Multislice Display of the Fetal Face Using 3-Dimensional Ultrasonography

McGahan, Michele C.; Ramos, Gladys A.; Landry, C.; Wolfson, Tanya; Sowell, B. Brooke; D'Agostini, Deborah; Patino, Cesar; Nelson, Thomas R.; Pretorius, Dolores H.

doi:10.7863/jum.2008.27.11.1573

Cited by 14 publications

(14 citation statements)

References 18 publications

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“…This difference might be due to inhomogeneous and nonstandardized study designs which do not distinguish clearly between three-dimensional and bi-dimensional ultrasound, between different study populations, between screening or diagnostic conditions (context bias 83 ), between cleft lip and cleft of the alveolar ridge of the maxilla, 84 between cleft lip and palate and cleft of the palatine bone alone, between different terminologies, such as "hard palate" "primary palate" and "secondary palate", between a normal versus a pathological palate, or between different three-dimensional ultrasound techniques. Three-dimensional ultrasound axial, 80 coronal, 81,82 sagittal, 71 and oblique 74 acquisition planes have been evaluated for imaging of the secondary palate.…”

Section: Imaging Of the Hard Palatementioning

confidence: 98%

Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Bäumler¹,

Bigorre²,

Faure³

2012

RMI

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This paper reviews screening and three-dimensional diagnostic ultrasound imaging of the fetal face. The different techniques available for analyzing biometric and morphological items of the profile, eyes, ears, lips, and hard and soft palate are commented on and briefly compared with the respective bi-dimensional techniques. The available literature supports the use of three-dimensional ultrasound in difficult prenatal diagnostic conditions because of its diagnostic accuracy, enabling improved safety of perinatal care. Globally, a marked increase has been observed in the accuracy of three-dimensional ultrasound in comparison with the bidimensional approach. Because there is no consensus about the performance of the different three-dimensional techniques, future studies are needed in order to compare them and to find the best technique for analysis of each of the respective facial elements. Universal prenatal standards may integrate these potential new findings in the future. At this time, the existing guidelines for prenatal facial screening should not be changed.

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Section: Imaging Of the Hard Palatementioning

confidence: 98%

Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Bäumler¹,

Bigorre²,

Faure³

2012

RMI

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“…It allows for better characterization of the normal anatomy of the fetal face and has increased the diagnostic accuracy of anomalies. [4][5][6][7][8][9][10][11] Threedimensional ultrasonography can also enhance parents' understanding of anomalies and may allow for earlier bonding with their fetuses. It is important for sonologists and sonographers to have an understanding of how to evaluate the fetal face with 3DUS.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11] Three-dimensional ultrasonography enables fetal anatomy to be displayed in 3-orthogonal-plane and parallel-plane formats to allow for improved understanding of fetal anatomy and anomalies. It has become an important tool as an adjunct to 2DUS in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Benefits of a Systematic Approach in the Evaluation of Fetal Facial 3-Dimensional Volumes

Ramos

Kfir

D'Agostini

et al. 2011

Journal of Ultrasound in Medicine

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The benefits of using volume ultrasonography (3-dimensional ultrasonography [3DUS]) have been explored in diagnosing fetal anomalies 1-3 such as cleft lip and palate, 4-11 micrognathia, 12,13 congenital heart diseases, [14][15][16] and skeletal abnormalities. 17,18 However, clinical implementation of this new technology has been challenging for many reasons, including familiarity with the knobology and orientation within a volume of data. Training of physicians to use volume ultrasonography has been limited because of a lack of standardization, display, and manipulation of 3-dimensional (3D) volumes. 19 Abuhamad et al 20 recently showed that the Z technique was a useful method for teaching inexperienced physicians to obtain the coronal plane of the uterus from 3D volGladys A. Ramos, MD, Menashe Kfir, MD, Sujin Lee, MD, Deborah D'Agostini, RDMS, Tanya Wolfson, MA, Anthony Gamst, MD, Dolores H. Pretorius, MD Received November 3, 2010, ORIGINAL RESEARCHObjectives-The purpose of our study was to evaluate the accuracy and efficacy of using a systematic approach to teach maternal-fetal medicine physicians how to display a diagnostic fetal profile and palate using 3-dimensional ultrasonography (3DUS).Methods-Ten maternal-fetal medicine physicians were randomly assigned to 2 groups, A and B, and instructed on basic principles of 3DUS volume manipulation. Physicians in group A were asked to display the fetal profile in 5 volumes, including 1 fetus with abnormalities. Physicians in Group B were asked to display the fetal profile in the same 5 volumes after detailed instruction. The groups were combined, and detailed instruction was repeated. The physicians were asked to review an additional 5 volumes. In a separate session, the physicians were divided into their respective groups, and a similar exercise was repeated. This time, they were asked to display the fetal palate in 3-orthogonal-plane and parallel-plane images. The time required for manipulation was recorded. Images were reviewed for accuracy and clinical utility by 2 blinded experienced sonologists. Data were analyzed with mixed effects models.Results-Fetal profile and parallel-plane palate scores were significantly higher in group B (P < .001) compared to group A. There was no difference between groups in displaying the 3-orthogonal-plane image of the palate or after additional training for either group. The mean times for display did not differ between the groups. The time required for evaluation of the abnormal profiles was longer (P = .02) than that for evaluation of the normal profiles.Conclusions-Detailed instruction in obtaining 3DUS images of fetal profiles and palates improved the image quality obtained by physicians. Teaching physicians in a standardized way may help improve the use of 3DUS in clinical practice.

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“…In our center, we have used a modification of this technique in which the face is kept upright, and a curved thin render box is used to view the hard palate from the inferior aspect of the maxilla (Figs. 3,4). The initial volume is acquired slightly obliquely from the inferior aspect of the maxilla, pointing upward.…”

Section: Secondary Palatementioning

confidence: 99%

Diagnostic Evaluation of the Fetal Face Using 3-Dimensional Ultrasound

Ramos¹,

Ylagan²,

Romine³

et al. 2008

Ultrasound Quarterly

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Evaluation of the fetal face with 3-dimensional ultrasound allows for evaluation of the fetal face using surface rendering, multiplanar and multislice displays. Three-dimensional ultrasound offers many benefits in evaluating the fetal face because it can be rotated into a standard symmetrical orientation and reviewed millimeters by millimeters by scrolling through the volumes. New rendering tools now allow imaging of the hard palate. Clinical applications where 3-dimensional ultrasound adds value as an adjunct to 2-dimensional ultrasound imaging that are reviewed in this paper include cleft lip and palate, micrognathia and other profile abnormalities, metopic suture abnormalities, presence and absence of the nasal bones, orbit abnormalities, and ear abnormalities. In addition, the literature regarding parental bonding to the fetus after viewing 3-dimensional images of their fetuses is reviewed.

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Multislice Display of the Fetal Face Using 3-Dimensional Ultrasonography

Cited by 14 publications

References 18 publications

Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Benefits of a Systematic Approach in the Evaluation of Fetal Facial 3-Dimensional Volumes

Diagnostic Evaluation of the Fetal Face Using 3-Dimensional Ultrasound

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