Orthogonal Views Research Articles

Acute irreducible anterior shoulder dislocation due to interposition of the subscapularis muscle and the lesser tuberosity: a case report.

Efforts to reduce an anterior shoulder dislocation can fail due to numerous mechanical obstructions caused by soft tissue interposition (long head of the biceps, rotator cuff muscles, labrum, musculocutaneous nerve) and/or bony elements (displaced fragment of a greater tuberosity or glenoid fracture, bone impaction such as a Hill-Sachs lesion fixed on the glenoid rim, a bony Bankart lesion). Herein, we report the case of a 35-year-old man who sustained an anterior shoulder fracture-dislocation of his left shoulder after a fall. Despite a postreduction radiological examination that appeared misleadingly reassuring, subtle signs of persistent subluxation raised concerns. A computed tomography (CT) scan revealed subscapularis muscle entrapment along with avulsion of its bony insertion from the lesser tuberosity of the humerus, and a comminuted avulsion fracture of the greater tuberosity of the humerus. The patient underwent surgery using a deltopectoral approach. This involved releasing the entrapped subscapularis muscle and fixing the two fractured fragments. The lesser tuberosity was reduced and secured with two cannulated screws, and the comminuted fragment of the greater tuberosity was reattached using transosseous sutures. At 12-month follow-up, the patient achieved a Constant-Murley score of 85 of 100, with limitation in internal rotation at L3 but no signs of instability or new dislocation episode. This case underscores the importance of confirming shoulder reduction on at least two orthogonal views and paying close attention to the patient's feedback about sensation in their shoulder. Additionally, it highlights the utility of CT or magnetic resonance imaging scans if doubt exists about the integrity of the reduction.

Estimation of Inferior Vena Cava Size from Ultrasound Imaging in X-Plane

Ultrasound (US) scans of the inferior vena cava (IVC) provide useful information on the volume status of a patient. However, their investigation is user-dependent and prone to measurement errors. An important technical problem is the objective difficulty in studying a very compliant blood vessel like IVC, which makes large respirophasic movements and shows a complicated three-dimensional geometry. Using bi-dimensional (2D) B-mode views either in a long or short axis has improved the characterization of IVC dynamics compared to measurements along a single direction (M-mode). However, specific movements of the IVC can also challenge the information provided by these 2D sections. Thus, these two orthogonal views, provided by an US system in the X-plane, are integrated here using an innovative method. It is tested on simulated videos of the IVC by performing complicated movements, which are compensated by the new method, overcoming the biased measurements provided by 2D scans. The method is then applied on example experimental data.

Automatic segmentation of intraluminal thrombosis of abdominal aortic aneurysms from CT angiography using a mixed-scale-driven multiview perception network (M2Net) model

Intraluminal thrombosis (ILT) plays a critical role in the progression of abdominal aortic aneurysms (AAA). Understanding the role of ILT can improve the evaluation and management of AAAs. However, compared with highly developed automatic vessel lumen segmentation methods, ILT segmentation is challenging. Angiographic contrast agents can enhance the vessel lumen but cannot improve boundary delineation of the ILT regions; the lack of intrinsic contrast in the ILT structure significantly limits the accurate segmentation of ILT. Additionally, ILT is not evenly distributed within AAAs; its sparsity and scattered distributions in the imaging data pose challenges to the learning process of neural networks. Thus, we propose a multiview fusion approach, allowing us to obtain high-quality ILT delineation from computed tomography angiography (CTA) data. Our multiview fusion network is named Mixed-scale-driven Multiview Perception Network (M2Net), and it consists of two major steps. Following image preprocessing, the 2D mixed-scale ZoomNet segments ILT from each orthogonal view (i.e., Axial, Sagittal, and Coronal views) to enhance the prior information. Then, the proposed context-aware volume integration network (CVIN) effectively fuses the multiview results.Using contrast-enhanced computed tomography angiography (CTA) data from human subjects with AAAs, we evaluated the proposed M2Net. A quantitative analysis shows that the proposed deep-learning M2Net model achieved superior performance (e.g., DICE scores of 0.88 with a sensitivity of 0.92, respectively) compared with other state-of-the-art deep-learning models. In closing, the proposed M2Net model can provide high-quality delineation of ILT in an automated fashion and has the potential to be translated into the clinical workflow.

