ABSTRACT

During the past 25 years, two-dimensional (2D) imaging of the fetal heart has evolved into a sophisticated and widely practiced clinical tool, but most heart diseases still go undetected prenatally despite routine fetal ultrasound evaluations. Over the coming years, tremendous advances in fetal cardiac imaging, including 3D imaging, promise to revolutionize both the prenatal detection and diagnosis of congenital heart disease (CHD). Image resolution continues to improve year after year, allowing earlier and better visualization of cardiac structures. This chapter reviews the possibilities of 3D and 4D fetal echocardiography. 3D imaging of the fetal heart may improve the detection of outflow tract abnormalities and facilitate comprehension of complex forms of CHD. This review highlights the potential of acquiring a digital volume dataset of a heart cycle for later offline examination, for an offline diagnosis, for a second opinion (e.g., via Internet link), or for teaching fetal echocardiography to trainees and sonographers. On the other hand, other imaging modalities, such as Doppler tissue imaging and magnetic resonance imaging (MRI), continue to evolve and to complement 2D and 3D sonographic imaging of the fetal heart. As a result of these ongoing advances in prenatal detection and assessment of CHD, this is an exciting and promising time for the field of fetal cardiac imaging. 1