Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

A comparison of standard two-dimensional ultrasound to three-dimensional volume sonography for routine second-trimester fetal imaging

Journal of Perinatology volume 37, pages 380–386 (2017)Cite this article

Subjects

Abstract

Objective:

In comparison with standard two-dimensional (2D) imaging of fetal structure and biometry, we aimed to evaluate the role of three-dimensional (3D) imaging as a screening tool in the mid-trimester.

Study design:

Pregnant women presenting between 18and 22 weeks for routine anatomical survey and biometric measurements were recruited. Six volumes of fetal anatomic regions were obtained and archived for later reconstruction, along with three volumes of extra-fetal structures (placenta, cervix, amniotic fluid). The 2D standard fetal images were then obtained. Offline reconstruction of 3D volumes was performed for comparative analysis (2D vs 3D). Subsequently, 3D volumes were reconstructed to mirror traditional 2D and allow biometric comparison between the two techniques. Data of 98 patients were analyzed.

Results:

Complete visualization of vital anatomic structures was seen ⩾85% of the time with 3D ultrasound. The 3D imaging improved the assessment of the four heart chambers (P=0.003), thoracic spine (P=0.008) and lumbar spine (P=0.012) views. The 2D imaging was superior for the fetal head, placenta and upper limbs. Conditional probabilities were used to assess the clinical value of 3D when standard 2D views were incomplete (mean 0.8830; 95% confidence interval 0.8059 to 0.9320). Overall diagnostic accuracy of 3D ultrasound is not superior for all fetal anatomic structures. Fetal biometric measurements assessed by both techniques demonstrated substantial to excellent agreement.

Conclusion:

The use of 3D imaging as a primary screening tool is limited and may be best utilized as a second-stage test. Overall, there is good correlation between fetal biometry assessed by either 2D or 3D technology.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Dyson RL, Pretorius DH, Budorick NE, Johnson DD, Sklansky MS, Cantrell CJ et al. Three-dimensional ultrasound in the evaluation of fetal anomalies. Ultrasound Obstet Gynecol 2000; 16 (4): 321–328.

    Article  CAS  Google Scholar 

  2. Rizzo G, Pietrolucci M, Aiello E, Mammarella S, Bosi C, Arduini D . The role of three-dimensional ultrasound in the diagnosis of fetal congenital anomalies: a review. Minerva Ginecol 2011; 63 (5): 401–410.

    CAS  PubMed  Google Scholar 

  3. Rizzo G, Abuhamad AZ, Benacerraf BR, Chaoui R, Corral E, Addario VD et al. Collaborative study on 3-dimensional sonography for the prenatal diagnosis of central nervous system defects. J Ultrasound Med 2011; 30 (7): 1003–1008.

    Article  Google Scholar 

  4. Nelson TR, Pretorius DH, Lev-Toaff A, Bega G, Budorick NE, Hollenbach KA et al. Feasibility of performing a virtual patient examination using three dimensional ultrasonographic data acquired at remote locations. J Ultrasound Med 2001; 20 (9): 941–952.

    Article  CAS  Google Scholar 

  5. Merz E, Abramowicz JS . 3D/4D ultrasound in prenatal diagnosis: is it time for routine use? Clin Obstet Gynecol 2012; 55 (1): 336–351.

    Article  Google Scholar 

  6. Benacerraf BR, Shipp TD, Bromley B . Three-dimensional US of the fetus: volume imaging. Radiology 2006; 238 (3): 988–996.

    Article  Google Scholar 

  7. Baumler M, Faure JM, Bigorre M, Baumler-Patris C, Boulot P, Demattei C et al. Accuracy of prenatal three-dimensional ultrasound in the diagnosis of cleft hard palate when cleft lip is present. Ultrasound Obstet Gynecol 2011; 38 (4): 440–444.

    Article  CAS  Google Scholar 

  8. Sarris I, Ohuma E, Ioannou C, Sande J, Altman DG, Papageorghiou AT et al. Fetal biometry: how well can offline measurements from three-dimensional volumes substitute real-time two-dimensional measurements? Ultrasound Obstet Gynecol 2013; 42 (5): 560–570.

    Article  CAS  Google Scholar 

  9. American Institute of Ultrasound in Medicine. AIUM practice guideline for the performance of an antepartum obstetric ultrasound examination. J Ultrasound Med 2003; 22 (10): 1116–1125.

    Article  Google Scholar 

  10. Cargill Y, Morin L, Bly S, Butt K, Denis N, Gagnon R et al. Content of a complete routine second trimester obstetrical ultrasound examination and report. J Obstet Gynaecol Can 2009; 31 (3): 272–275, 276–280.

    Article  Google Scholar 

  11. Durkalski VL, Palesch YY, Lipsitz SR, Rust PF . Analysis of clustered matched-pair data. Stat Med 2003; 22 (15): 2417–2428.

    Article  Google Scholar 

  12. Schwarzler P, Senat MV, Holden D, Bernard JP, Masroor T, Ville Y . Feasibility of the second-trimester fetal ultrasound examination in an unselected population at 18, 20 or 22 weeks of pregnancy: a randomized trial. Ultrasound Obstet Gynecol 1999; 14 (2): 92–97.

    Article  CAS  Google Scholar 

  13. Tonni G, Grisolia G, Sepulveda W . Second trimester fetal neurosonography: reconstructing cerebral midline anatomy and anomalies using a novel 3-dimensional ultrasound technique. Prenat Diagn 2014; 34 (1): 75–83.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Dr Monica Taljaard from the Ottawa Hospital Research Institute for her assistance with the statistical analysis. ZMF holds a Canadian Institute of Health Research (CIHR) Postdoctoral Fellowship. The study was funded by The Ottawa Hospital Academic Medical Organization (TOHAMO).

Author information

Authors and Affiliations

  1. Department of Obstetrics, Division of Maternal-Fetal Medicine, Gynecology and Newborn Care, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada

    M E Roy-Lacroix, F Moretti, Z M Ferraro, L Brosseau, J Clancy & K Fung-Kee-Fung

  2. Department of Obstetrics and Gynecology, University of Sherbrooke, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada

    M E Roy-Lacroix

  3. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    F Moretti, Z M Ferraro & K Fung-Kee-Fung

  4. Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada

    Z M Ferraro

Authors
  1. M E Roy-Lacroix
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F Moretti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Z M Ferraro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L Brosseau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J Clancy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K Fung-Kee-Fung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K Fung-Kee-Fung.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Roy-Lacroix, M., Moretti, F., Ferraro, Z. et al. A comparison of standard two-dimensional ultrasound to three-dimensional volume sonography for routine second-trimester fetal imaging. J Perinatol 37, 380–386 (2017). https://doi.org/10.1038/jp.2016.212

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2016.212

Search

Advanced search

Quick links