Diagnosis Unit, Niguarda Hospital, Milano, Italy.
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Gonçalves LF, Lee W, Espinoza J, Romero R. Three- and 4-dimensional ultrasound in obstetric practice: does it help? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:1599-624. [PMID: 16301717 PMCID: PMC7062383 DOI: 10.7863/jum.2005.24.12.1599] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The purpose of this article was to review the published literature on 3-dimensional ultrasound (3DUS) and 4-dimensional ultrasound (4DUS) in obstetrics and determine whether 3DUS adds diagnostic information to what is currently provided by 2-dimensional ultrasound (2DUS) and, if so, in what areas. METHODS A PubMed search was conducted for articles reporting on the use of 3DUS or 4DUS in obstetrics. Seven-hundred six articles were identified, and among those, 525 were actually related to the subject of this review. Articles describing technical developments, clinical studies, reviews, editorials, and studies on fetal behavior or maternal-fetal bonding were reviewed. RESULTS Three-dimensional ultrasound provides additional diagnostic information for the diagnosis of facial anomalies, especially facial clefts. There is also evidence that 3DUS provides additional diagnostic information in neural tube defects and skeletal malformations. Large studies comparing 2DUS and 3DUS for the diagnosis of congenital anomalies have not provided conclusive results. Preliminary evidence suggests that sonographic tomography may decrease the examination time of the obstetric ultrasound examination, with minimal impact on the visualization rates of anatomic structures. CONCLUSIONS Three-dimensional ultrasound provides additional diagnostic information for the diagnosis of facial anomalies, evaluation of neural tube defects, and skeletal malformations. Additional research is needed to determine the clinical role of 3DUS and 4DUS for the diagnosis of congenital heart disease and central nervous system anomalies. Future studies should determine whether the information contained in the volume data set, by itself, is sufficient to evaluate fetal biometric measurements and diagnose congenital anomalies.
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Affiliation(s)
- Luís F. Gonçalves
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
- Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, USA
| | - Wesley Lee
- Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan, USA
| | - Jimmy Espinoza
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
- Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, USA
| | - Roberto Romero
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Chen CP, Shih JC, Tzen CY, Lin YH, Wang W. Recurrent short-rib polydactyly syndrome: prenatal three-dimensional ultrasound findings and associations with congenital high airway obstruction and pyelectasia. Prenat Diagn 2005; 25:417-8. [PMID: 15906413 DOI: 10.1002/pd.976] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
For longer than 40 years, ultrasound (US) has been a widely used imaging tool in medical practice, which has proved helpful for the diagnosis and staging of diseases. Although three-dimensional ultrasound (3D) US has been available for more than 10 years, it was only through the development of the most recent computer technologies and its adaptation to ultrasound systems, that 3D US has become able to achieve the high level of sensitivity and performance necessary to be considered seriously in clinical practice. 3D US is rapidly turning into a technology with an ever-increasing range of applications in numerous fields because, among other reasons, it helps overcome some of the key limitations related to two-dimensional imaging. 3D US can be used in ultrasonography for small parts, among other medical areas. The assessment of the testicle, parotid, thyroid and parathyroid glands is properly achieved. The multiplanar presentation and niche mode are quite useful to determine the extension--inside or outside the organs-, of nodules, cysts or tumors. The volume measurement is better assessed with 3D US and given this, we can perform studies that follow growth in order to decide medical or surgical treatment. The VOCAL makes it possible to obtain a proper after-treatment follow-up of focal disorders in these small organs. Neovascularization is clearly viewed with 3D US and probably can suggest malignant origin of a neoplasm. 3D US offers a more comprehensive image of anatomical structures and pathological conditions and also permits to observe the exact spatial relationships. We are aware more studies are needed to demonstrate specificity and sensibility of 3D US in particular clinical conditions, not only in small parts but also is some other non-Ob/Gyn applications.
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Affiliation(s)
- Leandro J Fernandez
- Laboratorio de Ecografia Avanzada, Instituto Medico La Floresta, Caracas, Venezuela.
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Gonçalves LF, Espinoza J, Mazor M, Romero R. Newer imaging modalities in the prenatal diagnosis of skeletal dysplasias. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2004; 24:115-120. [PMID: 15287046 DOI: 10.1002/uog.1712] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- L F Gonçalves
- Department of Obstetrics Gynecology, Wayne State University, Detroit, MI, USA
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Affiliation(s)
- Wesley Lee
- Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
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Mangione R, Lacombe D, Carles D, Guyon F, Saura R, Horovitz J. Craniofacial dysmorphology and three-dimensional ultrasound: a prospective study on practicability for prenatal diagnosis. Prenat Diagn 2003; 23:810-8. [PMID: 14558025 DOI: 10.1002/pd.681] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study is to compare two-dimensional and three-dimensional ultrasound for the visualization and diagnosis of craniofacial dysmorphism. METHODS In this prospective study, we performed three-dimensional (3D) ultrasound following good-quality two-dimensional (2D) ultrasound in an at-risk population. Findings from 2D and 3D examination were noted. RESULTS Our series included 41 patients. In 20 cases, 3D performed better than 2D, and in two cases 2D was more informative. In 9 cases, there was no difference between the performance of the two, and in two cases both 2D and 3D gave inadequate results. However, in 7 cases 3D images could not be obtained. CONCLUSION Although it is rarely decisive, 3D ultrasound is of interest when it comes to the precise description of craniofacial dysmorphisms and the study of the fetal ears.
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