Abnormalities of systemic and pulmonary venous connections are among the most frequently missed congenital heart disease (CHD) in prenatal ultrasound studies. In fact their prenatal US detection is difficult and requires adequate image resolution and attention to detail.
Recently, three-four D US has been suggested to provide a significant contribution to our understanding of the developing heart in both normal and anomalous cases. In particular “B-flow-STIC imaging” and “inversion mode” have been demonstrated to supply additional information over that provided by 2D US in the prenatal diagnosis of some congenital heart defects, including abnormalities of the venous connections.
In this chapter we report the 2D prenatal characterization of the most common anomalies of the venous connections, and describe the application and added value of 4D echocardiography with B-flow-STIC imaging or with inversion mode in the prenatal diagnosis of total anomalous pulmonary venous connections and abnormal systemic venous connections respectively.