Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

Abstract

AIMTo show imaging results from application of four-dimensional (4D) ultrasound lightening technique (HDlive™) in clinical obstetrics practice.METHODSNormal and abnormal fetuses at second and third trimester of pregnancy undergoing routine scan with 4D HDlive™ (5DUS) in the rendering mode are described. Realistic features of fetal structures were provided by 5DUS in the rendering mode. Normal anatomy as well as pathology like cleft lip, hypoplastic face, micrognathia, low-set ears, corpus callosum, arthrogryposis, aortic arch, left congenital diaphragmatic hernia are highlighted in this study. Anatomical details of the fetuses were provided by 5DUS with higher quality imaging modality compared to those obtained using conventional 2D/3D ultrasound.RESULTSRealistic views of fetal anatomy details were displayed by means of 5DUS in the rendering mode, with high image quality obtained either in low-risk or in high-risk obstetrics population. Corpus callosum, esophagus, and aortic arch were obtained in normal fetuses. Cleft lip, cleft lip and palate, micrognathia, hypoplastic face, low-set ears, arthrogryposis, left congenital diaphragmatic hernia, exomphalos, and clitoris hypertrophy were clearly rendered by 5DUS application.CONCLUSIONThe use of 5DUS in the rendering mode, when clinical available, was diagnostic in a variety of congenital anomalies, aided understanding of the parents-to-be and improved prenatal counseling and perinatal management.

Raine syndrome: Prenatal diagnosis based on recognizable fetal facial features and characteristic intracranial calcification

“…The use of 3-dimensional ultrasound surface rendering mode allowed us to see the entire fetal face in a single realistic view, much clearer than with 2D ultrasound, providing us with important information. 42,43 The craniofacial phenotype described by prenatal ultrasound in our three cases present such as the high forehead with frontal bossing, midface hypoplasia, severe ocular exorbitism, hypertelorism, a depressed and low nasal bridge with absent nasal bone, a small mouth with down-curved corners, retrognathia, and low-set ears with features resembling the Binder phenotype. 9,10,44,45 Other conditions associated with the Binder phenotype that has to be included in the differential diagnosis are chondrodysplasia punctate, Robinow syndrome, craniosynostosis syndromes as Apert, Pfeiffer, and Crouzon syndromes as well as exposure to warfarin and maternal autoimmune conditions.…”

“…The use of 3‐dimensional ultrasound surface rendering mode allowed us to see the entire fetal face in a single realistic view, much clearer than with 2D ultrasound, providing us with important information 42,43 . The craniofacial phenotype described by prenatal ultrasound in our three cases present such as the high forehead with frontal bossing, midface hypoplasia, severe ocular exorbitism, hypertelorism, a depressed and low nasal bridge with absent nasal bone, a small mouth with down‐curved corners, retrognathia, and low‐set ears with features resembling the Binder phenotype 9,10,44,45 …”

Realistic Vue: a new three-dimensional surface rendering approach for the in utero visualization of embryos and fetuses

“…( 6 ) , HDlive allows the embryonic development, as well as the fetal facial expressions in the third trimester, to be demonstrated. In fetal congenital anomalies, HDlive rendering images facilitate parental counseling and improve perinatal management by a multidisciplinary team ( 8 ) . The recently developed HDlive Flow with HDlive silhouette mode (GE Healthcare) allows the blood flow within a fetal structure to be identified, because of its ability to delineate the blood vessel walls, while the vascular lumina remain transparent ( 9 ) .…”