Objective To describe the anatomical structures that form the anterior (AC) and posterior (PC) complexes of the fetal brain and to categorize their anomalies in fetuses with cerebral abnormalities.
Methods
This pictorial review describes in detail the examination technique used to study the neonatal brain via the mastoid fontanelle and offers a panoramic view of the anatomical structures that can be identified in each US slice. The brain lesions are grouped as congenital malformations, haemorrhage, cerebellar lesions and sinus venous thrombosis. In each section, the additional information obtained through the mastoid fontanelle is provided.
Misleading images seen on US examination of the neonatal brain that could be misinterpreted as pathology are presented, with clues to their differentiation from true lesions.
Knowledge of misleading images seen on fetal neurosonographic studies that could be misinterpreted as lesions is essential for the proper interpretation of these studies and will help avoid the use of more invasive diagnostic tests. To the best of our knowledge, the majority of the pitfalls presented here have only been described in neonates.
Objective: To describe a technique for the visualization and measurement of cerebral aqueduct diameter through a 2D sagittal median plane, and to report its aspect and measurement in fetuses with aqueductal stenosis (AS). Methods: This was a cross-sectional study of 207 morphologically normal fetuses in low-risk pregnancies between 20 and 36 weeks of gestation. The cerebral aqueduct was visualized transvaginally in a midsagittal plane, and measurements of its greatest diameter (ampulla) were taken independently by an expert and a nonexpert sonographer. In addition, the aqueduct morphology from 7 fetuses with AS and complete follow-up were compared to the reference range. Results: Aqueductal measurements were obtained in 206 of 207 normal fetuses. Aqueductal growth occurred linearly with gestational age. Our method demonstrated excellent interobserver reproducibility. Among the 7 fetuses with AS, the aqueductal lumen could not be identified in 6 and had a funneling aspect in 1. Discussion: Our study demonstrated that it is possible to visualize and measure the cerebral aqueduct directly through a 2D ultrasound median plane. In fetuses with severe ventriculomegaly, the morphology and width of this structure could represent a relevant tool in improving AS diagnosis, differentiating it from other causes of significant ventricular dilation that carry a different outcome.
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