ABSTRACT
<p><b>BACKGROUND</b>Fetal brain development is a complicated process that continues throughout pregnancy. Fetal sulcus development has typical morphological features. Assessment of fetal sulcus development to understand the cortical maturation and development by prenatal ultrasound has become widespread. This study aimed to explore a reliable method to assess cortical sulcus and to describe the normal sonographic features of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation.</p><p><b>METHODS</b>A cross-sectional study was designed to examine the fetal cortical sulcus development at 18-41 weeks of gestation. Ultrasound was used to examine the insula, sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine fissure (CF). Bland-Altman plots were used for assessing the concordance, and the intraclass correlation coefficient was used for assessing the reliability.</p><p><b>RESULTS</b>SF images were successfully obtained in 100% of participants at 22 weeks of gestation, while the POF images and CF images could be obtained in 100% at 23 weeks of gestation and 24 weeks of gestation, respectively. The SF width, temporal lobe depth, POF depth, and the CF depth increased with the developed gestation. The width of uncovered insula and the POF angle decreased with the developed gestation. By 23 weeks of gestation, the insula was beginning to be covered. Moreover, it completed at 35 weeks of gestation. The intra- and inter-observer agreements showed consistent reproducibility.</p><p><b>CONCLUSIONS</b>This study defined standard views of the fetal sulcus as well as the normal reference ranges of these sulcus measurements between 18 and 41 weeks of gestation. Such ultrasonographic measurements could be used to identify fetuses at risk of fetal neurological structural disorders.</p>
Subject(s)
Adult , Female , Humans , Pregnancy , Brain , Embryology , Cross-Sectional Studies , Fetal Development , Physiology , Fetus , Embryology , Gestational Age , Ultrasonography, Prenatal , MethodsABSTRACT
Objective To assess the prenatal features of dural sinus malformation (DSM) by ultrasound. Methods The prenatal ultrasonography and MRI examination were applied in three fetuses who were suspected as brain abnormalities and transferred to Shenzhen Maternity and Child Healthcare Hospital for detailed antenatal ultrasound examination. Comparative analysis was performed on MRI, autopsy and prenatal ultrasonography. The prenatal characteristics were summarized. Results In the sonograms of all three cases, the torcular Herophili and superior sagittal sinus were dilated. No blood lfow was detected within or around lesions by color Doppler imaging. Posterior intracranial dual sinus thrombosis was detected in one case. MRI examinations were applied in two fetuses. The results of prenatal ultrasonography were consisted with those of MRI, MRI imaging showed dilated torcular Herophili and superior sagittal sinus with short T1 and short T2 signal. The thrombosis was presented as iso-hypointense with focal eccentric hyperintense. One case was undertook autopsy and the result was consisted with the prenatal sonographic findings. Conclusions The typical sonographic features of DSM is dilated torcular Herophili and superior sagittal sinus with no blood lfow in color Doppler imaging. DSM should be excluded when anechoic area was detected at the rear part of midline.
ABSTRACT
<p><b>OBJECTIVE</b>To study the value of prenatal ultrasound in the diagnosis of fetal malformations.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006.</p><p><b>RESULTS</b>The incidence rate of fetal malformation was 22.5 per thousand in our study group. The detection rate of prenatal ultrasound was 79.02% (1 062/1 344), among which the detection rate of the severe malformations (87.58%, 860/982) were significantly higher than that of the minor malformations (55.80%, 202/362) (P < 0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities.</p><p><b>CONCLUSION</b>Prenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.</p>
Subject(s)
Humans , Congenital Abnormalities , Diagnostic Imaging , False Negative Reactions , Retrospective Studies , Ultrasonography, PrenatalABSTRACT
<p><b>BACKGROUND</b>Because of lacking skills in scanning the normal fetal facial structures and their corresponding ultrasonic features, misdiagnoses frequently occur. Therefore, we studied the appearance features and improved displaying skills of fetal facial anatomy in order to provide basis for prenatal diagnosis.</p><p><b>METHODS</b>Twenty fetuses with normal facial anatomy from induced labor because of other malformations except facial anomalies were immersed in a water bath and then scanned ultrasonographically on coronal, sagittal and transverse planes to define the ultrasonic image features of normal anatomy. The coronal and sagittal planes obtained from the submandibular triangle were used for displaying the soft and hard palate in particular.</p><p><b>RESULTS</b>Facial anatomic structures of the fetus can be clearly displayed through the three routine orthogonal planes. However, the soft and hard palate can be displayed on the planes obtained from the submandibular triangle only.</p><p><b>CONCLUSIONS</b>The superficial soft tissues and deep bony structures of the fetal face can be recognized and evaluated by routine ultrasonographic images, which is a reliable prenatal diagnostic technique to evaluate the fetal facial anatomy. The soft and hard palate can be well demonstrated by the submandibular triangle approach.</p>