1. 3D/4D OB Ultrasound: Basics, Tips, and Possibilities Diana M. Strickland, RDMS, RDCS East Carolina University – Brody School of Medicine Greenville, NC

4. Technical considerations Optimal –Body surfaces –Tissue/fluid interfaces Suboptimal –Oligohydramnios –Fetal part against uterine wall Strong Echoes –Bone/ Spine Surface Rendering:

5. Measurements More accurate CRL Weight volume Quantify AFV

6. Artifacts Some will be unique to 3D –need to recognize Dropout –may simulate missing limbs Fetal small parts Fetal motion

7. Gynecology Coronal and transverse vaginal quality images of entire uterus Septums Adnexal masses –size, wall structure, internal characteristics, vascularity Follicles Fibroids Endometrial thickness, Sonohysterography

9. Comparison with 2D Imaging Multiple views, planes, and angles Volumetric storage -Better appreciate size Photographic quality image –Improved patient understanding ADVANTAGES

10. Comparison with 2D Imaging Slow learning curve Placental interference Obesity Oligohydramnios Small parts interference Fetal motion (20%) Expert sonographer Expense DISADVANTAGES

11. Clinical Applications Still not a necessary component for diagnosis (Adjunct) May Improve Diagnosis –Confirmation of a 2D diagnosis –Helps to re-evaluate after initial diagnosis Counseling –Help patient to conceptualize diagnosis

12. 4D or STIC Dynamic view of beating heart Fetal movement and behavior * Placental blood Flow Serial 3D * http://www.ob-ultrasound.net/images/yawn.mov Gated 3D

14. Transparency Mode X-ray Mode