Fetale Neurosonografie mittels 3-dimensionaler multiplanarer Sonografie

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.

Schlüsselwörter

3D Ultraschall - multiplanar rendering - fetale Neurosonografie - fetale Hirnentwicklung - Ultraschall Tomografie

Key words

3D ultrasound - multiplanar rendering - fetal neurosonography - fetal brain development - tomographic ultrasound

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