by Norman H. Silverman Over the last two decades, the value of examining the fetal heart has moved from an experimental procedure of diagnostic curiosity to a front-line form of evaluating fetal cardiac health and disease. There have been numerous advances in the associated te- nology, including high-resolution imaging, the introduction of reliable color flow and pulse Doppler, and M-Mode and continuous-wave Doppler recordings in some inst- ments. Such advances continue, with the potential for 3D imaging using spatiotem- ral image correlation (STIC) and full-volume fetal technology. The techniques used by obstetric sonographers in all fields, including physicians from the fields of radiology, obstetrics, and pediatric cardiology, together with te- nologists who support and do most of the scanning, require a fundamental understanding of ultrasound as well as anatomy, physiology, and the various cardiac pathologies that occur in the fetus. This book addresses these fundamentals, providing correlations by means of diagrams and images of fetal cardiac morphology and pathology. The scans are quite unique, having been collected over several years by the principal author, Dr. Enrico M. Chiappa, from his laboratories in Italy, and provide exquisite echoc- diography of normal and congenitally malformed hearts. These are complemented by the excellent pathological images of Dr. Andrew C. Cook and Dr. Gianni Botta, who provided high-quality images of normal and pathological fetal heart conditions, which are displayed as support for the echocardiographic images. The organization of this book is oriented toward practitioners.
Whether in fetal or postnatal life, echocardiographic diagnosis is based on moving images. With recent advances in ultrasound systems, storing multiple digital frames and clips with superb image quality has become a reality. These advances have brought innovative applications into the clinical field and can be integrated into powerful multimedia presentations for teaching purposes.
Sections of cardiac specimens are usually compared with corresponding sections in echocardiography textbooks. These sections are mainly obtained from isolated hearts, due to ease and speed of acquisition. Nevertheless, sections of the whole body are a better tool with which to understand the relationship between cardiac and extracardiac structures. This understanding is particularly important in fetal echocardiography, where the number of visible structures around the heart is much greater and the approaches to the fetal thorax are more variable.
The DVD accompanying the book presents morphological images from tomographic sections of the whole fetal body, as well as high-quality dynamic echocardiographic images of normal fetuses and of some of the most common congenital heart defects.
The extraordinary amount of information provided in this work makes this publication a highly useful resource for obstetricians, sonographers, and pediatric cardiologists.