Displaced humeral shaft fractures: Assessment of fracture union and complications following dual plate fixation using an anterior approach

The humeral bone is subject to torsional forces. In case of displaced shaft fractures, internal fixation remains the standard of care. This retrospective two-center study assessed the fracture union rate and complications after dual 3.5 mm locking compression plate (LCP) fixation using an anterolateral approach. Over a 9-year period, 38 patients underwent surgery in two centers. They had a mean age of 53.7 years (15–97, ± standard deviation (SD) 26) and there were three open fracture cases (7.9 %). The dominant side was affected in 21 cases (55.3 %) and there were 11 polytrauma patients (29 %). Mean operative time was 78 min (40–124, ± 19.8 SD). Patients were treated with dual 3.5 mm LCP fixation (6 screws on either side of the fracture line, anterolateral approach without a tourniquet). The first two orthogonal views showing at least 3 cortical bridges out of 4 determined fracture healing, as assessed by two independent raters. Pre- and postoperative complications were tabulated. Clinical outcomes included range of motion (ROM) and return to activities, while functional outcomes were assessed with the Disability of the Arm Shoulder and Hand (DASH), the Constant score, the Subjective Shoulder Score (SSV) and the Mayo Elbow Performance Score (MEPS). Minimum follow-up was 1 year. Four patients were given a shoulder immobilizer to wear for 3 weeks; immediate mobilization was the standard of care for the other patients. Fracture union was achieved in all cases within a mean of 11.7 weeks (6–28 ± 7.1 SD) without any heterotopic ossification of the brachialis muscle. There were eight patients with preoperative radial nerve palsy and two cases of postoperative palsy. There was one surgical site infection (2.6 %). Return to work for active patients was possible in 87 % of cases within a mean of 23 weeks (6–72 ± 11 SD). The Constant score was 84.6 (35–100, ± 13.4 SD), the SSV score was 80.7 (60–100, ± 8.2 SD), the DASH score was 13.5 (0–38.3, ± 8.8 SD) and the MEPS score was 85 (55–100, ± 11.9 SD). Traditional fixation methods provide little control over torsional forces, leading to non-union rates between 3 % and 12 % and delayed union (12 to 20 weeks). The simplicity of the technique described here, and the short operative time, may help explain the low infection rate. Dual plate fixation makes it possible to use more screws and allows nerve exploration and decompression in case of preoperative nerve palsy. Dual plate fixation to treat humeral shaft fractures is a simple and reliable technique.

DPCalib: Dual-Perspective View Network for LiDAR-Camera Joint Calibration

The precise calibration of a LiDAR-camera system is a crucial prerequisite for multimodal 3D information fusion in perception systems. The accuracy and robustness of existing traditional offline calibration methods are inferior to methods based on deep learning. Meanwhile, most parameter regression-based online calibration methods directly project LiDAR data onto a specific plane, leading to information loss and perceptual limitations. A novel network, DPCalib, a dual perspective view network that mitigates the aforementioned issue, is proposed in this paper. This paper proposes a novel neural network architecture to achieve the fusion and reuse of input information. We design a feature encoder that effectively extracts features from two orthogonal views using attention mechanisms. Furthermore, we propose an effective decoder that aggregates features from two views, thereby obtaining accurate extrinsic parameter estimation outputs. The experimental results demonstrate that our approach outperforms existing SOTA methods, and the ablation experiments validate the rationality and effectiveness of our work.

Septal Venous Channel Perforation during Left Bundle Branch Area Pacing: A Prospective Study.

