3D And 4D Flashcards
When do we use 3D and 4D?
Obstetrics and gynaecology
What are some clinical applications of 3D and 4D for obstetrics?
- Fetal portrait
- Nose/Lips
- Neural tube defects
- Hands, feet, and ankles
- Heart
What are some clinical application of 3D and 4D for gynaecology?
- EV
- Müllerian duct anomalies
- Endometrium
- IUCD
How many methods can we gain 3D/ 4D?
3 main methods of acquiring images
- Free hand
- Mechanical
- 3D/4D matrix transducers
How many 3D/4D capabilities are available?
- Limitless capabilities once volume data is acquired
- Anatomy can be re-evaluated in all three planes after the patient has left the unit
What is the free hand method of getting 3D/4D? What are some limitations? What are some requirements?
Transducer manual moving over the area of interest
- No measurements
- No extra equipment required
- 3D only- 4D only
What is the Mechanical 3D/4D transducer method? How does it work?
- Motor within transducer provides sweep
- Transducer elements sweep in a fanlike motion
What is the 3D/4D matrix transducer method for 3D/4D? What applications does it have?
- Cardiac applications
- More crystals
- Beam is electronically steered
What is MPR?
Multiplayer reconstruction
What is a voxel?
3D volume data set (think of a cube version of the pixel)
_______ is area to include in the volume
ROI
What does the volume angle determine?
- How much information acquired in the z axis
- Distance the transducer covers in a sweep
- How wide the sweep is from right to left
What is the volume angle for a fetal heart?
Small volume angle
What is the volume angle for a uterus?
Large volume angle
What are two types of acquisition speed?
Slow and fast
What can we see during slow acquisition speed?
- More slices
- Better quality volume
- Higher resolution
What will we see during faster acquisition speed?
- Active fetus
- Eliminates fetal motion
- Can be better with 4D
What is the image quality of 3D/ 4D scans?
- Same as 2D
- Optimal 2D image produces optimal 3D imaging
What are some factors that affect image quality or 3D/ 4D
- Maternal size
- Decreased amniotic fluid
- Fetal position
What is 3D multiplanar reconstruction
- Volume information displayed in useable format
- Rendered image of all planes on the same screen
What are the three planes for 3D multiplanar resconstruction?
X, Y, Z
For multipanar reconstruction A or X plane is what?
Sagittal of the object being scanned
For multiplanar reconstruction B or Y plane is what?
Transverse of the object being scanned
For multiplanar reconstruction C or Z plane is what?
Coronal of the object being scanned
A and B planes determine what for multiplanar reconstruction?
ROI
What does C determine for multiplanar reconstruction?
Size or volume
What does B and C have in terms of resolution compared to A?
Lower resolution
What has the lowest resolution in terms of the plane?
C
What is the dot?
The point where all three planes intersect
What is the benefit of virtual rescan?
Sonographer or radiologist can use the MPR after the patient has left the clinic to “rescan”
What are some things that virtual rescan can do?
- Not limited to these images
- A multitude of images may be reconstructed
- Can rotate images in any axis
- Can sweep through each plane as well
- Similar to repositioning the transducer
Different ___________ are used to displayed 3D data on the screen
Algorithms
What does rendering modes allow us to do? What are some examples?
- Different characteristics to be highlighted
- Bony structures like the fetal skull
- Soft tissue like the face, nose, lips, ear
What are some surface rendering settings?
- Surface smooth
- Surface texture
- Gradient light
- Threshold is manually adjusted
What is the surface smooth function? Why do we do it?
- Rendering gives the face smooth surface of the skin
- Popular with parents
- No underlying structures are displayed
What is the surface texture setting?
Enhances the details of a surface
What is the gradient light surface rendering setting?
Gives impression of depth by adding a light source
How is threshold ad justed for surface rendering settings?
Manual adjusted
What are some things to caution when adjusting threshold for surface rendering settings? What does low and high threshold look like?
- Use caution as important information can be eliminated
- Low threshold > Skin seen > Fetal face
- Higher threshold > Eliminates skin > Bony structures of face
What does the scalpel function do? What is an example?
- Removes unwanted structures from image
- Placenta from face
- Uterine wall
What does maximum skeletal or x-ray mode do?
- Eliminates weaker signals like soft tissue
- Visualized bones or stronger signals betters
Why would we use maximum skeletal or X-ray mode?
Some syndromes have Wormian bones in the skull sutures. We would now be able to identify these this way
Wha this the inversion function?
- Hyperechoic structures turned into solid structure
- A digital cast
- Grey scale is removed
- Cystic area visualized as an echogenic area.
When would we use inversion techniques?
- Gynaecology
- Obstetrical application
How would inversion technique assist gynecology?
