3D Ultrasound in Prenatal Diagnosis A Practical Approach
2nd Edition
Visit the link below to download the full version of this book:
https://medipdf.com/product/3d-ultrasound-in-prenatal-diagnosis-a-practical-appr
oach-2nd-edition/
Click Download Now
For Kathleen, Amin, and Ella Chaoui.
For Rajae, Anais, Reem, and Anna Heling.
Preface to the 2nd edition
It is with great pleasure that we present hereby the second edition of 3D Ultrasound in
Prenatal Diagnosis, a practical approach. We would like to take this opportunity to
thank the readers of the German and English editions who have given us feedback on
the practical approach of the book and how the book was of great value in clinical
practice. We would also like to thank our colleagues in China who translated our book
into Mandarin so that it was also accessible to Chinese physicians. This positive feed-
back, combined with our passion, inspired and motivated us to create this second edi-
tion of the book, thereby expanding the content based on our practical experience over
the past eight years and building on the success of the first edition.
The first three-dimensional (3D) ultrasound demonstration of a fetal face was per-
formed in 1989, a moment considered as the birth of 3D ultrasound. Around the year
2000, with the advent of fast processors, 3D ultrasound equipment became widely
available. Today, all available high-level ultrasound systems offer the 3D/4D tool as an
option with integrated software and special 3D transducers.
Although most 3D applications are similar regardless of the ultrasound system
manufacturer, this book reports on our experience gained exclusively with the ultra-
sound systems Voluson E10 and Expert 22 of General Electric HealthCare, which can be
adapted to all newer systems of the Voluson series.
We have divided the book into three main sections as in the previous edition: the
first section describes how to acquire and navigate within a volume, the second section
describes different modes of volume rendering, whereas the third section focuses on
organ-specific application of 3D techniques such as e. g., brain, heart, bone, first trime-
ster. In a total of 20 chapters, this book summarizes the essentials you need to know
about the practical approach in using 3D in prenatal ultrasound.
In this new edition, we have included more than 470 new figures to illustrate dif-
ferent aspects of 3D ultrasound, from explaining the various render modes to illustrat-
ing the clinical applications of these tools. It was difficult to decide which images would
make it into the book in the end, but we wanted to keep the spectrum broad and limit
the number to 20 to 30 images per chapter. The text was adapted accordingly, consider-
ing the authors’ evolving experience since the first edition.
We are indebted to several people for their significant contribution to our 3D ultra-
sound journey. First and foremost, our friend Dr. Bernard Benoit (Monaco), a giant in
the field of ultrasound imaging, who was and is a great source of inspiration for us.
Many of the 3D ultrasound tools could not have been developed without his enormous
technical and artistic experience. We would also like to thank the engineering and
management teams at General Electric-HealthCare in the Voluson Valley in Zipf, Aus-
tria for their close collaboration and tireless support over the years, especially during
the Covid pandemic. We thank our patients who have contributed to all the images in
this book and who continue to motivate us to push the boundaries of this technology.
This book would not have been possible without the professional team at De Gruyter
https://doi.org/10.1515/9783111249513-201
VIII Preface to the 2nd edition
publishing, in particular Dr. Bettina Noto, Jessika Kischke, Andreas Brandmair, and
Dr. Jo Nagel (L42 AG), who have supported us tirelessly and with great dedication.
We hope that this book will motivate you to try out the great imaging opportunities
that 3D ultrasound affords and to discover your artistic approach to medical diagnosis
in fetal medicine.
Berlin, Friedrichstrasse Rabih Chaoui
November 2023 Kai-Sven Heling
Technical ultrasound terms
All 3D examinations and experiences in this book are based on Voluson ultrasound
equipment produced by GE HealthCare of General Electric. The images in this book
were generated with Voluson e10 and Expert 22 equipment and most tools presented in
this book, namely VCI®, TUI®, Magicut®, Glass-body mode®, Silhouette®, HDlive®, Omni-
view®, Sono-AVC®, VOCAL®, and others are protected names. To facilitate reading we
decided to omit the ® sign within the book.