To characterize the diagnosis, frequency, and procedural implications of septal venous channel perforation during left bundle branch area pacing (LBBAP). All consecutive patients undergoing LBBAP over an 8-month period were prospectively studied. During lead placement, obligatory septal contrast injection was performed twice, at initiation (implant entry zone) and completion (fixation zone). An intuitive fluoroscopic schema using orthogonal views (LAO/RAO) and familiar landmarks is described. Using this, we resolved zonal distribution (I-VI) of lead position on the ventricular septum and its angulation (post-fixation angle θ). Subjects with/without septal venous channel perforation were compared. Sixty-one-patients [Male 57.3%, Median Age (IQR) 69.5(62.5-74.5) years] were enrolled. Septal venous channel perforation was observed in 8 (13.1%) patients [Male 28.5%, Median Age (IQR) 64(50-75) years]. They had higher frequency of, i) right-sided-implant (25% vs. 1.9%, p=0.04), ii) fixation in zone III at the mid-superior septum (75% vs 28.3%, p=0.04), iii) steeper angle of fixation- median θ (IQR) [19(10-30)° vs. 5(4-19)°, p=0.01), and iv) longer median penetrated-lead-length (IQR) [13(10-14.8) vs. 10(8.5-12.5)mm, p=0.03]. Coronary sinus drainage of contrast was noted in 5 (62.5%) patients. Abnormal impedance drops during implantation (12.5% vs. 5.7%, p=NS) were not significantly different. When evaluated systematically, septal venous channel perforation may be encountered commonly after LBBAP. The fiducial reference framework described using fluoroscopic imaging identified salient associated findings. This may be addressed with lead repositioning to a more inferior location and are not associated with adverse consequence acutely or in early follow-up.

A 3D Descriptive Geometry Problem-Solving Methodology Using CAD and Orthographic Projection

In solving descriptive geometry (DG) problems, board (i.e., hand drawing) methods are frequently used, despite this discipline is still very important to enhance spatial vision. These methods are very different from CAD tools which are used in the field of design. CAD facilitates the realization of geometric constructions and transformations (i.e., rotation, translation, copying, scaling, alignment, and symmetry, among others) are performed analytically. For this reason, a 3D DG problem-solving methodology using CAD and orthographic projection (CADOP) is introduced. Once the principles of DG, orthographic projection, and CAD fundamentals and tools are described, CADOP is applied to obtain (i) orthogonal views; (ii) principal lines of a plane; (iii) true-size view of a plane; (iv) parallelism, perpendicularity, and distance, and (v) angles. Considering the user coordinate system in CADOP allows one to place the horizontal plane in the suitable position to solve DG problems directly in one step. In the traditional methods, the use of auxiliary views must be carried out in several steps instead. The dynamic management of the 3D view of the scene is facilitated in CADOP, improving its understanding, and achieving the precision inherent in analytical calculations.

Event-Based Optical Flow via Transforming Into Motion-Dependent View.

Event cameras respond to temporal dynamics, helping to resolve ambiguities in spatio-temporal changes for optical flow estimation. However, the unique spatio-temporal event distribution challenges the feature extraction, and the direct construction of motion representation through the orthogonal view is less than ideal due to the entanglement of appearance and motion. This paper proposes to transform the orthogonal view into a motion-dependent one for enhancing event-based motion representation and presents a Motion View-based Network (MV-Net) for practical optical flow estimation. Specifically, this motion-dependent view transformation is achieved through the Event View Transformation Module, which captures the relationship between the steepest temporal changes and motion direction, incorporating these temporal cues into the view transformation process for feature gathering. This module includes two phases: extracting the temporal evolution clues by central difference operation in the extraction phase and capturing the motion pattern by evolution-guided deformable convolution in the perception phase. Besides, the MV-Net constructs an eccentric downsampling process to avoid response weakening from the sparsity of events in the downsampling stage. The whole network is trained end-to-end in a self-supervised manner, and the evaluations conducted on four challenging datasets reveal the superior performance of the proposed model compared to state-of-the-art (SOTA) methods.

