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INTRODUCTION
3DUS is a recent technique in clinical practice, which has been mostly used in Obstetrics and Gynecology. Although there is relatively little experience in other areas, it is increasing day by day.

Unfortunately, most people still tend to believe that 3DUS is only about getting nice and amazing pictures of baby faces, legs or genitalia. It is precisely this belief and lack of information what has driven us to present to you a set of some different and updated applications that have proved to be useful as well as a range of other feasible and promising uses of this outstanding technology, not only in the already known applications in Obstetrics and Gynecology, but also in the rest of the medical specialties.

There are different types of 3DUS:
 Vascular
 Volumetric
 Surface
 Multiplanar
 Niche Mode (which we refer to as Echo-Tomography) 
 VOCAL (Virtual Organ Computer-aided Analysis)

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3DUS IN GASTROENTEROLOGY

3DUS is an excellent tool to observe the spatial distribution of the liver vessels. Besides, the arterial, venous and portal components can be clearly seen. We can therefore, explore focal or diffuse disorders and TIPS (Transjugular Intrahepatic Porto-systemic Shunt) when the Vascular 3DUS is used. With Multiplanar 3DUS it is possible to see the point of insertion of that prosthesis.

This technology also allows to view the Portal system accurately. By rotating the image of the hepatic hilium, we can see hidden branches of the portal vein.

Portal hypertension is also well evaluated, because the 3DUS makes a spatial reconstruction of the dilated collateral vessels, illustrating the vascular abnormality in these cases. It is possible to differentiate the shape and dichotomy of the portal system in a normal liver from those in a cirrhotic liver where the porta is irregular.

Using echo-enhancers (contrast agents) we can depict the neovascularization of liver tumors and create a 3D rendering which allows us to observe the vascular pattern of the different neoplasms such as hepatocarcinoma, metastasis or hemangioma.

The Multiplanar, Niche Mode or Echo-Tomography and VOCAL are extremely useful in Radiology, Internal Medicine or Surgery, because they help us define the anatomical relationships, identify the hepatic segments affected and do a precise follow-up of oncological patients. The Echo-Tomography provides milimetric “cuts” of any structure, defining the precise limits of a lesion or eventual tumoral invasion to another segments or organs. The VOCAL is a very useful tool in these cases, because it is able to automatically calculate the volume of a tumor.

3DUS allows us to perform a remarkably clear visualization of gallbladder stones, and examine with great detail their shape and size. Also, it is possible to detect the calculi localization within the biliary tract. We can see the structures that are behind the stones that we would not be able to see with 2DUS, due to the posterior acoustic shadow it produces.

Another advantage is that with 3DUS we are able to get a very clear picture of the choledocho duct going from the liver to the retro pancreatic portion.

The pancreas is seen with multiplanar presentation, with high definition of all its structures, including the Wirsung’s duct.

We can get an overall image of the spleen and focus on the vascularity organization. It is possible to observe infarction areas inside the parenchyma with 3DUS Power Doppler.

There are data supporting the superior accuracy of 3DUS when compared to 2DUS. Some authors demonstrated similar advantages when comparing 3DUS and 3DCT, in abdominal studies.