Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

Figure 1 Normal fetal brain at 28 wk of gestation. A: 4DUS using HDlive^TM shows, with impressive image quality resembling that of gross anatomy, the cerebral cortex (ccx), the corpus callosum (cc), the cavum septum pellucidum (csp), the thalamus (th) and brainstem (bs) in mid-sagittal plane; B: The same images using the conventional 3DUS in the rendering mode.

Figure 2 Normal fetal esophagus at 28 wk of gestation. A and B: 4DUS using HDlive^TM application may be used to obtain a clear imaging of inner structure of esophagus (arrow) during fetal swallowing at the time of routine second trimester scan.

Figure 3 Normal fetal aortic arch at 28 wk of gestation. 4DUS echocardioangiography using HDlive^TM application to the study of the great artery and veins: the AoA (A, image is rotated), the UV and the DV (B) are rendered with an enhanced quality resembling that of an angiographic study (sp, fetal spine). AoA: Aortic arch; UV: Umbilical vein; DV: Ductus venosus; sp: Fetal spine.

Figure 4 4DUS using Hlive^TM (5DUS) lightening technique: Realistic rendering in a case (A) of left-sided cleft lip and palate and left-sided cleft lip (B). C and D: The same images using the conventional 3DUS in the rendering mode.

Figure 5 4DUS using Hlive^TM showing the right-sided cleft lip and palate (arrow) in a fetus with 21 wk-3 d.

Figure 6 4DUS using HDlive^TM: Micrognathia (arrow) is clearly rendered.

Figure 7 4DUS using HDlive^TM showing a hypoplastic face.

Figure 8 4DUS using HDlive^TM enabled a clear snapshot of low-set ears in this case detected at 24 wk of gestation.

Figure 9 Arthrogryposis multiplex congenital. A: 4DUS using HDlive^TM, note the characteristic muscular contractions causing fingers deviation; B: The same using the conventional 3DUS in the rendering mode.

Figure 10 4DUS using HDlive^TM application in a case of left congenital diaphragmatic hernia. AoA: Aortic arch; L: Lung.

Figure 11 4DUS using HDlive^TM application in a fetus with exomphalos (curved arrow) was diagnosed at early second trimester scan (15 wk-3 d).

Figure 12 4DUS using HDlive^TM application in a case of clitoris hypertrophy (arrow) detected at 27 wk of gestation in an intersexual state (postnatal chromosomal assessment resulted in 46,XY karyotype).