Characterizing cardiac contractile motion for noninvasive radioablation of ventricular tachycardia

BackgroundRespiratory motion management strategies are used to minimize the effects of breathing on the precision of stereotactic ablative radiotherapy for ventricular tachycardia, but the extent of cardiac contractile motion of the human heart has not been systematically explored. ObjectiveWe aim to assess the magnitude of cardiac contractile motion between different directions and locations in the heart. MethodsPatients with intracardiac leads or valves who underwent 4D cardiac computed tomography (4DCT) prior to a catheter ablation procedure for atrial or ventricular arrhythmias at 2 medical centers were studied retrospectively. The displacement of transvenous right atrial appendage (RA), right ventricle (RV) ICD, coronary sinus (CS) lead tips and prosthetic cardiac devices across the cardiac cycle were measured in orthogonal 3D views on a maximal-intensity projection CT reconstruction. ResultsA total of 31 pre-ablation cardiac 4DCTs were analyzed. The LV lead tip had significantly greater motion compared to the RV lead in the anterior-posterior direction (6.0±2.2mm vs 3.8±1.7mm; p=0.01) and superior-inferior direction (4.4±2.9mm vs 3.5±2.0mm; p=0.049). The prosthetic aortic valves had the least movement of all fiducials, specifically compared to the RV lead tip in the left-right direction (3.2±1.2mm vs 6.1±3.8mm, p=0.04) and the LV lead tip in the antero-posterior direction (3.8±1.7mm vs 6.0±2.2mm, p=0.03). ConclusionThe degree of cardiac contractile motion varies significantly (1mm to 15.2 mm) across different locations in the heart. The effect of contractile motion on the precision of radiotherapy should be assessed on a patient-specific basis.

The development of a systematic ultrasound protocol facilitates the visualization of foreign bodies within the canine distal limb.

Ultrasonography is an excellent investigative tool that can assist with the diagnosis of soft tissue conditions. In human medicine, ultrasonography is a fundamental diagnostic tool for the investigation of suspected vegetal foreign bodies (VFB), with protocol-based ultrasonography providing increased accuracy compared to lesion-focused examinations. Protocol-based ultrasonography is an emerging tool within the veterinary field, however, compared to human medicine is not routinely employed. The objective of this study was to develop a systematic ultrasound protocol to examine the distal limb for the visualization of vegetal foreign bodies (SUEDVEG). A 12 MHz linear and an 18 MHz high-frequency small-footprint linear array transducer was used on cadaver forelimbs (n = 6) and hindlimbs (n = 6) with images obtained from three common foreign body locations within the distal limb; 1; the interdigital webbing, 2; the palmar/plantar aspect of the phalanges and metacarpus and 3; the dorsal region of the phalanges and metacarpus. From these images, a 13-step systematic musculoskeletal protocol was developed and utilized on eight clinical cases or 10 limbs that had signs typical of distal limb VFB to preliminarily validate the proposed method. Vegetal foreign bodies were successfully identified and retrieved in seven (n = 8) clinical cases with method steps 9 and 11 (orthogonal views) identifying the majority of VFBs. The described ultrasound method appears highly useful for visualizing soft tissue locations of the canine distal limb known for tracking foreign bodies. Further studies are required to validate the described systematic examination method as the preferred clinical protocol over currently used lesion-focused exploration techniques.

Osteochondrodysplasia and the c.1024G>T variant of TRPV4 gene in Scottish Fold cats: genetic and radiographic evaluation.