Some abbreviations are listed below:
3D Three-dimensional ultrasound
4D Four-dimensional ultrasound
HD High-definition
Sono-AVC® Sonographic Automatic Volume Calculation
Sono-VCAD® Sonographic Volume Computer Aided Diagnosis
SRI® Speckle Reduction Imaging
TUI® Tomographic Ultrasound Imaging
V-SRI® Volume Speckle Reduction Imaging
VCI® Volume Contrast Imaging
VOCAL® Virtual Organ Computer Aided Analysis (VOCAL)
https://doi.org/10.1515/10.1515/9783111249513-202
Inhalt
Preface to the 2nd edition VII
Technical ultrasound terms IX
Part I: Basics of 3D Sonography
1 Basics of 3D and 4D Volume Acquisition 3
1.1 Introduction 3
1.2 Preparing volume acquisition 3
1.2.1 Optimizing a 2D image before volume acquisition 4
1.2.2 Choice of the best starting plane at volume acquisition 5
1.2.3 The acquisition box or volume box 5
1.2.4 Acquisition angle 6
1.2.5 Acquisition quality 8
1.3 Transducers for 3D/4D acquisition 11
1.3.1 Mechanical transducers 11
1.3.2 Electronic or matrix array transducers 11
1.4 Types of volume acquisition 12
1.4.1 Static 3D acquisition 12
1.4.2 Spatio-Temporal Image Correlation (STIC) acquisition 13
1.4.3 Real-time 4D with a mechanical or an electronic transducer 13
1.5 Display of a volume data set 14
1.6 Conclusions 15
2 Orientation and Navigation within a Volume Data set 17
2.1 Introduction 17
2.2 Storing and exporting volume data sets 17
2.3 Orientation in the three orthogonal planes 18
2.4 Navigation within the orthogonal planes 19
2.5 Artifacts in the multiplanar mode 26
2.6 Conclusions 28
Part II: 3D Display Methods
3 3D Rendering and the Rendering Modes 31
3.1 Introduction 31
3.2 The render box and the orientation within a 3D volume 31
3.3 Artifacts in 3D rendering 36
3.4 Different rendering modes and mixture of modes 37
XII Inhalt
3.4.1 Surface mode rendering 38
3.4.2 Transparency mode rendering 40
3.5 Special effects in 3D: dynamic depth rendering and light source 42
3.6 Threshold, transparency, brightness, and color scales 46
3.7 Magicut, the electronic scalpel 47
3.8 SonoRender live 52
3.9 Conclusions 52
4 Volume Contrast Imaging (VCI) 53
4.1 Introduction 53
4.2 Principle of VCI 53
4.3 Static VCI 55
4.4 VCI with color Doppler 59
4.5 4D with VCI-Omniview 61
4.6 4D with VCI-A 63
4.7 Conclusions 65
5 Multiplanar Display I: Orthogonal Mode and Omniview Planes 67
5.1 Principle 67
5.2 Multiplanar reconstruction and different displays of cross-sectional images
67
5.3 Practical approach in orthogonal mode 68
5.4 Practical approach in obtaining an “anyplane” using Omniview mode 73
5.5 Typical applications of the Omniview mode 74
5.6 Conclusions 81
6 Multiplanar Display II: The Tomography Mode 83
6.1 Principle 83
6.2 Practical approach 83
6.3 Typical applications of the tomography mode 89
6.4 Conclusions 99
7 The Surface Mode 101
7.1 Principle 101
7.2 Practical approach 101
7.3 Typical applications of the surface mode 107
7.4 Conclusions 117
8 The Maximum Mode 119
8.1 Principle 119
8.2 Practical approach 121
8.3 Typical applications for bones’ visualization 126
8.4 Conclusions 132
Inhalt XIII
9 The Minimum Mode 133
9.1 Principle 133
9.2 Practical approach 133
9.3 Typical applications of the minimum mode 135
9.4 Conclusions 140
10 The Inversion Mode 141
10.1 Principle 141
10.2 Practical approach 142
10.3 Typical applications of the inversion mode 143
10.4 Conclusions 149
11 The Silhouette Mode 151
11.1 Principle 151
11.2 Practical approach 152
