Fetale Neurosonografie mittels 3-dimensionaler multiplanarer Sonografie

 

 Buy Article Permissions and Reprints

Zusammenfassung

Die Arbeit bietet eine Übersicht über die Untersuchung des fetalen Gehirns mithilfe des 3-dimensionalen Ultraschalls und des multiplanaren rendering Modus. Die Routineuntersuchung des Gehirns erfolgt in Querschnittsebenen, bei einer gezielten fetalen Neurosonografie sollten jedoch zusätzlich koronare und sagittale Ebenen eingestellt werden, um ein gesamtes Bild der unterschiedlichen Hirnstrukturen zu erhalten. Da diese Ebenen häufig schwierig zugänglich sind, zeigt die Arbeit auf, wie aus einem digitalen Volumendatensatz ein oder mehrere rekonstruierte Bilder mittels 3D-Untersuchung mit multiplanarem Modus entstehen. Diese können entweder als orthogonale Ebenen, als tomografische Ebenen mit parallelen Schnittebenen oder als einzelne Ebene des zu untersuchenden Bereichs dargestellt werden. Dadurch können Strukturen wie Corpus callosum, Kleinhirnwurm, der Drei-Hörnerblick oder der fetale Hippocampus in einfacher Weise demonstriert werden. Zusätzlich ermöglicht die frühe Neurosonografie die Darstellung des sich entwickelnden fetalen Gehirns ab 7 Schwangerschaftswochen.

Abstract

This review focuses on the examination of the fetal brain, using three-dimensional (3D) ultrasound and the multiplanar rendering mode (MPR). The routine examination of the brain is achieved with axial planes but a dedicated fetal neurosonogram requires additional coronal and sagittal views, in order to provide a complete view of the different brain structures. Because these planes are difficult to obtain under many conditions, the present paper shows how 3D MPR allows one to obtain 1 or multiple reconstructed images from a digital volume. The display can be either as orthogonal planes, tomographic planes with parallel slices or as one single plane of the region of interest, which can be selected by the examiner. This approach allows easily the demonstration of the corpus callosum, the cerebellar vermis, the three-horn view, the foetal hippocampus and other regions. In addition, early neurosonography of the developing brain from the 7^th week of pregnancy onwards can be achieved.

