Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 17 , ISSUE 3 ( July-September, 2023 ) > List of Articles


Nomenclature of Three-dimensional and Four-dimensional Ultrasound in Obstetrics, Gynecology, and Fetal Echocardiography

Jing Deng

Keywords : Fetal echocardiography, Nomenclature, Obstetrics and gynecology, Three-dimensional and four-dimensional, Ultrasound

Citation Information : Deng J. Nomenclature of Three-dimensional and Four-dimensional Ultrasound in Obstetrics, Gynecology, and Fetal Echocardiography. Donald School J Ultrasound Obstet Gynecol 2023; 17 (3):234-247.

DOI: 10.5005/jp-journals-10009-1985

License: CC BY-NC 4.0

Published Online: 30-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


This article attempts to define various three-dimensional (3D) or four-dimensional (4D) terms with rationales behind these definitions and with a focus on most frequently but often inconsistently or misused terms. It is based on the author's own 3D/4D experiences and a review of related literature.

  1. Baba K, Okai T, Satoh K. Development of scan head position indicator for ultrasonic fetal three-dimensional reconstruction. J Med Ultrasonics 1986;13(Suppl. 1):121–122.
  2. Merz E, Macchiella D, Bahlmann F, et al. Fetale Fehlbildungsdiagnostik mit Hilfe der 3D-sonographie. Ultraschall Klin Prax 1991;6:147.
  3. Lees WR, Gardener JE, Gillams AR. Three-dimensional ultrasound of the fetus. Radiology 1991;181(P):132–132.
  4. von Ramm OT, Smith SW. Real time volumetric ultrasound imaging system. J Digit Imaging 1990;3(4):261–266. DOI: 10.1007/BF03168124
  5. Nelson TR, Pretorius DH, Sklansky M, et al. Three-dimensional echocardiographic evaluation of fetal heart anatomy and function: acquisition, analysis, and display. J Ultrasound Med 1996;15(1):1–9. DOI: 10.7863/jum.1996.15.1.1
  6. Deng J, Gardener JE, Rodeck CH, et al. Fetal echocardiography in three and four dimensions. Ultrasound Med Biol 1996;22(8):979–986. DOI: 10.1016/s0301-5629(96)00119-6
  7. Merz E, Abramovicz J, Baba K, et al. 3D imaging of the fetal face - recommendations from the International 3D Focus Group. Ultraschall Med 2012;33(2):175–182. DOI: 10.1055/s-0031-1299378
  8. Carvalho JS, Allan LD, Chaoui R, et al. ISUOG Practice Guidelines (updated): sonographic screening examination of the fetal heart. Ultrasound Obstet Gynecol 2013;41(3):348–359. DOI: 10.1002/uog.12403
  9. DeVore GR, Satou G, Sklansky M. 4D fetal echocardiography-an update. Echocardiography 2017;34(12):1788–1798. DOI: 10.1111/echo.13708
  10. Mabrouk M, Raimondo D, Del Forno S, et al. Pelvic floor muscle assessment on three- and four-dimensional transperineal ultrasound in women with ovarian endometriosis with or without retroperitoneal infiltration: a step towards complete functional assessment. Ultrasound Obstet Gynecol 2018;52(2):265–268. DOI: 10.1002/uog.18924
  11. Benacerraf BR, Abuhamad AZ, Bromley B, et al. Consider ultrasound first for imaging the female pelvis. Am J Obstet Gynecol 2015;212(4):450–455. DOI: 10.1016/j.ajog.2015.02.015
  12. Baken L, Benoit B, Koning AHJ, et al. First-trimester crown-rump length and embryonic volume of fetuses with structural congenital abnormalities measured in virtual reality: an observational study. Biomed Res Int 2017;2017:1953076. DOI: 10.1155/2017/1953076
  13. Tutschek B, Blaas HK, Abramowicz J, et al. Three-dimensional ultrasound imaging of the fetal skull and face. Ultrasound Obstet Gynecol 2017;50(1):7–16. DOI: 10.1002/uog.17436
  14. Barisic LS, Stanojevic M, Kurjak A, et al. Diagnosis of fetal syndromes by three- and four-dimensional ultrasound: is there any improvement? J Perinat Med 2017;45(6):651–665. DOI: 10.1515/jpm-2016-0416
  15. ISUOG 3D Focus Group. Prevalence of 3D/4D articles published in Ultrasound in Obstetrics & Gynecology and preference for 3D/4D terms used. Ultrasound Obstet Gynecol 2013;42(Suppl. 1):127–128. DOI: 10.1002/uog.12964
  16. Deng J. Terminology of three-dimensional and four-dimensional ultrasound imaging of the fetal heart and other moving body parts. Ultrasound Obstet Gynecol 2003;22(4):336–344. DOI: 10.1002/uog.890