The objectives of this study were to investigate the c.1024G>T SNP in the TRPV4 gene in Scottish Straight and Fold cats, and to evaluate the pattern of skeletal phenotype and the evolution of radiological signs of Scottish Fold osteochondrodysplasia (SFOCD) over time in heterozygous subjects. DNA was obtained from blood samples of 17 cats (Scottish Fold: n = 12; Scottish Straight: n = 5) and subsequently genotyped by sequencing in a 249 bp region of the TRPV4 gene (exon 6), including the known c.1024G>T causative mutation for osteochondrodysplasia. Orthopaedic and radiographic analyses were performed on animals carrying the mutant allele. Genotyping by sequencing confirmed that all and only the Scottish Fold cats carried the mutant allele in a heterozygous asset. Furthermore, two other exon variants, already described in the literature as silent variants, were found in some of the sampled cats. Comparative orthogonal radiographic views of the shoulder, elbow, carpus, hip, stifle and tarsus were obtained. A mediolateral projection of the thoracic and lumbar column was also performed. Three out of four cats were clinically and radiographically examined again 1.5 years later. Although the presence of the mutant allele in all the tested Scottish Fold cats was confirmed, only 1/12 showed clinical signs of SFOCD. Furthermore, no cats in the 1.5-year follow-up showed skeletal changes. Although significant, the c.1024G>T mutation in the TRPV4 gene, supposedly, is not the only cause or risk of developing SFOCD.

Artificial Intelligence in BI-RADS Categorization of Breast Lesions on Ultrasound: Can We Omit Excessive Follow-ups and Biopsies?

Artificial intelligence (AI) systems have been increasingly applied to breast ultrasonography. They are expected to decrease the workload of radiologists and to improve diagnostic accuracy. The aim of this study is to evaluate the performance of an AI system for the BI-RADS category assessment in breast masses detected on breast ultrasound. MATERIALSAND METHODS: A total of 715 masses detected in 530 patients were analyzed. Three breast imaging centers of the same institution and ninebreast radiologists participated in this study. Ultrasound was performed by one radiologist who obtained two orthogonal views of each detected lesion. These images were retrospectively reviewed by a second radiologist blinded to the patient's clinical data. A commercial AI system evaluated images. The level of agreement between the AI system and the two radiologists and their diagnostic performance were calculated according to dichotomic BI-RADS category assessment. This study included 715 breast masses. Of these, 134 (18.75%) were malignant, and 581 (81.25%) were benign. In discriminating benign and probably benign from suspicious lesions, the agreement between AI and the first and second radiologists was moderate statistically. The sensitivity and specificity of radiologist 1, radiologist 2, and AI were calculated as 98.51% and 80.72%, 97.76% and 75.56%, and 98.51% and 65.40%, respectively. For radiologist 1, the positive predictive value (PPV) was 54.10%, the negative predictive value (NPV) was 99.58%, and the accuracy was 84.06%. Radiologist 2 achieved a PPV of 47.99%, NPV of 99.32%, and accuracy of 79.72%. The AI system exhibited a PPV of 39.64%, NPV of 99.48%, and accuracy of 71.61%. Notably, none of the lesions categorized as BI-RADS 2 by AI were malignant, while 2 of the lesions classified as BI-RADS 3 by AI were subsequently confirmed as malignant. By considering AI-assigned BI-RADS 2 as safe, we could potentially avoid 11% (18 out of 163) of benign lesion biopsies and 46.2% (110 out of 238) of follow-ups. AI proves effective in predicting malignancy. Integrating it into the clinical workflow has the potential to reduce unnecessary biopsies and short-term follow-ups, which, in turn, can contribute to sustainability in healthcare practices.

Temporal trends of frame expansion and paravalvular leak reduction after transcatheter aortic valve replacement with self-expandable prostheses.

