Evaluation of three-dimensional ultrasonography and magnetic resonance imaging in assessment of congenital heart anomalies in fetal cardiac specimens

In this observational study, multiplanar three-dimensional ultrasound images were reconstructed from tomographic views obtained by scanning seven cadavaric fetal hearts with various congenital heart defects. Comparisons were made with multiplanar three-dimensional magnetic resonance imaging (MRI) of the hearts. Good-quality echocardiographic images were obtained in all but one of the fetal hearts. Multiplanar as well as three-dimensional reconstructions were possible and allowed accurate assessment of complex cardiac defects. Overall, the MRI projections had better image quality and revealed more structural details than the sonographic views, although both imaging modes showed the same cardiac anatomical abnormalities. Our initial results demonstrate that simultaneous multiplanar display of cross-sectional echocardiographic views can be performed to provide three-dimensional images of the fetal heart, demonstrating structural cardiac malformation. However, the clinical application of three-dimensional fetal echocardiography is at present limited by the time required for image data acquisition and the need for accurate temporal and positional gating in the living fetus.