- Saline filled uterus
- PCOS
- Hydrasalpinx
- Follicular monitoring
How would inversion technique help obstetrical application?
- Fetal ventricles
- Dilated fetal urinary tract
- Heart and vessels
- Fetal stomach
What is the glass body or transparency function used in conjunction with? Why would we use it? Does it use grey scale?
- Used in conjunction with power doppler
- Tissue becomes transparent
- Visualize vessels better
- Grey scale completely removed
What is another name for tomographic ultrasound?
Ultrasound computed tomography (USCT)
What is tomographic ultrasound?
A series of tomographic images
What is tomographic ultrasound similar to?
- CT and MRI
- Will see Multislice
Can doppler and power doppler be used for tomographic ultrasound?
Yes
What kind of protocols similar to in terms of tomographic ultrasound?
More uniform to our imaging modalities
What does VOCAL stand for?
Virtual Organ Compoter Aided Analysis
What is vocal?
Software program used to measure the volume of an irregular object
What does vocal allow us to do?
- Contour mapping of a structure
- Data set is rotated 180 degrees around a fixed central axis
- Tracing of the object contours
- Contours outlined
- System reconstructs a model of all the contours
What does Vocal do?
Creates a 3D model and the system reconstructs a contour model
What is a 3D scan?
- Static
- Single sweep through an area
- Volume is stored and viewed in many formats
What are 4D images?
- Live or real-time (can observe fetal facial expressions)
- Transducer elements continuous sweeping back and forth
What are some uses of 3D/ 4D gynecology?
- Congenital uterine anomalies
- IUCD location
- Endometrial lesions
- Origin of Adnexal masses
- Infertility evaluation
What are some endometrial lesions for 3D/4D in gynecology?
- Ashermans
- Polyps
- FIbroids
What is a bicornuate uterus? What is a indicator of bicornuate uterus?
- Two separate uterine cornea on a coronal imaging plane
- An external fundal indentation of greater than 1 cm is diagnostic of a bicornuate uterus
What is sonohysterography?
A volume of the uterus that can be obtained
What does the sonohysterography allows us to do? What does it allow us to see/ do?
3D reconstruction
1. Improves visualization of polyps
2. Fibroids
3. Adhesions
What is a benefit of sonohysterography?
Patient comfort: images can be constructed after patient leaves the department
What is a benefit of 3D/4D for IUCD location? Which view is best?
- Improves precise location of IUCD in the uterus
- Coronal view is the best
What are some restrictions for 3D/4D?
Endometrial restrictions
1. <5mm are technically difficult to reconstruct
What is the z technique?
Standardized step by step technique to obtain a coronal plane of the uterus
What are some benefits of 3D/4D in obstetrics?
- Facial anomalies
- Nasal bone
- CNS anomalies
- Cranial sutures
- Extremities
- Fetal heart
- Chromosomal abnormalities
- Fetal movement and behavior
What do we usually use 3D to obtain?
Mostly of the face to view things like,
1. cleft lip
2. Cleft palate
3. Forehead
4. Nasal bone
5. Mandible
Just as in 2D, ________ and __________ play a significant role in obtaining images?
- Fetal position
- Amniotic fluid
What does off plane 2D results in regards to absent nasal bone?
False positive result
MPR can assist sonographer to assure what?
Correct plane for absent nasal bone
Finding 3D ears anomalies are associated with what?
Congenital syndromes
What do we look for in terms of cranial bones?
- Sutures
- Fontaine’s
- Bones for completeness
- Wormian bones
What are Wormian bones?
Small bones between (within) the cranial sutures
What is Wormian bones in association with?
- Osteogenesis imperfects
- Hypopohosphatasia
- Down syndrome
- Can also be a normal variant
What is the spine scan importance?
More comprehensive assessment
What can be seen in the spine scan?
Spina bifida which can identify the level of defect
What is hemivertibrae?
Only one side of the vertebrae forms
What are some things that we look for during the 1st trimester in 3D?
Nuchal translucency: This measurement is performed in less time
What are some extremities that can be taken in 3D?
- Club feet
- Hands
- Rocker bottom feet
- Overlapping fingers
- Polydactyly
What is STIC stand for?
Spatial temporal image correlation
What is STIC? What does it demonstrate? What type of view is needed?
- A motion gated scanning method
- Demonstrates function and anatomical information form one full cardiac cycle
- Only need a 4 chamber view
What other views are reconstructed by stored data for STIC?
- Outflows
- Venous connections
- Aortic arch
- 5 Chamber
- 3 Vessel
What is the greatest benefit for STIC?
Off site review
What is STIC used for?
Cardiac
What is this an example of?
Inversion technique
What is this an example of?
Glass body or transparency technique
What is this an example of?
IUCD in a bicornuate uterus