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Three-Dimensional Sonographic Evaluations of Embryonic Brain Development

Inner Visions Women’s Ultrasound, Nashville, Tennessee USA (P.J., C.T.); Department of Obstetrics and Gynecology, Flushing Hospital Medical Center, Flushing, New York USA (M.S.K.); and Department of Obstetrics and Gynecology, Princess Grace Hospital, Monaco (B.B.).

Address correspondence to Mi Suk Kim, MD, Department of Obstetrics and Gynecology, Flushing Hospital Medical Center, 4500 Parsons Blvd, Flushing, NY 11355 USA. E-mail: misuksmile{at}gmail.com

Objective. The purpose of this presentation is to show 3-dimensional development of the ventricles of the brain in early pregnancy, from 6 to 13 weeks, and to provide a reference for early diagnosis of central nervous system anomalies such as hydrocephalus and holoprosencephaly. Methods. From March 2007 to August 2007, 46 patients were included. All patients had routine first-trimester 2- and 3-dimensional sonographic examinations at the same time. All cases were examined with a Voluson 730 Expert or Voluson E8 ultrasound scanner (GE Healthcare, Milwaukee, WI) using a 4- to 8- or 6- to 12-MHz transvaginal probe. Volumes were reviewed and analyzed with GE 4DView release 6 software. After the inversion-rendering mode was selected, volumes were dissected by the MagicCut function to show the ventricles. Results. A total of 34 volumes from 7 to 12 complete gestational weeks were successfully dissected. Those before 7 and after 12 weeks could not be dissected properly. The crown-rump length ranged from 12.7 to 68 mm. Twelve representative images of the rendered volumes in chronologic order are shown. The brain volume dissections of 2 fetuses with ventriculomegaly and alobar holoprosencephaly are shown for comparison. Conclusions. Early human brain ventricular structures could be evaluated in vivo with 3-dimensional sonography. This presentation shows the timeline of brain development and provides reference images to compare possible anomalies of development.

Key Words: brain embryology • first-trimester sonography • holoprosencephaly • inversion rendering • ventricle development • ventriculomegaly

Abbreviations: CRL, crown-rump length • 3D, 3-dimensional • 2D, 2-dimensional