Yanagihara T, Hata T
Department of Perinatology, Kagawa Medical University, Miki, Kagawa, Japan.
Gynecol Obstet Invest. 2000;49(1):12-6. doi: 10.1159/000010205.
To demonstrate the potential of using three-dimensional (3D) sonography to reveal anomalies of fetal skeleton.
Forty-two normal fetuses and 3 anencephalic fetuses from 14 to 27 weeks' gestation were studied with a specially developed abdominal 3D transducer (3.5 MHz). This imaging system provided conventional two-dimensional (2D) sonographic images and also generated within seconds high-quality 3D images in the surface and transparent mode with no need for an external workstation.
Using this imaging system, we obtained 2D and 3D images of fetal skeleton (skull, scapula, spine, rib, humerus, ulna/radius, pelvis, femur, and tibia/fibula) at two gestational ages. The percentages of fetal skeletal visualization at less than 20 weeks of gestation using 3D sonography were 78-100%, whereas those with 2D sonography were all 100%. The percentages of skeletal structures revealed after 20 weeks' gestation using 3D sonography were 82-100%, whereas those with 2D sonography were all 100%. We found no significant differences in detection rates of the fetal skeleton between 2D and 3D sonography. However, 3D sonographic images generally provided a more comprehensive view of the fetal skeleton than did conventional 2D sonography. In 2 cases with anencephaly, 3D sonography clearly revealed the defect of cranium.
The new 3D sonographic technology can generate within seconds high-quality 3D images of the fetal skeleton. The 3D technology seems to perform at least as well as conventional 2D sonography. Our results suggest that 3D sonography has the potential to supplement 2D sonography and might be useful in identifying malformations of the fetal skeleton and chromosomal abnormalities in utero.
展示使用三维（3D）超声检查揭示胎儿骨骼异常的潜力。
使用专门开发的腹部3D换能器（3.5兆赫）对42例孕14至27周的正常胎儿和3例无脑儿进行研究。该成像系统可提供传统的二维（2D）超声图像，还能在数秒内生成表面模式和透明模式的高质量3D图像，无需外部工作站。
使用该成像系统，我们在两个孕周获得了胎儿骨骼（颅骨、肩胛骨、脊柱、肋骨、肱骨、尺骨/桡骨、骨盆、股骨和胫骨/腓骨）的2D和3D图像。孕20周前使用3D超声检查胎儿骨骼可视化的百分比为78 - 100%，而使用2D超声检查的百分比均为100%。孕20周后使用3D超声检查揭示的骨骼结构百分比为82 - 100%，而使用2D超声检查的百分比均为100%。我们发现2D和3D超声检查在胎儿骨骼检测率上无显著差异。然而，3D超声图像通常比传统2D超声检查能更全面地显示胎儿骨骼。在2例无脑儿病例中，3D超声检查清晰地揭示了颅骨缺陷。
新的3D超声技术能在数秒内生成胎儿骨骼的高质量3D图像。3D技术的表现似乎至少与传统2D超声检查一样好。我们的结果表明，3D超声检查有潜力补充2D超声检查，可能有助于识别胎儿骨骼畸形和子宫内染色体异常。
