Three-dimensional Ultrasound Method Research Articles

Perspectives on Drug Development in Early ADPKD.

Perspectives on Drug Development in Early ADPKD.

Study of positioning of fetal conus medullaris by detecting atlanto-axial intervertebral space with three-dimensional ultrasound

Objective To explore the imaging rate and diagnostic rate of positioning the fetal conus medullaris by three-dimensional ultrasound method to detect atlantoaxial intervertebral space, comparing it with the traditional two-dimensional and three-dimensional ultrasound methods. Methods Consecutively 318 singleton fetuses received routine ultrasound screening during the second trimester were enrolled from November 2017 to December 2018 in Shenzhen Luohu People′s Hospital and Shenzhen People′s Hospital. These fetuses included 276 normal cases and 42 abnormal cases. The abnormal group contained 11 cases tethered cords fetuses(tethered cords group) and 31 cases non-tethered fetuses(non-tethered group). A new ultrasound method named detecting atlanto-axial intervertebral space with three-dimensional ultrasound and traditional two-dimensional and three-dimensional ultrasound methods were used to acquire and store the images. The positions of the fetal conus medullaris were analyzed blindly and recorded by three experienced physicians using three different methods with off-line software. Results ①The χ2 test comparing multiple sample rates was used to compare the imaging acquisition success rate of fetal conus medullaris by three ultrasound methods. The test level was adjusted to be α′=0.05/4=0.0125, the results showed that there were no statistically significant differences between the three methods in the normal group (χ2=7.39, P=0.025) and the abnormal group (χ2=5.32, P=0.070). ②The χ2 test comparing multiple sample rates was used to compare the diagnostic accuracy of fetal conus medullaris position in normal group by three methods, it showed there was no significant difference in the correct rate of conus medullaris position in the normal group (χ2=2.52, P=0.284). ③The χ2 test comparing multiple sample rates was used to compare the diagnostic accuracy of the fetal conus medullaris in tethered cord group and non-tethered group using 3 methods, the difference was not statistically significant in tethered cord group (χ2=1.22, P=0.543), while the difference was statistically significant in non-tethered group(χ2=9.69, P=0.008). Conclusions The method of detecting atlanto-axial intervertebral space with three-dimensional ultrasound has a high imaging rate and diagnostic accuracy in positioning the fetal conus medullaris. Positioning of fetal conus medullaris by detecting atlanto-axial intervertebral space with three-dimensional ultrasound is better than traditional two-dimensional and three-dimensional ultrasound in the abnormal non-tethered fetuses, which can provide more valuable information for prenatal diagnosis consultation and prenatal and postnatal care. Key words: Ultrasonography; Atlanto-axial intervertebral space; Fetal conus medullaris; Tethered cord

Diagnostic value of three-dimensional ultrasonography to fetal limb skeletal dysplasia

Objective To explore the diagnostic value of three-dimensional ultrasonography to fetal limb skeletal dysplasia. Methods From December 2005 to December 2009, the fetus with pregnancy of 14 to 40 weeks after routine ultrasound screening were given two dimensional prenatal ultrasound screening, and we found fetal limb skeletal growth abnormalities retained images, meanwhile we used three-dimensional ultrasound surface imaging mode and transparent imaging mode techniques, the location and types of malformations observed by these two kinds of methods were compared. Results Among the 38 974 cases, 70 cases of abnormalities detected by two-dimensional method, while 78 ones detected by three-dimensional ultrasound method, during postpartum follow-up study, 14 cases of miss diagnosis were found, including 4 cases of polydactylism, 2 cases of polydactyly, 2 cases of toe absence, 4 cases of syndactyly, and 2 cases of abnormal finger posture; while in those with three-dimensional ultrasound method, there were only 6 cases found as miss diagnosis, including polydactylism, polydactyly and syndactyly,2 cases for each. The detectable rate for fetal limb deformities of three-dimensional ultrasound was significantly higher than that of two-dimensional ultrasound method. The methods were mainly used to increase diagnostic accuracy for fetal fingers and toes deformities.Conclusions There is no obvious difference in fetal long bone deformity diagnosis between the methods of two-dimensional and three-dimensional ultrasound, but in the fetal fingers, toes and other details, the results of the three-dimensional ultrasound diagnosis is better than that of two-dimensional one. The three-dimensionul ultrasound diagnosis image is intuitive which provides convenience for communicating with pregnant women. Key words: Real-time three-dimensional uhrasonography; Fetus; The fetal four limbs growth malformations; Diagnosis

Three-dimensional ultrasound examination of unusual abdominal masses

The three-dimensional ultrasound method has been incorporated in the new-generation of the US equipments. The gastroenterological indications have become clearer and clearer.

Intrauterine growth restriction.

