Three-dimensional HDlive rendering images of the fetal heart

Our objective is to describe our experience with reconstruction of normal fetal cardiac structures and congenital heart anomalies using the 3-D HDlive rendering mode with spatiotemporal image correlation (STIC). Four normal fetuses and three fetuses with congenital heart anomalies (Ebstein's anomaly, hypoplastic left heart syndrome and tetralogy of Fallot) at 25-35 wk of gestation were studied using the 3-D HDlive rendering mode with STIC. In normal fetuses, the natural appearance of the dynamic motion of the foramen ovale flap and both atrioventricular valves was clearly visualized in real time in the four-chamber view. Moreover, new, realistic sensations of each leaflet of atrioventricular valves and semilunar valves of the pulmonary artery were obtained in the en face view of both atrioventricular valves and great vessels. In the case of Ebstein's anomaly, the procedure rendered the natural and anatomically realistic appearance of significantly low attachment of the tricuspid valve and atrialized portion of the right ventricle. In hypoplastic left heart syndrome, thickened tricuspid and dysplastic pulmonary valves were clearly revealed. In tetralogy of Fallot, an overriding aorta and ventricular septal defect were realistically depicted. The 3-D HDlive rendering mode with STIC provides entirely new visual experiences for obstetricians and pediatric cardiologists owing to the anatomically realistic depiction of normal and abnormal fetal cardiac structures of the beating heart.

Antenatal three-dimensional sonographic diagnosis of persistent cloaca

We present a case of fetal persistent cloaca diagnosed by two- (2D) and three-dimensional (3D) sonography and the HDlive rendering mode. 2D sonography revealed a bicornate uterus with hydrometra, bilateral hydrosalpinx, a single umbilical artery, and ascites. 3D sonography and the HDlive rendering mode clearly showed these intra-abdominal structures. To the best of our knowledge, this is the first report of persistent cloaca employing antenatal 3D sonography and the HDlive rendering mode.

Three- and four-dimensional HDlive rendering image of fetal acrania/exencephaly in early pregnancy

We present two cases of fetal acrania/exencephaly reconstructed employing the three- (3D) and four-dimensional (4D) HDlive rendering mode in early gestation. Two fetuses with acrania/exencephaly were studied with the 3D/4D HDlive rendering mode at 13 and 15 weeks, respectively. In Case 1, at 13 weeks' gestation, deformed and degenerated brain tissues were clearly shown using the 3D/4D HDlive rendering mode. In Case 2, at 15 weeks and 6 days of gestation, two amniotic bands and acrania/exencephaly were depicted with the 3D/4D HDlive rendering mode. Fragile brain hemispheres with amniotic bands were rocking with fetal movements. The 3D/4D HDlive rendering mode provides physicians, couples, and their families with important and additional information, and has the potential to supplement two-dimensional and conventional 3D ultrasound in diagnosing fetal acrania/exencephaly.