Radiological evaluation of the fetal face using three-dimensional ultrasound imaging

Marcel B umler,1–3 Michèle Bigorre,1,4 Jean-Michel Faure1,51CHU Montpellier, Centre de Compétence des Fentes Faciales, H pital Lapeyronie, Montpellier, 2Clinique du Parc, Imagerie de la Femme, Castelnau-le-Lez, 3Cabinet de Radiologie du Trident, Lunel, 4CHU Service de Chirurgie Plastique Pédiatrique, H pital Lapeyronie, Montpellier, 5CHU Montpellier, Service de Gynécologie-Obstétrique, H pital Arnaud de Villeneuve, Montpellier, FranceAbstract: This paper reviews screening and three-dimensional diagnostic ultrasound imaging of the fetal face. The different techniques available for analyzing biometric and morphological items of the profile, eyes, ears, lips, and hard and soft palate are commented on and briefly compared with the respective bi-dimensional techniques. The available literature supports the use of three-dimensional ultrasound in difficult prenatal diagnostic conditions because of its diagnostic accuracy, enabling improved safety of perinatal care. Globally, a marked increase has been observed in the accuracy of three-dimensional ultrasound in comparison with the bi-dimensional approach. Because there is no consensus about the performance of the different three-dimensional techniques, future studies are needed in order to compare them and to find the best technique for analysis of each of the respective facial elements. Universal prenatal standards may integrate these potential new findings in the future. At this time, the existing guidelines for prenatal facial screening should not be changed.Keywords: prenatal three-dimensional ultrasound, prenatal screening, prenatal diagnosis, cleft lip and palate, fetal profile, retrognathism