  17. Vinals F. Current experience and prospect of internet consultation in fetal cardiac ultrasound. Fetal Diagn Ther 2011;30(2):83–87. DOI: 10.1159/000330113
  18. Houck RC, Cooke J, Gill EA. Three-dimensional echo: transition from theory to real-time, a technology now ready for prime time. Curr Probl Diagn Radiol 2005;34(3):85–105. DOI: 10.1016/j.cpradiol.2005.02.001
  19. Sklansky MS, DeVore GR, Wong PC. Real-time 3-dimensional fetal echocardiography with an instantaneous volume-rendered display: early description and pictorial essay. J Ultrasound Med 2004;23(2):283–289. DOI: 10.7863/jum.2004.23.2.283
  20. Deng J. 3D/4D specific artefacts: how to recognise, minimise and avoid them. 3D Workshop at the 27th World Congress on Ultrasound in Obstetrics and Gynecology; 19 September 2017, 2017; Vienna, Austria.
  21. Sur SD, Jayaprakasan K, Jones NW, et al. A novel technique for the semi-automated measurement of embryo volume: an intraobserver reliability study. Ultrasound Med Biol 2010;36(5):719–725. DOI: 10.1016/j.ultrasmedbio.2010.03.006
  22. Hata T, Kanenishi K, Nitta E, et al. HDlive Flow with HDlive silhouette mode in diagnosis of molar pregnancy. Ultrasound Obstet Gynecol 2018;52(4):552–554. DOI: 10.1002/uog.19106
  23. Chaoui R. Three-dimensional ultrasound assessment of the fetal heart. Echocardiographic Anatomy in the Fetus. Springer Science & Business Media 2009.
  24. Deng J, Hall-Craggs MA, Pellerin D, et al. Real-time three-dimensional ultrasound visualization of erection and artificial coitus. Int J Androl 2006;29(2):374–379. DOI: 10.1111/j.1365-2605.2005.00617.x
  25. Deng J, Crouch NS, Creighton SM, et al. Minimally-compressive, three- and four-dimensional ultrasound imaging of the clitoris: a feasibility study. Ultrasound Med Biol 2006;32(10):1479–1484. DOI: 10.1016/j.ultrasmedbio.2006.06.006
  26. Chatterjee R, Deng J, Pellerin D, et al. Feasibility of dynamic 3-D color Doppler ultrasound for imaging penile vascular change in renal transplant patients with erectile dysfunction responding to sildenafil. Ultrasound Med Biol 2008;34(6):885–891. DOI: 10.1016/j.ultrasmedbio.2007.11.013
  27. Burton P, Deng J, McDonald D, et al. Real-time 3D ultrasound imaging of infant tongue movements during breast-feeding. Early Hum Dev 2013;89(9):635–641. DOI: 10.1016/j.earlhumdev.2013.04.009
  28. Baba K, Okai T, Kozuma S, et al. Real-time processable three-dimensional US in obstetrics. Radiology 1997;203(2):571–574. DOI: 10.1148/radiology.203.2.9114124
  29. Kozuma S, Baba K, Okai T, et al. Dynamic observation of the fetal face by three-dimensional ultrasound. Ultrasound Obstet Gynecol 1999;13(4):283–284. DOI: 10.1046/j.1469-0705.1999.13040281.x
  30. Campbell S. 4D, or not 4D: that is the question. Ultrasound Obstet Gynecol 2002;19(1):1–4. DIO: 10.1046/j.0960-7692.2002.00625.x
  31. Kuno A, Akiyama M, Yamashiro C, et al. Three-dimensional sonographic assessment of fetal behavior in the early second trimester of pregnancy. J Ultrasound Med 2001;20(12):1271–1275. DOI: 10.7863/jum.2001.20.12.1271
  32. Benoit B, Hafner T, Kurjak A, et al. Three-dimensional sonoembryology. J Perinat Med 2002;30(1):63–73. DOI: 10.1515/JPM.2002.009
  33. Kurjak A, Vecek N, Hafner T, et al. Prenatal diagnosis: what does four-dimensional ultrasound add? J Perinat Med 2002;30(1):57–62. DOI: 10.1515/JPM.2002.008
  34. Timor-Tritsch IE, Platt LD. Three-dimensional ultrasound experience in obstetrics. Curr Opin Obstet Gynecol 2002;14(6):569–575. DOI: 10.1097/00001703-200212000-00001
  35. Deng J. Start of the art of the heart. Ultrasound Obstet Gynecol 2001;18(4):405–406. DOI: 10.1046/j.0960-7692.2001.00527.x
  36. Wang XF, Xiao JP. [Fetal echocardiography - a method for pregnancy diagnosis]. Chinese J Obstet Gynecol 1964;10:267–269.
  37. Campbell S. An improved method of fetal cephalometry by ultrasound. J Obstet Gynaecol Br Commonw 1968;75(5):568–576. DOI: 10.1111/j.1471-0528.1968.tb00161.x
