Three-dimensional HDlive rendering image of cystic hygroma

Three-dimensional (3D) HDlive rendering images with both adjustable lighting and new skin-like colors give the normal embryo and fetus, fetal anomalies, and intrauterine abnormalities a natural and anatomically realistic appearance [1–4]. Cystic hygroma is characterized by septated fluid-filled sacculations of the bilateral neck and nuchal region that result from lymphatic dysplasia [5]. We present our experience of cystic hygroma reconstructed employing the three-dimensional (3D) HDlive rendering mode. A total of three cystic hygromas at 11-17 weeks’ gestation were studied employing transvaginal or transabdominal 3D sonography with the HDlive rendering mode (VOLUSON E8, General Electric Medical Systems, Zipf, Austria). Using a curved array transabdominal transducer (4–8.5 MHz) or mechanical transvaginal transducer (4.5–11.9 MHz), the sweep took less than a few seconds at an angle of 70 –85 . The data set was stored on a 700-MB CD-R and could be retrieved for further analysis [3, 4]. All volume data for each fetus were examined, and optimal images were selected for further analysis. Three-dimensional reconstruction was carried out using the HDlive rendering algorithm. The light source was adjusted until the structures of interest were visualized for the examiner to create favorable lighting and shadowing effects [4]. The 3D HDlive rendering mode provided new realistic sensations for the diagnosis of cystic hygroma (Figs. 1, 23). There have been three reports on conventional 3D sonographic diagnosis of cystic hygroma [5–7]. However, conventional 3D surface rendering images are not realistic. In the present report, the 3D HDlive rendering mode provided extraordinarily natural and realistic imaging of cystic hygroma, with greater detail and clarity than are possible with conventional 3D sonography. In particular, the 3D HDlive rendering mode provides new realistic sensations for the diagnosis of cystic hygroma in utero, and it seems to be almost impossible to differentiate between gross specimens and 3D HDlive rendering images, because nearphotographic images were obtained by employing the 3D HDlive rendering mode.