• Literatur

• 1 ISUOG . Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’. Ultrasound Obstet Gynecol 2007; 29: 109-116
  CrossrefPubMedGoogle Scholar
• 2 Karl K, Kainer F, Heling KS et al. Fetal neurosonography: extended examination of the CNS in the fetus. Ultraschall Med 2011; 32: 342-361
  Article in Thieme ConnectPubMedGoogle Scholar
• 3 Zollner U, Rehn M, Girschick G et al. Sonografische Auffälligkeiten des fetalen ZNS im Zeittrimesterscreening-Abklärung nach neuen Mutterschaftsrichtlinien. Z Geburtshilfe Neonatol 2012; 216: 1-10
  Article in Thieme ConnectPubMedGoogle Scholar
• 4 Chaoui R, Heling KS. Three-dimensional ultrasound in prenatal diagnosis. Curr Opin Obstet Gynecol 2006; 18: 192-202
  CrossrefPubMedGoogle Scholar
• 5 Pilu G, Ghi T, Carletti A et al. Three-dimensional ultrasound examination of the fetal central nervous system. Ultrasound Obstet Gynecol 2007; 30: 233-245
  CrossrefPubMedGoogle Scholar
• 6 Pilu G, Segata M, Ghi T et al. Diagnosis of midline anomalies of the fetal brain with the three-dimensional median view. Ultrasound Obstet Gynecol 2006; 27: 522-529
  CrossrefPubMedGoogle Scholar
• 7 Correa FF, Lara C, Bellver J et al. Examination of the fetal brain by transabdominal three-dimensional ultrasound: potential for routine neurosonographic studies. Ultrasound Obstet Gynecol 2006; 27: 503-508
  CrossrefPubMedGoogle Scholar
• 8 Kalache K, Eder K, Esser T et al. Three-dimensional ultrasonographic reslicing of the fetal brain to assist prenatal diagnosis of central nervous system anomalies. J Ultrasound Med 2006; 25: 509-514
  PubMedGoogle Scholar
• 9 Rizzo G, Abuhamad AZ, Benacerraf BR et al. Collaborative study on 3-dimensional sonography for the prenatal diagnosis of central nervous system defects. J Ultrasound Med 2011; 30: 1003-1008
  PubMedGoogle Scholar
• 10 Rizzo G, Capponi A, Pietrolucci M et al. An algorithm based on OmniView technology to reconstruct sagittal and coronal planes of the fetal brain from volume datasets acquired by three-dimensional ultrasound. Ultrasound Obstet Gynecol 2011; 38: 158-164
  PubMedGoogle Scholar
• 11 Timor-Tritsch IE, Monteagudo A, Mayberry P. Three-dimensional ultrasound evaluation of the fetal brain: the three horn view. Ultrasound Obstet Gynecol 2000; 16: 302-306
  CrossrefPubMedGoogle Scholar
• 12 Karl K, Knabl J, Kästner R et al. Sonografische 3D Rekonstruktion des fetalen Hippocampus. Z Geburtshilfe Neonatol 2011; 215: 234
  Article in Thieme ConnectPubMedGoogle Scholar
• 13 Vinals F, Munoz M, Naveas R et al. The fetal cerebellar vermis: anatomy and biometric assessment using volume contrast imaging in the C-plane (VCI-C). Ultrasound Obstet Gynecol 2005; 26: 622-627
  CrossrefPubMedGoogle Scholar
• 14 Volpe P, Contro E, De Musso F et al. The brainstem-vermis and brainstem-tentorium angles allow accurate categorization of fetal upward rotation of the cerebellar vermis. Ultrasound Obstet Gynecol 2012; in press
  PubMedGoogle Scholar
• 15 Vinals F, Munoz M, Naveas R et al. Transfrontal three-dimensional visualization of midline cerebral structures. Ultrasound Obstet Gynecol 2007; 30: 162-168
  CrossrefPubMedGoogle Scholar
• 16 Blaas HG, Eik-Nes SH, Isaksen CV. The detection of spina bifida before 10 gestational weeks using two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol 2000; 16: 25-29
  CrossrefPubMedGoogle Scholar
• 17 Blaas HG, Eik-Nes SH. Sonoembryology and early prenatal diagnosis of neural anomalies. Prenat Diagn 2009; 29: 312-325
  CrossrefPubMedGoogle Scholar
• 18 Chaoui R, Benoit B, Mitkowska-Wozniak H et al. Assessment of intracranial translucency (IT) in the detection of spina bifida at the 11–13-week scan. Ultrasound Obstet Gynecol 2009; 34: 249-252
  PubMedGoogle Scholar
• 19 Chaoui R, Benoit B. Heling KS et al. Prospective detection of open spina bifida at 11–13 weeks by assessing intracranial translucency and posterior brain. Ultrasound Obstet Gynecol 2011; 6: 722-726
  PubMedGoogle Scholar
• 20 Scheier M, Lachmann R, Petros M et al. Three-dimensional sonography of the posterior fossa in fetuses with open spina bifida at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2011; 6: 625-629
  PubMedGoogle Scholar
• 21 Loureiro T, Ushakov F, Montenegro N et al. Cerebral ventricular system in fetuses with open spina bifida at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2012; in press
  PubMedGoogle Scholar
• 22 Blaas HG, Eik-Nes SH, Kiserud T et al. Three-dimensional imaging of the brain cavities in human embryos. Ultrasound Obstet Gynecol 1995; 5: 228-232
  CrossrefPubMedGoogle Scholar
• 23 Blaas HG, Eik-Nes SH, Vainio T et al. Alobar holoprosencephaly at 9 weeks gestational age visualized by two- and three-dimensional ultrasound. Ultrasound Obstet Gynecol 2000; 15: 62-65
  CrossrefPubMedGoogle Scholar
• 24 Kim MS, Jeanty P, Turner C et al. Three-dimensional sonographic evaluations of embryonic brain development. J Ultrasound Med 2008; 27: 119-124
  PubMedGoogle Scholar
• 25 Timor-Tritsch IE, Monteagudo A, Santos R. Three-dimensional inversion rendering in the first- and early second-trimester fetal brain: its use in holoprosencephaly. Ultrasound Obstet Gynecol 2008; 32: 744-750
  CrossrefPubMedGoogle Scholar