  38. Allan LD, Tynan MJ, Campbell S, et al. Echocardiographic and anatomical correlates in the fetus. Br Heart J 1980;44(4):444–451. DOI: 10.1136/hrt.44.4.444
  39. DeVore GR, Donnerstein RL, Kleinman CS, et al. Real-time–directed M-mode echocardiography: a new technique for accurate and rapid quantitation of the fetal preejection period and ventricular ejection time of the right and left ventricles. Am J Obstet Gynecol 1981;141(4):470–471. DOI: 10.1016/0002-9378(81)90617-7
  40. Baba K, Satoh K, Sakamoto S, et al. Development of an ultrasonic system for three-dimensional reconstruction of the fetus. J Perinat Med 1989;17(1):19–24. DOI: 10.1515/jpme.1989.17.1.19
  41. Wikipedia. Persistence of vision. Accessed 6 Sept 2023.
  42. Deng J, Yates R, Demetrescu C, et al. Impact of live 4D ultrasound volume rate on recognition of fetal cardiac structures in reformatted 2D views. Ultrasound Obstet Gynecol 2010;36(Suppl. 1):3. DOI: 10.1002/uog.7775
  43. Deng J. How to optimise 4D settings for fetal echo: from theoretical to technical considerations. 3D Workshop at the 26th World Congress on Ultrasound in Obstetrics and Gynecology; 2016; Rome, Italy.
  44. Youssef A, Montaguti E, Sanlorenzo O, et al. Reliability of new three-dimensional ultrasound technique for pelvic hiatal area measurement. Ultrasound Obstet Gynecol 2016;47(5):629–635. DOI: 10.1002/uog.14933
  45. Tudorache S, Florea M, Dragusin R, et al. 3D ultrasound assessment of the uterus: why an accuracy study for mullerian congenital anomalies is not feasible, while screening already is, and should be done. J Clin Diagn Res 2017;5:134. DOI: 10.4172/2376-0311.1000134
  46. Deng J, Ruff CF, Linney AD, et al. Simultaneous use of two ultrasound scanners for motion-gated three-dimensional fetal echocardiography. Ultrasound Med Biol 2000;26(6):1021–1032. DOI: 10.1016/s0301-5629(00)00220-9
  47. Deng J, Rodeck CH. Current applications of fetal cardiac imaging technology (invited review). Curr Opin Obstet Gynecol 2006;18(2):177–184. DOI: 10.1097/01.gco.0000192987.99847.a4
  48. Goncalves LF, Espinoza J, Lee W, et al. A new approach to fetal echocardiography: digital casts of the fetal cardiac chambers and great vessels for detection of congenital heart disease. J Ultrasound Med 2005;24(4):415–424. DOI: 10.7863/jum.2005.24.4.415
  49. Paladini D, Vassallo M, Sglavo G, Martinelli P. Assessment of cardiac function impairment by four-dimensional echocardiography with inversion mode rendering in fetal congenital heart disease. Ultrasound Obstet Gynecol 2005;26(4):346. DOI: 10.1002/uog.2133
  50. Dindoyal I, Lambrou T, Deng J, et al. 2D/3D fetal cardiac dataset segmentation using a deformable model. Med Phys 2011;38(7):4338–4349. DOI: 10.1118/1.3592638
  51. Cao HY, Wang Y, Hong L, et al. Morphological features of complex congenital cardiovascular anomalies in fetuses: as evaluated by cast models. J Huazhong Univ Sci Technolog Med Sci 2017;37(4):596–604. DOI: 10.1007/s11596-017-1778-9
  52. Kurjak A, Hafner T, Kupesic S, et al. Three-dimensional power Doppler in study of embryonic vasculogenesis. J Perinat Med 2002;30(1):18–25. DOI: 10.1515/JPM.2002.003
  53. Chaoui R, Kalache KD, Hartung J. Application of three-dimensional power Doppler ultrasound in prenatal diagnosis. Ultrasound Obstet Gynecol 2001;17(1):22–29. DOI: 10.1046/j.1469-0705.2001.00305.x
  54. Deng J, Yates R, Sullivan ID, et al. Dynamic three-dimensional colour Doppler ultrasound of human fetal intracardiac flow. Ultrasound Obstet Gynecol 2002;20(2):131–136. DOI: 10.1046/j.1469-0705.2002.00752.x
  55. Gindes L, Hegesh J, Weisz B, et al. Three and four dimensional ultrasound: a novel method for evaluating fetal cardiac anomalies. Prenat Diagn 2009;29(7):645–653. DOI: 10.1002/pd.2257
  56. Wikipedia. Wagon-wheel effect. Accessed 6 Sept 2023.
  57. Deng J. Direct Volume Scan or Indirect Volume Scan Four Relativity Issues in Four-Dimensional Ultrasonography (applicable to other multi-dimensional imaging modalities). in Merz E, Kurjak A eds: 3D and 4D Sonography in Clinical Practice. London: JP Medical 2019, p75–93.
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