Editor: Giuseppe Rizzo

4D Fetal Echocardiography

Special Offer (PDF + Printed Copy): US $119
Printed Copy: US $119
ISBN: 978-1-60805-634-7 (Print)
ISBN: 978-1-60805-044-4 (Online)
Year of Publication: 2010
DOI: 10.2174/97816080504441100101


Congenital heart defects (CHD) are the most frequent malformation in the human fetus and are the leading cause of mortality due to malformations in the first year of life. Despite its clinical importance screening performed by ultrasonographic examination during the second trimester of pregnancy has shown disappointingly low detection rates mainly due to the difficulties in obtaining an adequate examination of the fetal heart. Four-dimensional (4D) ultrasound of the fetal heart has been recently suggested as a tool to improve the detection rate of CHD by decreasing the dependency on operator skills required in two-dimensional ultrasound scans but up to now no practical manuals are available in describing its application in clinical practice for the study of fetal heart. The objective of this Ebook is to explain the role of 4D during second trimester examination and in fetuses with CHD. The technique of obtaining 4D volume of the fetal heart, how to navigate in the volume to obtain diagnostic planes and how to use semiautomatic and automatic software of analysis are described. We believe that after reading this book the standard fetal cardiac anatomy survey can be performed in the second trimester fetus by 4D in both normal and abnormal hearts. This approach may reduce the operator dependency in diagnosis CHD. This Ebook should prove to be a valuable resource for obstetricians, sonographers and pediatric cardiologists.


The examination of the fetal heart is part of the comprehensive fetal scan, but this examination is still considered a challenge even for experienced sonographers. Over the years, the number of ultrasound techniques used in fetal cardiology impressively increased and no other fetal organ is examined with as many modalities as the fetal heart including high resolution two dimensional (2D) imaging, M-mode examination, spectral, color, power, high-definition digital Doppler, B flow as well as tissue Doppler. It is, however, common knowledge that despite the availability of all these technologies, screening programs, especially when limited to the study of the "four chamber view", have shown disappointing low detection rates for congenital heart disease (CHD). Although the identification of CHD can be improved by routinely visualizing the outflow tracts, their diagnosis is greatly affected by the skill of the operator as well as his ability to interpret the findings.

Very recently, three- and four- dimensional (3D and 4D) technologies have been introduced in fetal cardiology and have revolutionized the way in which it is possible to study the heart. 4D ultrasonography may reduce the operator dependency of CHD diagnosis and adds the possibility to obtain offline virtual planes in cardiac examinations, views of the fetal heart difficult or impossible to obtain with conventional 2D ultrasound.

This new fetal cardiology ebook, we believe, will be of great value for all practicing clinicians wanting to start the study of the fetal heart with 4D ultrasonography. We have chosen a panel of contributors that are both leaders in this field and can represent the differences in practice between Europe and United States. This is a comprehensive guide intended for anyone interested in fetal heart scanning performing both routine screening ultrasonographic examinations and targeted heart scans. It aims to assist the reader with the following questions: how can I use this technology to acquire cardiac volumes?; how do I handle cardiac volume data sets after acquisition?; how can I improve diagnosis and definition of CHD? It is our hope that this book will provide a bridge between scientists using and testing new technologies for research purposes and clinicians wishing to improve their daily practice.

Giuseppe Rizzo
Domenico Arduini


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