OP03.04: Basic as well as detailed neurosonogram can be performed by an off‐line analysis of 3D fetal brain volumes

Abstract

To evaluate the feasibility and the processing time using off-line analysis of 3D brain volumes to perform basic as well as detailed, targeted, fetal neurosonogram. Three dimensional fetal brain volumes were obtained in 20 consecutive healthy fetuses that underwent routine anatomical survey at 20 to 23 post menstrual weeks. Grey scale and power Doppler volumes of the fetal brain were acquired in the axial, coronal and the sagittal planes using trans-abdominal and transvaginal approaches, respectively. Off-line analysis of each volume was performed by two of the authors in a blinded fashion. Initially, a list containing the basic structures, as defined by ISUOG and AIUM guidelines, complete with intra-cranial biometrical measurements was attempted. Subsequently, we attempted to identify a list of CNS structures recommended by ISUOG guidelines for fetal neurosonogram. Additional structures that were selected by the authors were also sought (see * in table). The feasibility of obtaining diagnostic quality images was evaluated. The processing times of volume acquisition as well as the off-line analysis were recorded. Volume acquisition time was 3–6 sec/volume and a mean processing time of 9.5 and 11 minutes to complete both the ‘basic’ and the ‘detailed’ neurosonogram was recorded by the two examiners, respectively. The feasibility of obtaining diagnostic quality images of the different structures is displayed in the table. Off-line analysis of fetal 3D brain volumes at 20–23 weeks of gestation can identify all the structures necessary to complete a detailed fetal neurosonogram. This approach may provide several potential advantages such as a short processing time, increased safety due to shorter dwell time, increased patient through-put, and the ability to obtain off-site expert consultation if necessary.