Paravalvular leakage (PVL) is a common finding after transcatheter aortic valve replacement (TAVR) and affects late clinical outcome. It is more frequent with self-expandable (SE) transcatheter-heart-valve (THV). Few is known about SE-THV expansion after implantation. The purpose is to assess SE-THV frame expansion and its possible influence on PVL. We designed a prospective pilot study to assess the time-course of SE-THV frame dimensions and PVL after TAVR. Consecutive patients undergoing TAVR with SE-THV were enrolled. Prosthesis fluoroscopy and echocardiography were prospectively performed immediately after TAVR (T0) and before discharge (T1) to grade PVL. Prosthesis diameters were assessed in 2 fluoroscopic orthogonal views. PVL reduction ≥1+ from T0 to T1 at echocardiography was the primary study endpoint. Twenty-five patients were enrolled. Mean interval between T0 and T1 evaluations was 5 days. Grade 1 or 2 was present in 76% of patients at T0 and in 68% at T1 (P=0.034). A total of 7 patients (28%) improved PVL ≥1 grade from T0 to T1. Differences between T0 and T1 fluoroscopic diameters were not statistically significant. When comparing the diameter changes according to PVL evolution, patients with PVL improvement (as compared with those without) had significantly larger minimum diameter increase at both annulus/inflow (P=0.016) and outflow/distal edge (P=0.027). PVL may improve in the early days after SE-THV and those patients with PVL improvement may have THV frame expansion. Further studies are needed to confirm such preliminary observations and to establish the clinical relevance of this phenomenon.

Results of the Pediatric Shaft Femur Fracture Treated with Closed Rigid Lateral Trochanteric Entry Intramedullary Nail in North Indian Population

Objectives The femoral shaft fractures constitute 1.6% of the pediatric fractures. Intramedullary nailing is a common mode of fixation in older children and adolescents. The rigid intramedullary locking nail is a preferred choice over flexible nails in overweight patients and children older than 11 years of age. The adolescent age group with skeletal immaturity deserves special attention from the surgeons because of grave complications like avascular necrosis of the femur head and angular deformities. The aim of this study is to report the outcome of an adolescent femur shaft fracture treated with a rigid intramedullary interlocking nail in North Indian patients. Material and Methods This is a retrospective analysis performed by retrieving records of 19 patients. Patients with open fractures, polytrauma and neurovascular injuries were excluded. The preoperative and post-operative radiographic orthogonal views were analyzed to assess parameters like alignment, union and avascular necrosis (AVN). Results The mean age was 12.3 years. The mean follow-up was 1.5 years. The average time for union was 8 weeks. All the fractures were united in an acceptable alignment and rotation. There was no avascular necrosis, angular deformity and infection. The mean femur length discrepancy was 7 mm. Conclusion The rigid intramedullary interlocking nail is a valuable option for the fixation of femoral shaft fractures in an adolescent age group with a good union rate and minimal complications.

Gait recognition based on Orthogonal view feature extraction

Gait recognition based on Orthogonal view feature extraction

A 3D/2D registration method based on reconstruction of orthogonal-view Xray images

To establish a 3D/2D registration method for preoperative CT and intra-operative X-ray images in imageguided spine surgery. We propose a 3D/2D registration algorithm based on 3D image reconstruction. The algorithm performs 3D image reconstruction of 2D orthogonal view X-ray images, thus converting the problem into 3D/3D registration. By constructing an end-to-end framework that combines the two tasks of reconstruction and registration, the geodesic distance is measured in the 3D manifold space to complete the registration. We conducted experiments on the public dataset CTSpine1k. The tests on two test sets with different initial registration errors showed that for data with small initial errors, the proposed algorithm achieved a rotation estimation error of 0.115±0.095° and a translation estimation error of 0.144±0.124 mm; for data with larger initial errors, a rotation estimation error of 0.792±0.659° and a translation estimation error of 0.867±0.701 mm were achieved. The proposed method can achieve robust and accurate 3D/2D registration at a speed that meets real-time requirements to improve the performance of spine surgery navigation.

