This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mittal, P. Articles by Romero, R. Search for Related Content PubMed PubMed Citation Articles by Mittal, P. Articles by Romero, R.

Objective Evaluation of Sylvian Fissure Development by Multiplanar 3-Dimensional Ultrasonography

Department of Obstetrics and Gynecology (P.M., L.F.G., J.E.) and Center for Molecular Medicine and Genetics (R.R.), Wayne State University School of Medicine, Detroit, Michigan USA; Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland/Detroit, Michigan USA. (L.F.G., J.P.K., J.E., J.K.N., E.S., R.R.); and Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan USA (W.L.).

Address correspondence to Roberto Romero, MD, Perinatology Research Branch, NICHD/NIH/DHHS, Wayne State University/Hutzel Women’s Hospital, 3990 John R, Box 4, Detroit, MI 48201 USA. E-mail: warfiela{at}mail.nih.gov

Objective. Evaluation of fetal cerebral cortex sulcation is important for the pre-natal diagnosis of neuronal migration disorders. Although abnormal sylvian fissure morphologic features are frequently observed in these conditions, the diagnosis of an abnormal sylvian fissure relies on subjective interpretation of ultrasonographic images. This study was performed to develop an objective ultrasonographic parameter for sylvian fissure evaluation. Methods. This cross-sectional study included 202 normal singleton pregnancies without fetal anomalies. Using multiplanar, 3-dimensional ultrasonography, the sylvian fissure midpoint was identified. The sylvian fissure-to-parietal bone distance (SPB) was measured from the midpoint to the inner surface of the parietal bone, perpendicular to the falx cerebri. Bland-Altman plots were used to determine intraobserver and interobserver agreement. Regression analysis was used to evaluate the correlation between SPB measurements and gestational age. Results. Two hundred (99%) of 202 pregnancies had a visible sylvian fissure, identifiable as early as 12 weeks of gestation. The mean SPB values at 12 and 41 weeks were 2.1 and 14.3 mm, respectively. Intraobserver and interobserver mean differences between paired measurements were 0.01 mm (95% limits of agreement, –0.41 to 0.43 mm) and 0.05 mm (95% limits of agreement, –1.79 to 1.90 mm), respectively. A linear correlation was observed between the SPB and gestational age (multiple R = 0.91; R² = 0.82 [SPB = –2.85 + 0.42 x gestational age]). Conclusions. (1) The SPB can be reproducibly measured from 12 weeks of gestation to term; and (2) a strong positive correlation was observed between the SPB and gestational age.

Key Words: fetal brain • sylvian fissure • 3-dimensional ultrasonography

Abbreviations: SPB, sylvian fissure-to-parietal bone distance • 3D, 3-dimensional • 2D, 2-dimensional

This article has been cited by other articles:

				J. Espinoza, S. S. Hassan, F. Gotsch, J. P. Kusanovic, W. Lee, O. Erez, L. F. Goncalves, M. L. Schoen, and R. Romero A Systematic Approach to the Use of the Multiplanar Display in Evaluation of Abnormal Vascular Connections to the Fetal Heart Using 4-Dimensional Ultrasonography J. Ultrasound Med., November 1, 2007; 26(11): 1461 - 1467. [Abstract] [Full Text] [PDF]