Chapter 6

Fetal Brain Anatomy by Three-dimensional Ultrasound Neuroscan

Gabriele Tonni and Edward Araujo Junior

Abstract

Although two-dimensional (2D) ultrasound represents the standard approach to the study of the brain anatomy in the fetus, the technical advancement offered by three-dimensional (3D) ultrasound, as well as the increased equipment availability and operator skill, is such that integrating 2D with 3D ultrasound may be considered the “gold standard” of care in the current diagnostic investigation of central nervous system anatomy. 3D ultrasound of the fetal brain or neuroscan may be performed using the standard multiplanar mode or 3D software techniques such as tomographic ultrasound imaging, Omniview or other commercially available reconstructing technique. 3D neuroscan offers the advantage to insonate planes that are usually difficult to image using 2D ultrasound, even when a transvaginal approach is considered. In addition, volume of the cerebral structures can be calculated using virtual organ computer-aided analysis (VOCAL) methodology. Notwithstanding, 3D volumes may be filed and reconstructed accurately by offline “navigation”. Moreover, volume can be sent at remote site for expert consultation using telemedicine or submitted using low cost streaming Internet channel for real-time counseling at tertiary center with expertise in 3D/four-dimensional (4D) ultrasound. The digital technology of 3D/4D ultrasound may be used in teaching and training setting as volume can freely be sectioned on demand on three orthogonal planes. Finally, 3D volume data sets can be incorporated with fetal magnetic resonance imaging (MRI) 3D data and converted to create physical models of the congenital anomalies, thus enhancing parents understanding of the pathologic conditions and aiding both the prenatal counseling and the perinatal management.

Total Pages: 73-90 (18)

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