12th world congress in fetal...
TRANSCRIPT
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Advanced brain ultrasound
Elisenda Eixarch
Maternal Fetal Medicine Research Group
Hospital Clinic-University of Barcelona, Spain
12th World Congress in Fetal Medicine
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www.medicinafetalbarcelona.org/
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basic examination CNS
Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’.UOG.2007
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basic examination CNS
Sylvian fissure
Appears 18 w
Identified 22 w
Parieto-occipital fissure
Appears 18 w
Identified 23 w
LR. Pistorius Ultrasound Obstet Gynecol 2010; 36: 700
Superior temporal sulcus
Appears 23 w
Identified 26 w
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www.medicinafetalbarcelona.org/ Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’.UOG.2007
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advanced examination CNS
midsagittal parasagittal transfrontal transcaudate transthalamic transcerebellar
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Coronal planes
transfrontal transcaudate transthalamic transcerebellar
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Interhemispheric fissure
Anterior horns
Ocular orbits
Sphenoidal bone
Transfrontal plane
Sagittal sinus
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Transcaudate plane
Anterior horns
Cavum septum pellucidum
Caudate nuclei
Genu corpus callosum
Subarachnoid space
Sinocortical space
Craniocortical space
Anterior horns
Sondhi et al. Acta Pædiatrica. 2008; 97: 738–44; Malinger et al. Prenat Diagn. 2000; 20: 890-3
Interhemispheric fissure
Sagittal sinus
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Transcaudate plane
Sondhi et al. Acta Pædiatrica. 2008; 97: 738–44; Malinger et al. Prenat Diagn. 2000; 20: 890-3
Anterior hors
Agenesia corpus callosum
Hyperecogenicity
Anterior horns
Cavum septum pellucidum
Caudate nuclei
Genu corpus callosum
Subarachnoid space
Interhemispheric fissure
Sagittal sinus
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Thalami
Sylvian fissure
Insula
Body corpus callosum
Transthalamic plane
Cortical displasia
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Occipital horns
Cerebellar hemispheres Vermis
Calcarine fissure Choroid plexus
Transcerebellar plane
Posterior fossa cyst
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Coronal planes
midsagittal parasagittal
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Cavum septum pellucidum
Body Corpus callosum
Cingulate fissure
Fornix
Vermis Pons
IV ventricle
Splenium Corpus
callosum
Midsagittal plane
Cerebellar tentorium
Cavum vergae
III ventricle
Cisterna magna
Genu Corpus
callosum
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Midsagittal plane
Achiron et al. Ultrasound Obstet Gynecol 2001; 18: 343–347
Genu Corpus
callosum
Cavum septum pellucidum
Body Corpus callosum
Fornix
Vermis Pons
IV ventricle
Splenium Corpus
callosum
Cerebellar tentorium
Cavum vergae
III ventricle
Cisterna magna
Cingulate fissure
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Midsagittal plane
Corpus Callosum agenesis
Corpus callosum digenesis
Body Corpus callosum Cingulate fissure
Splenium Corpus
callosum
Genu Corpus
callosum
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Midsagittal plane
Malinger et al. Prenat Diagn. 2001; 21: 687–92
Genu Corpus
callosum
Cavum septum pellucidum
Body Corpus callosum
Fornix
Vermis Pons
IV ventricle
Splenium Corpus
callosum
Cerebellar tentorium
Cavum vergae
III ventricle
Cisterna magna
Cingulate fissure
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Midsagittal plane
primary
fissure
secondary
fissure
fastigium
tentorium
Dandy Walker malformation
Blake’s pouch cyst
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Frontal horn
Cerebellar hemisfere
Temporal horn
Caudate
Choroid plexus
Parasagittal plane
Occipital horn
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advanced examination CNS
Calcarine fissure
Appears 18 w
Identified 23 w
Cingulate fissure
Appears 22 w
Identified 26 w
LR. Pistorius Ultrasound Obstet Gynecol 2010; 36: 700
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Axial planes are not enough for complete evaluation of CNS pathology
Coronal and sagittal planes are essential for diagnosis of corpus callosum and
posterior fossa anomalies
Neurosonography tips:
Be systematic
Bear in mind gestational age
Take home messages
Thank you
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