Pathophysiological processes underlying intrauterine growth restriction are very complex and poorly understood. Growth restricted fetuses are at risk of hypoxia and, therefore, an early diagnosis of intrauterine growth restriction is important for initiation of fetal surveillance. Application of a three-dimensional ultrasound method for estimation of fetal weight promises better precision. Use of conditional standard deviation scores of fetal biometric variables has been suggested for improved individualized evaluation of intrauterine growth. Application of umbilical artery Doppler velocimetry in the clinical management of growth-restricted fetuses after 32 weeks of gestation leads to decreased perinatal mortality and lower rates of obstetric interventions. Evaluation of fetal state before 32 weeks is difficult and should include Doppler examination of placental circulation and several fetal arterial and venous vessel beds. In addition, recordings of short-term variability of fetal heart rate and biophysical profile have been suggested for fetal surveillance. Important new data on the time sequence of Doppler changes in various vessels of compromised very preterm growth restricted fetuses have been presented, which will enable the establishment of clinical management protocols for evaluation in prospective randomized studies.

Three‐dimensional ultrasound: accuracy of distance and volume measurements

The aim of this study was to evaluate the accuracy of three-dimensional ultrasound distance and volume measurements using a commercially available three-dimensional ultrasound scanner. Sixty-two distance measurements were performed twice on an ultrasound tissue-mimicking phantom located in a water bath. Three-dimensional ultrasound distance measurements were compared to the actual distance. Volume measurements were made in a water bath with 21 balloons of various shapes ranging in volume from 20 ml to 490 ml. Three-dimensional ultrasound volume measurements were compared to actual balloon volumes and to conventional two-dimensional ultrasound volume calculations. The mean absolute error in three-dimensional ultrasound distance measurements was 1.0 +/- 0.8% (range, -2.3 to +1.9%) in the plane of acquisition and 1.0 +/- 0.6% (range, -2.0 to -0.2%) for planes with other orientations. Three-dimensional ultrasound volume measurements showed a mean absolute error of 6.4 +/- 4.4% (range, -6.0% to +15.5%), which was considerably better than two-dimensional ultrasound volume estimates having a mean absolute error of 12.6 +/- 8.7% (range, -27.5% to +39.2%). Volume measurements using two-dimensional ultrasound methods were much less accurate than three-dimensional ultrasound methods for irregularly shaped objects. In conclusion, our data show that three-dimensional ultrasound measurements of distance and volume are sufficiently accurate to use clinically.

Influence of vascular risk factors for atherosclerotic carotid artery plaque progression.

Investigations regarding arteriosclerosis of carotid arteries showed an association between increased intima-media thickness and vascular risk factors. A newly developed three-dimensional ultrasound method increases the reproducibility of plaque volume measurements because more exact volume measurements can be performed with a reduction of the disadvantages of two-dimensional measurements. In a pilot study the influence of vascular risk factors on carotid artery plaque progression was examined. Volumes of atherosclerotic plaques in carotid arteries in 54 patients were measured with a three-dimensional ultrasound system during a 12-month period to determine the relationship between progression or regression of plaque volume, vascular risk factors, dose of aspirin, and flow turbulence in the plaque region. A progression of plaque volume occurred in 67% (36/54) of all plaques. In no plaque was a regression of plaque volume seen. The optimal adjustment of all risk factors showed a significant influence on plaque progression (r = .31). Diastolic blood pressure was the strongest predictor of plaque progression (P < .01), followed by diabetes (P < .03). Turbulence in the plaque region was found in 78% of the patients in the progression group (n = 36) versus 61% in the nonprogression group (n = 18) but was not significant. Dose of aspirin (100 mg versus 250/300 mg) had no influence on plaque volume after 1 year. Treatment of vascular risk factors reduces the progression of carotid artery plaque volume in three-dimensional ultrasound. The most important factor for plaque progression is a high diastolic blood pressure. Turbulence in the flow pattern and the examined doses of aspirin showed no significant influence.

Three‐dimensional ultrasound

The papers in this issue show that the feasibility of three-dimensional ultrasound methods in the clinical setting using commercially available equipment is nearby. Their results demonstrate some of the advantages compared to two-dimensional ultrasound and other diagnostic modalities, including reduced scanning times that will offer more cost-effective use of equipment and sonographer time. Other benefits of three-dimensional ultrasound include allowing the physician: to evaluate arbitrary planes not available with two-dimensional ultrasound due to patient body habitus; to measure organ dimensions and volumes; to obtain anatomic and blood flow information; to improve assessment of complex anatomic anomalies; to confirm normalcy; to standardized the ultrasound exam procedures; to enhance the understanding of physicians in primary care facilities and communicate volume data over networks for consultation at tertiary facilities. Standardization of the ultrasound examination protocols can lead to uniformly high-quality examinations and decreased health care costs. Ultimately, three-dimensional ultrasound imaging will make it easier for primary care physicians to understand complex patient anatomy. Tertiary care physicians specializing in ultrasound can further enhance the quality of patient care by using high-speed computer networks to review volume or dynamic data at specialization centers with primary care physicians. Access to volume data at specialization centers affords more sophisticated analysis and review, further augmenting patient diagnosis and treatment and reducing health care costs.