Demet KIRMIZI AYDOĞAN

The Significance of 4D Ultrasonography in Fetal Anomaly Screening

Ultrasonography has been a reliable diagnostic tool used for years in fetal anomaly screening. Along with technological improvements, the image quality of ultrasound devices has also increased. Four-dimensional (4D) ultrasound with real time imaging capability is the latest technological tool in this area. Today, its use in perinatologic screening of fetal ano malies is becoming widespread This situation has opened the debate on the diagnostic value of 4D ultrasound in fetal evaluation. 4D ultrasound when performed in experienced hands provides more detailed information on organ functions, fetal anomalies, and understanding of movement and behavioral characteristics. In contrast, conventional 2D ultrasound maintains an indispensable position in the evaluation of fetuses. In the literature, the superiority of 4D to 2D has not been shown. However, diagnostic accuracy is expected to increase when the techniques are used together. A general evaluation was made in our article and the significance of the two ultrasound technologies in detecting fetal anomalies were compared.

___

1. American Institute of Ultrasound in medicine. Acoustic output measurement standards for diagnostic ultrasound equipment. Laurel (MD): AIUM; 1998.

2. Stark CR, Orleans M, Haverkamp AD, Murphy J. Short- and long-term risks after exposure to diagnostic ultrasound in utero. Obstet Gynecol 1984; 63: 194-200.

3. Kurjak A, Azumendi G, Andonotopo W, Salihagic-Kadic A. Three- and four-dimensional ultrasonography for the structural and functional evaluation of the fetal face. Am J Obstet Gynecol 2007; 196: 16-28.

4. Pretorius DH, House M, Nelson TR, Hollenbach KA. Evaluation of normal and abnormal lips in fetuses: comparison between three- and two-dimensional sonography. AJR Am J Roentgenol 1995; 165: 1233-1237.

5. Tonni G, Centini G, Rosignoli L. Prenatal screening for fetal face and clefting in a prospective study on low-risk population: can 3- and 4-dimensional ultrasound enhance visualization and detection rate? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100: 420-426.

6. Merz E, Welter C. 2D and 3D Ultrasound in the evaluation of normal and abnormal fetal anatomy in the second and third trimesters in a level III center. Ultraschall Med 2005; 26: 9-16.

7. Merz E, Abramowicz JS. 3D/4D ultrasound in prenatal diagnosis: is it time for routine use? Clin Obstet Gynecol 2012; 55: 336-351.

8. Gonçalves LF, Nien JK, Espinoza J, et al. What does 2-dimensional imaging add to 3- and 4- dimensional obstetric ultrasonography? J Ultrasound Med 2006; 25: 691-699.

9. Öcal DF, Nas T, Güler I. The place of fourdimensional ultrasound in evaluating fetal anomalies. Ir J Med Sci 2015; 184: 607-612

.10. Merz E, Bahlmann F, Weber G. Volume scanning in the evaluation of fetal malformations: a new dimension in prenatal diagnosis. Ultrasound Obstet Gynecol 1995; 5: 222-227.

11. Michailidis GD, Papageorgiou P, Economides DL. Assessment of fetal anatomy in the first trimester using two- and three-dimensional ultrasound. Br J Radiol 2002; 75: 215-219.

12. Yagel S, Cohen SM, Messing B, Valsky DV. Three-dimensional and four-dimensional ultrasound applications in fetal medicine. Curr Opin Obstet Gynecol 2009; 21: 167-174.

13. Dashe JS, McIntire DD, Twickler DM. Maternal obesity limits the ultrasound evaluation of fetal anatomy. J Ultrasound Med 2009; 28: 1025- 1030.

14. Andonotopo W, Kurjak A. The assessment of fetal behavior of growth restricted fetuses by 4D sonography. J Perinat Med 2006; 34(6): 471- 478.