Freehand three‐dimensional ultrasound in the diagnosis of fetal anomalies

Abstract

Purpose: To determine the clinical impact and additional information of freehand three‐dimensional ultrasound (3DUS) in the diagnosis of fetal anomalies compared to two‐dimensional ultrasound (2DUS).Methods: We studied a total of 146 anomalies found in 95 fetuses. In all of them the fetal anomaly was first assessed by 2DUS, and then by freehand 3DUS. According to the fetal anomaly, fetal or maternal conditions, one or more of the following modes of data capture were employed: volume capture (n = 42 anomalies), static capture (n = 21 anomalies), and free style capture (n = 83 anomalies), then the most suitable screen presentation was used. Clinical impact, fetal outcome and additional information were determined in all cases.Results: Freehand 3DUS images provided additional information only in three anomalies (2%) compared with 2DUS, were equivalent in 132 anomalies (90%), and were disadvantageous in 11 anomalies (8%) In most cases, when the anomalies were well visualized by 2DUS, the 3DUS images added no further information. In none of the cases the 3DUS changed the clinical management. Furthermore, all files obtained by 3DUS were more advantageous in term of post‐processing capabilities, manipulation of images by multiples physician and teaching activities compared with 2DUS.Conclusions: The different freehand 3DUS modalities were diagnostic equivalent to 2DUS in the majorities of the clinical cases and has no additional clinical impact on patient management. The most important advantages were related to the post‐processing capabilities.