Yeo's index: A novel index that combines anatomic and haemodynamic assessment of the severity of mitral stenosis

BackgroundA mitral leaflet separation index (MLSI), measuring the anatomical separation of the mitral valve (MV) leaflet tips in diastole, was previously described as an accurate method of assessing mitral stenosis (MS). We propose a novel modification of the MLSI by including a hemodynamic assessment which we term Yeo's index that may improve its diagnostic performance. Methods and resultsWe retrospectively studied 174 patients with varying severity of MS without significant mitral regurgitation, aortic valve disease or ventricular septal defect. MLSI was measured in 2 orthogonal views on transthoracic echocardiography as previously described. MV dimensionless index (DI) was calculated by dividing the left ventricular outflow tract pulsed-wave Doppler time velocity integral (TVI) by the MV continuous-wave Doppler TVI. We defined Yeo's index as the product of MLSI and DI. With linear correlation, Yeo's index demonstrated good correlation against MVA by planimetry (r = 0.728), pressure half-time (r = 0.677), and continuity equation (r = 0.829), with improved performance over the MLSI. Using ROC analysis, Yeo's index demonstrated good ability to correctly classify MS as severe (MVA ≤1.5cm2) (AUC 0.874, 95% CI 0.816–0.920). Yeo's index ≤0.260 cm correctly classified severe MS with sensitivity of 82% and specificity of 80%. Presence of AF did not affect the performance of Yeo's index. Yeo's index ≤0.147 cm also identified very severe MS (MVA ≤ 1.0 cm2) with specificity of 94% and sensitivity of 78%. ConclusionYeo's index performed well in identifying severe MS and may be a useful adjunct to existing measures of MS severity.

Effect of Perineal Urethrostomy on the Length of the Urethra of the Cat: A Cadaveric Study.

Ten male feline cadavers were used, and four markers were placed on the pelvic urethra via a ventral approach to the peritoneal and pelvic cavities. Two orthogonal radiographic views were acquired prior and subsequent to performing a PU. The distance of each marker to a predefined landmark/origin and the distances of the markers relative to each other were measured on all radiographs. PU resulted in significant caudal translation of the markers relative to the predefined landmark on all radiographic views; however, PU did not result in a significant change in the distances between the markers. Performing a PU results in caudal translation and minimal stretching of the mobilized pelvic urethra.

Open Reduction of Pediatric Femur Fracture: A Technical Trick

Open Reduction of Pediatric Femur Fracture: A Technical Trick

A Clinical Approach to Semiautomated Three-Dimensional Fetal Brain Biometry-Comparing the Strengths and Weaknesses of Two Diagnostic Tools: 5DCNS+TM and SonoCNSTM.

(1) Objective: We aimed to evaluate the accuracy and efficacy of AI-assisted biometric measurements of the fetal central nervous system (CNS) by comparing two semiautomatic postprocessing tools. We further aimed to discuss the additional value of semiautomatically generated sagittal and coronal planes of the CNS. (2) Methods: Three-dimensional (3D) volumes were analyzed with two semiautomatic software tools, 5DCNS+™ and SonoCNS™. The application of 5DCNS+™ results in nine planes (axial, coronal and sagittal) displayed in a single template; SonoCNS™ depicts three axial cutting sections. The tools were compared regarding automatic biometric measurement accuracy. (3) Results: A total of 129 fetuses were included for final analysis. Our data indicate that, in terms of the biometric quantification of head circumference (HC), biparietal diameter (BPD), transcerebellar diameter (TCD) and cisterna magna (CM), the accuracy of SonoCNS™ was higher with respect to the manual measurement of an experienced examiner compared to 5DCNS+™, whereas it was the other way around regarding the diameter of the posterior horn of the lateral ventricle (Vp). The inclusion of four orthogonal coronal views in 5DCNS+™ gives valuable information regarding spatial arrangements, particularly of midline structures. (4) Conclusions: Both tools were able to ease assessment of the intracranial anatomy, highlighting the additional value of automated algorithms in clinical use. SonoCNS™ showed a superior accuracy of plane reconstruction and biometry, but volume reconstruction using 5DCNS+™ provided more detailed information, which is needed for an entire neurosonogram as suggested by international guidelines.