3D and 4D Fetal Neuroscan: Sharing the Know-how and Tricks of the Trade (original) (raw)
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The Utilization of 3D and 4D Technology in Fetal Neurosonology
Ultrasound Clinics, 2008
This article discusses the clinical use of three-dimensional (3D) technology while performing a fetal neuroscan. Before reading this article, one should first be familiar with the technical aspects of performing this type of fetal study. For complete details and comprehensive discussion of the advantages of 3D technique as well as technical aspects of obtaining quality volume data and subsequently displaying quality images, the reader is referred to ''3D and 4D Fetal Neuroscan: Sharing the Know-how and Tricks of the Trade'' by Bornstein and colleagues in this issue of the Clinics.
Al-Azhar International Medical Journal
Background: Three dimensional ultrasound (3D US) has become the new standard in prenatal diagnosis of fetal congenital anomalies. This technique enables detailed examination of the fetal anatomy and higher quality depiction of congenital anomalies. Furthermore, four dimensional ultrasound (4D US) enables visualization of more details regarding the dynamics of small anatomical structures. Using the advantages of this technology, a physiologic pattern of embryonic or fetal motor development was made. Objective: This study aimed to evaluate the role of three dimensional (3D) ultrasound compared with two dimensional (2D) ultrasound in diagnosis of fetal central nervous system congenital malformations. Patients and Methods: This Prospective study was performed on total 100 patients with gestational age from 18 weeks to 24 weeks who underwent 2D ultrasound then examined by 3D ultrasound at Obstetrics and Gynecology Department, Bab el-Sheria, Al-Azhar University Hospital. Results: Statistical analysis revealed that the most common neurological malformations detected were Holoprosencephaly and Anencephaly which had significant high agreement between 2D and 3D regarding their diagnosis. There was significant agreement between 2D and 3D regarding the congenital fetal spinal and cranial malformations. The 2D and 3D ultrasound provided equal diagnostic information in microcephaly while 3D US provided more diagnostic information than 2D US for Choroid plexus cyst, agenesis of the corpus callosum and spina bifida. Conclusion: In comparison with 2D US, 3D US improves the diagnostic capability by illustrating more diagnostic details in evaluation of malformations of the fetus, especially in visualization of fetal malformations of the small cranial anomalies and spina bifida.
Three-dimensional fetal ultrasound
Best Practice & Research Clinical Obstetrics & Gynaecology, 2000
Three-dimensional (3D) imaging by ultrasound was proposed in the 1950s. Since the end of the 1980s, 3D ultrasound has become a major field of research in obstetrics and gynaecology. The technique of acquiring 3D data involves making a set of consecutive 2D ultrasound slices by moving the transducer and continuously storing the images. These ultrasound data must be converted into a regular cubic representation before presentation in different 3D visualization modes. The creation of new ultrasound sections from the 3D block and also the surface shading of a structure of interest promise improvement in the diagnosis of congenital anomalies and dysmorphology. In addition, the possibility of volume calculation by 3D ultrasound has to be considered as a clear innovation. At present, almost all of the diagnoses illustrated by 3D ultrasound can be made by 2D ultrasound, and this will continue to be so in the foreseeable future.
Interobserver reproducibility of transabdominal 3-dimensional sonography of the fetal brain
2009
Objective. The purpose of this study was to assess the interobserver reproducibility of transabdominal 3-dimensional (3D) fetal neurosonography. Methods. This was a prospective observational study. We studied 23 consecutive singleton pregnancies between 18 and 23 weeks' gestation. All cases had normal fetal neurosonographic examination findings, which were confirmed after birth. A 3D sonographic volume of the fetal head was acquired transabdominally by a single operator using an axial approach. Fetal brain anatomy was later analyzed offline by 2 different operators. Axial, sagittal, and coronal views of the fetal brain were obtained to perform a detailed evaluation of the fetal brain. Each operator defined the scanning planes obtained as adequate or inadequate. Results were evaluated with 2 × 2 tables and the Cohen κ coefficient to assess interobserver agreement. Results. Good-quality multiplanar images were obtained in 23 of 23 cases. The rate of adequate visualization was 100% for all of the axial planes, with κ values of 1.00. For sagittal and coronal planes, the rate of visualization ranged between 78% and 91%, with κ values ranging between 0.61 and 0.83. Conclusions. Transabdominal 3D sonography of the fetal brain at 18 to 23 weeks' gestation has an acceptable degree of interobserver reproducibility.
