WS08‐02Three‐level view (TLV) of fetal brain imaging in the prenatal diagnosis of congenital anomalies

Abstract

The purpose of this study was to determine whether a systematic stream‐lined approach could be routinely used in the evaluation of the fetal intracranal anatomy, and which could be used to effectively and efficiently exclude all major intracranial malformation.Three planes were determined to be independent without overlay. Following the establishment of these three independent oblique planes across the intracranial anatomy, there were applied clinically to determine whether such planes would be sufficient to diagnose the major intracranial abnormalities.After retrospectively examining the various imaging levels taken, it was independently determined that three levels of intracranial imaging provided the greatest anatomic view of the entire fetal brain: the lateral ventricular level (Level I); the medial‐thalamic level (Level II); and the inferior‐posterior fossa view (Level III).We examined 131 cases of intracranial abnormalities that were prenatally diagnosed between 14 and 24 weeks gestation. One investigator was given the three‐level view protocol to determine if the anomalies could be identified using this system. It was determined that, of the 131 abnormal cases, 126 (96.2%) were diagnosed using Levels I, II or III, independently or in combination. There were no false‐positive test results.The present study investigated the efficacy of a three level view (TLV) imaging of the fetal brain representing a complete 2‐D examination. We found this approach to be applicable throughout pregnancy and suitable for visualization of normal intracranial structures as well as the identification of abnormalities.