Three-dimensional ultrasonic angiography of fetal, umbilical and placental vasculature using advanced dynamic flow

Background: Advanced Dynamic Flow (ADF), the software loaded in Toshiba's Aplio series of ultrasound apparatus (Toshiba Medical Systems, Tokyo, Japan), is useful for the detailed examination of small vessels such as fetoplacental or umbilical cord vasculature because of its high resolution and low blooming. The purpose of this study was to investigate the accuracy with which the fetoplacental vasculature is depicted by three-dimensional ultrasonic angiography using ADF. Materials and Methods: Approximately 100 placentas, umbilical cords and fetuses, with and without abnormalities, at various gestational ages were investigated over a period of 1 year. We performed freehand scanning with the sector-scanning bracket using a three-dimensional magnetic position sensor. Results: The umbilical cord insertion, placental vasculature, and superficial anastomosis in a monochorionic placenta were clearly depicted. Fetal vessels such as those of the portal and hepatic venous system could be clearly reconstructed. Conclusion: ADF is suitable for the accurate depiction of fetoplacental vasculature for the three-dimensional reconstruction of vessels. The technique of three-dimensional ultrasonic angiography using ADF is reliable for visualizing fetal, umbilical and placental vasculature.