![]() Mum knows she is pregnant and feels the babe, but now Dad can really see the cutie causing the havoc, and big brother or sister can better understand Mum's distraction Is this just some psycho mumbo‐jumbo? No, I think it's real, and comes at a time when sometimes there may be extra strains within a relationship, or within a family. The reaction of parents and sonographers upon seeing this is special.ģD surface image face at anatomy scan showing descriptive facial and hand expressions. The happy second trimester fetus can be seen making facial expressions, tongue‐poking, exploring its body with hands, and even giving the hippy peace sign or other “gangsta” hand signals ( Fig. With 4D ultrasound we can see the “happy” 12‐week fetus, not only jumping around, but break‐dancing, kickboxing, waving and exploring its world. At the moment our focus on fetal wellbeing (“happiness”) is largely confined to third trimester biophysical profile and Doppler. 3D will enable a better understanding of fetal behaviour. Perhaps this will help clarify the rights of the fetus/unborn child, and may also help with ethical considerations. Although some of these are debatable, and also unscientific, they still are real, and for me they have been a giant leap forward in the use of ultrasound.ģD ultrasound further “humanises” the fetus in the eyes of the parents and sonographers. There are numerous indirect ways in which 3D ultrasound helps in first and second trimester ultrasound. It has opened up the possibilities of what we can do with ultrasound, and its beneficial uses will increase with people's imagination. So far, we are only really scratching at the surface with 3D. Just as the development of reasonable technique for things such as NT scanning, nasal bone, tricuspid and ductus, requires 50–100 or so cases, similarly basic expertise in 3D scanning can be acquired and used during anatomy assessment Certainly, to look at the face and limbs only takes a few moments, and with enthusiasm and some practice, the heart and spine can often be shown in a more useful way. Some 3D/4D imaging can be incorporated into the routine screening anatomy scan with not much effort or increase in scanning time in the majority of patients. In conventional 2D ultrasound review of the examination is generally limited to the findings detected and documented by the sonologist. This means the data can be assessed at a remote site by a more expert clinician who is not limited by the findings detected by the first examiner It also allows all images in all planes to be reviewed in cine‐loop, and the complete data volume can be stored, reviewed and manipulated later. With an experienced sonologist, evaluation time may be shortened, especially with complex defects. It improves resolution, offers unlimited images in any plane, allows simultaneous correlation between image planes that are perpendicular to the acquisition plane and 3D rendered images can be reconstructed STIC has many benefits both for screening in the routine anatomy scan, and for further evaluating the heart where an abnormality is suspected. The Spatio‐Temporal Image Correlation (STIC) volume acquisition, can allow rapid depiction of the cardiac anatomy, and with an enthusiastic sonographer can give a quick and accurate depiction of the chambers and major vessels I will outline some of the areas where I have found 3D helpful in my scanning (private practice). Already, there is a proliferation of papers outlining the uses, a lot may stay as research or of academic interest only (hype), but some will translate to real advances in everyday practical fetal ultrasound (helpful). This enthusiasm for 4D scanning should have the effect of improving our (operator) technique, and will also encourage the development of how we use 4D. ![]() However, with the advent of high quality real‐time 4D scanners, which are easy to use and have a high rate of successful imaging, there is a sustained enthusiasm of use with colleagues and patients. My experience initially with manually swept 3D was that my personal enthusiasm did not translate widely to either my colleagues or to the public. In fact, it is fair to say that at this time, the technology advances have been so profound that they have left the technique of most of us (human sonologists) way behind. Accompanying the hardware has been a similar explosion in software programming allowing complex manipulation and storage of the data. This lead to 4D (real‐time 3D), and now the development of solid‐state electronically oscillating transducers. The technology began with “hand swept” slice acquisition using standard transducers followed by mechanically oscillating 3D transducers. 3D ultrasound has been the most rapidly evolving technique and technology in fetal ultrasound in the past few years.
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