11.3 Typical applications of the silhouette mode 154
11.4 Conclusions 168
12 The Glass-Body Mode 169
12.1 Principle 169
12.2 Practical approach 169
12.3 Typical applications of the glass-body mode 172
12.4 Conclusions 184
13 Calculation of 3D Volumes 185
13.1 Principle 185
13.2 Practical approach 185
13.2.1 Virtual Organ Computer-aided Analysis (VOCAL) Software 185
13.2.2 Sonographic Automatic Volume Calculation (Sono-AVC) 188
13.3 Typical applications of volume calculations 190
13.4 Conclusions 191
14 The Electronic Matrix Transducer 193
14.1 Principle 193
14.2 Biplane display 194
14.2.1 Practical approach 194
14.2.2 Typical applications of the biplane display 194
14.3 Volume Contrast Imaging of the A-plane (VCI-A) 201
14.3.1 Practical approach 201
14.3.2 Typical applications of the VCI-A display 201
14.4 The new tool VCI-2D 207
14.5 Conclusions 208
XIV Inhalt
Part III: Clinical Applications in Prenatal Diagnosis
15 The Fetal Face in 3D 211
15.1 Examination of the face in 2D and 3D ultrasound 211
15.2 The normal face in 3D surface mode 212
15.2.1 2D image before 3D acquisition 212
15.2.2 The insonation angle 212
15.2.3 3D presets before acquisition 213
15.2.4 Post processing 3D rendering and volume manipulation 214
15.3 The normal face in 4D surface mode 217
15.4 The normal face at different gestational ages 218
15.5 The abnormal face in 3D/4D 222
15.6 The normal and abnormal ear 225
15.7 The face in multiplanar display 226
15.8 Conclusions 231
16 3D Fetal Neurosonography 233
16.1 Introduction 233
16.2 Transabdominal 3D examination of the brain and multiplanar reconstruc-
tion 233
16.2.1 3D acquisition of a brain volume 236
16.2.2 Multiplanar reconstruction and display 237
16.3 Transvaginal 3D examination of the brain and multiplanar reconstruc-
tion 244
16.4 Fetal brain visualized with 3D volume rendering 248
16.5 The intracerebral vascular system in 3D glass-body mode 251
16.6 3D of the fetal brain before 14 gestational weeks 253
16.7 Conclusions 259
17 3D of Skull, Spine, and Limbs 261
17.1 Examination of the fetal skeleton with 2D ultrasound 261
17.2 3D imaging of the facial and cranial bones 261
17.3 3D imaging of the fetal spine and ribs 265
17.4 3D imaging of the fetal limbs 272
17.5 Conclusions 279
18 3D of Intrathoracic and Abdominal Organs 281
18.1 Introduction 281
18.2 The intrathoracic organs 282
18.3 The gastrointestinal organs 285
18.4 The urogenital system 290
18.5 Conclusions 295
Inhalt XV
19 Fetal Echocardiography in 3D and STIC 297
19.1 Fetal cardiac scanning in grayscale and color Doppler 297
19.2 Different acquisitions of cardiac volume data sets 297
19.2.1 Static 3D acquisition 297
19.2.2 STIC/eSTIC volume acquisition 298
19.2.3 Real-time 4D acquisition with an electronic matrix transducer 300
19.3 Fetal heart in 3D and STIC with multiplanar reconstruction 301
19.4 Fetal heart in grayscale STIC with rendering 309
19.5 Fetal heart in color Doppler STIC with glass-body rendering 314
19.6 Automated cardiac volume evaluation and Sono-VCAD 318
19.7 Other applications of 3D/4D fetal heart examination 319
19.8 Conclusions 319
20 3D in Early Pregnancy 321
20.1 Introduction 321
20.2 3D volume rendering in early gestation 322
20.3 Multiplanar display in early gestation 333
20.4 3D Color Doppler in early gestation 339
20.5 Conclusions 342
21 Further literature references and sources 343
Register 349
Part I: Basics of 3D Sonography
