By Giuseppe Rizzo, Domenico Arduini
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Additional resources for 4D Fetal Echocardiography
Real Time Three Dimensional Fetal Echocardiography Using Four Dimensional Fetal Echocardiography 33 Figure 5: Real time 3D fetal echocardiography. Fetal cardiac 3D image volume data is shown with the orthogonal (line box around the volume) and adjustable (green panel) cropping planes. This technique permits a systematic examination of the cardiac chambers, the atrioventricular connections, the mitral and tricuspid valves, the interventricular and interatrial septa, and the outflow tracts and their interrelationship (Fig.
The flow pattern reflects left atrial events, the “suction” effect of atrial relaxation, followed by descent of the mitral valve orifice, late systole, passive opening of the mitral valve, early diastole, and atrial contraction that may cause minimal flow reversal in late ventricular diastole. In the second trimester, the ventricles should be approximately equal in size, however, it is important to note that in later gestation, the right ventricle becomes slightly larger than left and should not be confused with pathologic right ventricular dilation [23, 24].
In the adult or pediatric patient this is provided by the electrocardiogram of the patient. Obviously this is not feasible in the fetus. We have successfully simulated cardiac gating with an external electronic pulse generator trigger enabling us to acquire full volume data set of the fetal heart without any recognizable artifacts. The gating function is now integrated in the device. THREE DIMENSIONAL IMAGE DISPLAY AND ANALYSES The final critical component in 3D imaging is the analyses and display of the volume data set.
4D Fetal Echocardiography by Giuseppe Rizzo, Domenico Arduini