Clinical application of three-dimensional ultrasound in fetal brain assessment
Croatian medical journal, 2000
To clarify the usefulness of three-dimensional (3D) ultrasound in the assessment of the fetal head and brain, according to 3D ultrasound surface reconstruction, multiplanar image analysis, three-dimensional angiography, and volume calculation. We examined 326 normal fetuses between 10 and 40 weeks of gestation using 3D ultrasound (Voluson, 530D, Medison, Seoul, Korea), mainly with transvaginal 3D transducer. Fetal head structures, such as the skull, brain structure, and brain circulation, were presented by surface mode, multiplanar imaging mode, and three-dimensional Doppler mode. After automatic volume acquisition of the fetal head, image analyses were performed off-line, and 3D View software was used for volume imaging of the lateral ventricle and choroid plexus in randomly selected 30 normal fetuses. Seven fetuses with intracranial abnormalities were evaluated by 3D ultrasound functions. Surface mode of 3D ultrasound objectively depicted in vivo development of the cranial bones a...
Fetal neuroimaging by transvaginal 3D ultrasound and MRI
The Ultrasound Review of Obstetrics & Gynecology, 2006
Three-dimensional (3D) ultrasound is one of the most attractive modality in the field of fetal ultrasound imaging. In multiplanar imaging of the brain structure, it is possible to demonstrate not only the sagittal and coronal sections but also the axial section of the brain, which cannot be demonstrated from parietal direction by a conventional 2D transvaginal sonography. Parallel slicing provides a tomographic visualization of internal morphology similar to MR imaging. Fetal neuroimaging with advanced 3D ultrasound technology is easy, noninvasive and reproducible methods. It produces not only comprehensible images but also objective imaging data. It has been controversial whether ultrasound or MRI is more practical and effective in prenatal assessment of fetal CNS abnormalities. In the assessment of enlarged ventricles, no significant difference between dedicated neurosonography and MRI in detection of intracranial structure. However, MRI is superior to ultrasound in evaluation of the brainstem, posterior fossa and cortical development especially in the late pregnancy. Meanwhile, transvaginal high-frequent 3D ultrasound has superiority to MRI in detection of intracranial calcification, vascular anatomy, intratumoral vascularity, bony structure. For CNS anomaly screening scan, ultrasound is no doubt the first modality, and once CNS abnormality is suspicious, after considering each advantage and disadvantage of transvaginal 3D ultrasound and MRI, it is suggested to use those different technologies according to what to be detected and evaluated in each abnormal CNS case. Of course, those two technologies should be utilized as alternatives and complementaries as well. In terms of fetal neurological function analysis, four-dimensional ultrasound research on fetal behavior have been launched in multicenters, and it will be greatly expected to elucidate relations between antenatal behavior and postnatal neurological prognosis.
