1233 0361-803X/95/1 655-1 233 © American Roentgen Ray Society Evaluation of Normal and Abnormal Lips in Fetuses: Comparison Between Three- and Two-Dimensional Sonography Dolores H. Pretorius1 Michael House1 Thomas R. Nelson1 Kathryn A. Hollenbach2 OBJECTIVE. The purpose of this study was to determine if three-dimensional (3D) sonography could improve prenatal evaluation of fetal lips in comparison with con- ventional two-dimensional (2D) sonography. MATERIALS AND METHODS. Sixty-one high-risk pregnant women and 10 low-risk pregnant women were examined with conventional 2D sonography followed by 3D sonography with a volume transducer. The ability to visualize cleft lips and normal lips was compared between the two techniques. RESULTS. Of the 71 fetuses studied, faces were seen in 68 and not seen in three by either 2D or 3D sonography. Abnormal lips were seen in five fetuses on both 2D and 3D sonograms. Of the remaining fetuses, 3D sonography was able to confirm the presence of a normal lip in 92% (58/63) compared with 76% (48/63) with 2D sonography. In the subgroup of fetuses less than 24 weeks’ estimated gestational age, 3D sonography confirmed a normal lip in 93% (38/41) of fetuses as compared with 68% (28/41) for 2D sonography. There was no difference between 3D and 2D in the subgroup of fetuses older than 24 weeks. One false-positive finding of cleft lip was observed at 36 weeks’ gestational age with the rendered surface display on 3D sonography, whereas the 3D planar views of the same volume showed the lips to be normal. CONCLUSION. 3D sonography was able to confirm the presence of normal lips more frequently than did 2D sonography in fetuses less than 24 weeks’ gestational age. Abnormal lips were seen on both 2D and 3D sonograms; however, 3D Images of cleft lip were easier to understand for both the family and clinical colleagues. AJR 1995;165:1233-i237 Received April 12, 1 995: accepted after revision June22, 1995. 1 Department of Radiology-0610, University of Califomia, San Diego, 9500 Gilman Dr., La Jolla, CA 92093. Address correspondence to D. H. Pretorius. 2Department of Family and Preventive Medi- cine-0361 -C, University of California, San Diego, La Jolla, CA 92093. Use of three-dimensional (3D) sonognaphy of the fetus has been reported in 5ev- enal recent investigations [1-9]. A particularly promising application of 3D sonogra- phy is the diagnosis of fetal anomalies [3, 5, 7]. Cleft lip and palate is an example of an anomaly that is difficult to detect by conventional two-dimensional (2D) sonogna- phy [1 0-12]. As a cleft lip and palate is associated with other anomalies and chro- mosome abnormalities in 10-15% of fetuses [13-15], early diagnosis may aid in the management of the pregnancy [1 6]. In this article we compare 2D and 3D sono- graphic images of the fetal face to determine whether 3D sonognaphy can improve prenatal evaluation of fetal lips in comparison with conventional 2D sonography. Materials and Methods Study Population A total of 71 fetuses (15-39 weeks’ gestational age) were examined with 3D sonography between March and November 1 994. Sixty high-risk pregnant women undergoing conven- tional 2D sonography at a peninatal referral center were recruited, and one patient requested to participate because of a family history of cleft lip. Indications for 2D sonography scanning included advanced maternal age (n = 8), family history of cleft lip (n = 8), teratogen expo- Downloaded from www.ajronline.org by 52.73.204.196 on 05/16/22 from IP address 52.73.204.196. Copyright ARRS. For personal use only; all rights reserved