The Midline Sagittal View of Fetal Brain: Moving from 3D to 2D

Abstract

The objective of the present study was to investigate the effectiveness of a simplified approach by using two dimensional (2D) technique for evaluation of the midline structures of the fetal brain and comparing it with the three dimensional (3D) technique. The study was performed in 60 fetuses with normal intracranial anatomy and 10 fetuses with anomalies involving the midline cerebral structures from 19 to 28 weeks of gestation. Ultrasound examinations were performed on Voluson E8 BT10. 2D median planes were obtained by aligning the transducer through the anterior and posterior fontanelle and the sutures by either transabdominal sonogram or transvaginal sonogram (TVS) approach. Median planes were also obtained by 3D. Visualization of the relevant anatomic details, corpus callosum and cerebellar vermis in particular, was noted by both 2D and 3D images. 2D and 3D median planes were compared qualitatively. 3D midline sagittal planes could be visualized in 48/50 normal fetuses. 2D median planes were obtained in all, usually more easily and rapidly. TVS was also used in fetuses with breech presentation. There was a good correlation between 2D and 3D images. The abnormal group included 10 fetuses. In all cases, the diagnosis could be made by both 2D and 3D views but 3D added clinically useful information especially in two fetuses with posterior fossa lesions. The 2D median views yielded excellent display of anatomy as well as the abnormalities. With high resolution probes, 2D median planes are good enough which can substitute 3D median plane views, especially in developing countries where there is less availability of 3D equipment and expertise of the 3D technique.

Keywords

Fetal brain - Three-dimensional ultrasound - Corpus callosum - Vermis

Publication History

Received: 17 August 2015

Accepted: 13 November 2015

Article published online:
08 May 2023