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a Chapter 7 Three-dimensional Color and Power Doppler Ultrasonography of the Fetal Cardiovascular System 93
Fig. 7.19. Great vessels of a normal fetus (left) and a fetus
with transposition of the great arteries (right). In the left
image the crossing of the vessels is recognized with the
course of the aorta under the pulmonary trunk (TP) and
the connection of the ductus arteriosus (DA) at the level of
the isthmus (ISTH). In transposition both vessels are parallel
and the aorta is on the right side of the pulmonary trunk
Fig. 7.20. A normal fetus (left) compared with a fetus with
left isomerism (polysplenia; right): On the left the inferior
vena cava is seen entering the heart and on the right side
of the aorta the tiny azygos vein is recognized connecting
with the superior vena cava. In left isomerism there is an
interruption of the inferior vena cava (star), which is absent
on 3D PDU. Venous blood from the inferior part of the
body returns via the azygos vein, which is dilated and seen
side by side near the aorta
Table 7.7. Conditions for potential 3D power and color
Doppler application in fetal echocardiography
Anomalies of the four chambers
Abnormal atrioventricular connection
Malformations of the great arteries in conotruncal malformations
such as transposition
Severe tricuspid regurgitation
Aberrant course of vessels such as right aortic arch and
double aortic arch
in different anomalies may represent future application
fields [18, 19]. Venous anomalies could be of
further interest in the future (Fig. 7.20). Table 7.7
summarizes some of these fields of interest.
References
1. Heling KS, Chaoui R, Bollmann R (2000) Prenatal diagnosis
of an aneurysm of the vein of Galen with threedimensional
color power angiography. Ultrasound Obstet
Gynecol 15:333±336