The value of 3D and 4D assessments of the fetal heart

Abstract

Edward Araujo Júnior, Liliam Cristine Rolo, Luciane Alves Rocha, Luciano Marcondes Machado Nardozza, Antonio Fernandes MoronDepartment of Obstetrics, Federal University of São Paulo (UNIFESP), São Paulo, BrazilAbstract: The objective of this review was to demonstrate the main tools of three- and four-dimensional ultrasonography, using the spatiotemporal image correlation software and its respective applications for assessing the fetal heart and its vascular connections, along with its potential contribution towards screening for congenital heart diseases. Today, conventional, two-dimensional, echocardiography continues to be the gold standard for diagnosing congenital heart diseases. However, recent studies have demonstrated that spatiotemporal image correlation offers some advantages that boost two-dimensional accuracy in detecting congenital heart diseases, given that the fetal heart assessment can be completed in the absence of the patient (offline) and be discussed by different examiners. Additionally, data volumes can be sent for analysis in reference centers via internet links. Spatiotemporal image correlation also enables direct measurement of heart structures in rendering mode, such as the interventricular septum and the annulus of the atrioventricular valves. Furthermore, it enables assessment of cardiac function when used in association with the virtual organ computer-aided analysis software, thus making it possible to calculate the total systolic function, ejection fraction, and cardiac output.Keywords: fetus, screening, congenital heart disease, echocardiography, three- and four-dimensional ultrasound, spatiotemporal image correlation