Three-dimensional Evaluation of the Fetal Brain
Donald School Journal of Ultrasound in Obstetrics and Gynecology
Three-dimensional (3D) ultrasound is one of the most attractive modalities in the field of fetal ultrasound imaging. Combination of both transvaginal sonography and 3D ultrasound may be a great diagnostic tool for evaluation of 3D structure of fetal central nervous system (CNS). Recent advanced 3D ultrasound equipments have several useful functions, such as surface anatomy imaging; multiplanar imaging of the intracranial structure; tomographic ultrasound imaging of fetal brain in the any cutting section; bony structural imaging of the calvaria and vertebrae; thick slice imaging of the intracranial structure; simultaneous volume contrast imaging of the same section or vertical section of fetal brain structure; volume calculation of target organs, such as intracranial cavity, ventricle, choroid plexus, and intracranial lesions; and 3D sonoangiography of the brain circulation (3D power or color Doppler). Furthermore, recent advanced technologies, such as HDlive silhouette and HDlive flow are quite attractive modalities and they can be applied for neuroimaging. Up-to-date 3D technologies described in this study allow extending the detection of congenital brain maldevelopment, and it is beyond description that noninvasive direct viewing of the embryo/fetus by all-inclusive ultrasound technology is definitely the first modality in a field of fetal neurology and helps our goal of proper perinatal care and management, even in the era of molecular genetics and advanced sequencing of fetal deoxyribonucleic acid (DNA) in the maternal blood. As a future aspect, collaboration of both molecular genetics and 3D neuroimaging will reveal responsible gene mutation of neuronal migration disorder, and this fetal neuro-sono-genetics will be able to contribute to accurate diagnoses, proper management, possible genetic therapy, and prophylaxis.
Recent Advances in 3D Assessment of Various Fetal Anomalies
Donald School Journal of Ultrasound in Obstetrics & Gynecology, 2009
Recent advances of ultrasound technology including 3D/4D sonography have revealed embryonal/fetal morphology, intrauterine vascularity and fetal behavior from early gestation. Modern ‘sonoembryology’ allows the definition of in vivo anatomy including visualization of dynamic features, which cannot be characterized in fixed specimens after embryonic death in embryology. Furthermore, recent highresolutional ultrasound technologies have remarkably approached accurate prenatal diagnoses with vivid and distinct sonographic depiction. Nowadays, the antenatal diagnosis is no longer ‘maybe’ nor ambiguous, owing to progressive 3D/4D ultrasound which have contributed to the field of embryology, fetal physiology and pathology.
Applicability of three-dimensional imaging techniques in fetal medicine
Radiologia Brasileira, 2016
Objective: To generate physical models of fetuses from images obtained with three-dimensional ultrasound (3D-US), magnetic resonance imaging (MRI), and, occasionally, computed tomography (CT), in order to guide additive manufacturing technology. Materials and Methods: We used 3D-US images of 31 pregnant women, including 5 who were carrying twins. If abnormalities were detected by 3D-US, both MRI and in some cases CT scans were then immediately performed. The images were then exported to a workstation in DICOM format. A single observer performed slice-by-slice manual segmentation using a digital high resolution screen. Virtual 3D models were obtained from software that converts medical images into numerical models. Those models were then generated in physical form through the use of additive manufacturing techniques. Results: Physical models based upon 3D-US, MRI, and CT images were successfully generated. The postnatal appearance of either the aborted fetus or the neonate closely re...
Journal of Maternal-fetal & Neonatal Medicine, 2018
We aimed to compare three-dimensional (3D) fetal malformation images obtained using ultrasonography (US) and magnetic resonance imaging (MRI) on the same day during the third trimester of pregnancy. Methods: Total 33 fetuses were selected from cases evaluated for malformations. Morphological abnormalities were first scanned using 3DUS. MRI was used to confirm the previous preliminary 3DUS findings, and diagnoses were confirmed postnatally. 3DUS scans were performed transabdominally using an RAB (4-8L) probe, Voluson 730 Pro/Expert and E8 (General Electric, Healthcare, Zipf, Austria). MRI was performed using a 1.5-T scanner (Magneton Avanto, Siemens, Erlangen, Germany) with a body coil. The 3D reconstruction of the structure of interest was manually performed from a True FISP sequence using an interactive pen tablet (Syngo Multimodality 2009B, Siemens, Erlangen, Germany). Results: Despite recent advancements in 3DUS, the quality of 3D images obtained from MRI was superior during the third trimester. 3DUS had certain limitations, such as being influenced by the fetal position, the volume of amniotic fluid, and maternal obesity. Fetal movements during image acquisition were one of the main challenges for MRI. Conclusion:The quality of the 3D images obtained using MRI was superior to that of images obtained using US during the third trimester of pregnancy.