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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1-8 • 0278-4297

Three-Dimensional Ultrasonography of the Fetal Vermis at 18 to 26 Weeks’ Gestation

Time of Appearance of the Primary Fissure

Yaron Zalel, MD, Simcha Yagel, MD, Reuven Achiron, MD, Zvi Kivilevich, MD and Liat Gindes, MD

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer (affiliated with the Sackler School of Medicine, Tel-Aviv University), Ramat Gan, Israel (Y.Z., R.A., Z.K., L.G.); and Department of Obstetrics and Gynecology, Hadassah–Hebrew University Medical Center, Jerusalem, Israel (S.Y.)

Address correspondence to Yaron Zalel, MD, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, 52621 Ramat Gan, Israel., E-mail: zalel_y{at}netvision.net.il

Objective. The purpose of this study was to establish the normality of the fetal vermis, ie, the time of appearance of the primary fissure, as well as its measurements between 18 and 26 weeks’ gestation, using 3-dimensional (3D) ultrasonography. Methods. A prospective cross-sectional study of normal singleton pregnancies was conducted. Examinations were performed with high-resolution transabdominal ultrasonography using the axial plane in 173 fetuses between 18 and 26 weeks’ gestation. Postprocessing measurements of the fetal vermis were done with 4-dimensional software using static volume contrast imaging and tomographic ultrasound imaging in the C-plane. Detection of the primary fissure was evaluated in all cases, and the time of appearance was documented. Results. Adequate vermis measurements were obtained in 173 fetuses. Vermian length as a function of gestational age was expressed by regression equations, and the correlation coefficients were found to be highly statistically significant (P < .001). The normal mean ± 2 SD for each gestational week was defined. The primary fissure was observed at 24 weeks’ gestation in all cases, at 22 weeks in 94% of cases, and as early as 18 weeks in 40%. Conclusions. This 3D study documents the appearance of the primary fissure and presents the normal range of vermian measurements, confirming normal development of the fetal vermis starting as early as 18 weeks’ gestation. It also shows an easy method for visualizing the vermis with 3D ultrasonography at every gestational week regardless of fetal presentation.

Key Words: primary fissure • 3-dimensional ultrasonography • vermis

Abbreviations: MRI, magnetic resonance imaging • 3D, 3-dimensional • 3DUS, 3-dimensional ultrasonography • TUI, tomographic ultrasound imaging • 2D, 2-dimensional • 2DUS, 2-dimensional ultrasonography • VCI, volume contrast imaging

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.