Reference values for the length and the area of the fetal corpus callosum between 20 and 33 weeks' gestation were determined with high reproducibility.

with abnormal measurements of the fourth ventricle (intracranial translucency -IT) that provided the morphological support to evaluate the efficiency and specificity of posterior brain parameters. Prospectively we evaluated mean values and repeatability of most efficient and specific considered parameters of the posterior brain complex -brain stem diameter (BS), brain stem to occipital bone distance (BSOB) and BS to BSOB ratio were performed in 112 fetuses in 2D before obtaining 3D volumes, used to measure the parameters by the same examiner twice and by another examiner once. Results: Abnormal IT aspects were found in both OSB cases examined in the first trimester, but also in holoprosencephaly and hydrocephalus fetuses. BS and BSOB ratio were found with higher specificity for OSB detection. In the prospective study mean values increased with crown-rump length (CRL) for IT, BS, BSOB and BS to BSOB ratio decreased; the difference between measurements performed by the same sonographer was < 5% in 91% of the cases and between two sonographers < 5% in 88.4% of the paired 3D ultrasound measurements. Conclusions: Preliminary results show that abnormalities in the posterior brain may offer the possibility of first trimester diagnosis of OSB. IT abnormalities should be followed by careful CNS evaluation because false positive aspects of IT are likely to appear in fetuses with other CNS severe anomalies; BS and BSOB ratio ruled out spine anomaly in these cases. Posterior brain measurements are reproducible and the results obtained by 3D and 2D ultrasound are similar. P01.11Correlation of fetal length and area of corpus callosum by 3D sonography with 2D biometric parameters Department of Obstetrics, São Paulo Federal University (UNIFESP), São Paulo, BrazilObjectives: To correlate of fetal length and area of corpus callosum (CC) by three-dimensional (3D) ultrasonography with two-dimensional (2D) biometric parameters. Methods: This cross-sectional study involved 250 normal pregnancies with gestational age between 20 and 33 weeks. An Accuvix XQ equipment (Medison, Seoul, Korea) with a convex volumetric transducer (3-5 MHz) was used. To assess the CC, a transfrontal plane was obtained using the metopic suture as an acoustic window. Length was obtained by measuring the distance between the proximal and distal extremities of the CC. Area was obtained through manual tracing of the external CC surface. Scatter graphs were created to analyze the correlation between CC length and area and biparietal diameter (BPD), abdominal circumference (AC), head circumference (HC) and femur length (FL), the quality adjustments was realized according to the determination coefficient (R2). Results: There was a strong correlation between CC length and area and BPD, AC, HC and FL, with the best model represented by linear equation (R2 = 0. 84, 0.82, 0.86, 0.83, 0.71, 0.68, 0.72 and 0.69, respectively). Conclusions: The fetal CC length and area using transfrontal view by 3D-ultrasonography showed strong correlation with 2D-biometric parameters bet...

Artigo originalResumo OBJETIVO: determinar os valores de referência para o comprimento e a área do corpo caloso fetal entre a 20 a e 33 a semanas de gestação por meio da ultrassonografia tridimensional (US3D). MÉTODOS: foi realizado um estudo do tipo corte transversal com 70 gestantes normais entre a 20 a e 33 a semanas de gestação. Utilizou-se um aparelho da marca Accuvix XQ, equipado com transdutor convexo volumétrico (3 a 5 MHz). Para a obtenção do corpo caloso fetal, foi utilizado um plano transfrontal, com a sutura metópica como janela acústica. Para o cálculo do comprimento, utilizou-se a distância entre os pontos médios dos polos proximal e distal do corpo caloso. Para o cálculo da área, a delimitação manual da superfície externa do corpo caloso foi realizada. Para o comprimento e a área do corpo caloso, foram calculadas: as médias, as medianas, os desvios padrão e os valores máximo e mínimo. Para a correlação da área e do comprimento do corpo caloso com a idade gestacional e o diâmetro biparietal foram criados diagramas de dispersão, sendo a qualidade dos ajustes verificada pelo coeficiente de determinação (R 2 ). Para a variabilidade intraobservador, utilizou-se o coeficiente de correlação intraclasse (CCI). RESULTADOS: a média do comprimento do corpo caloso variou de 21,7 mm (18,6 -25,2 mm) a 38,7 mm (32,6 -43,3 mm) entre a 20 a e 33 a semanas, respectivamente. A média da área do corpo caloso variou de 55,2 mm 2 (41,0 -80,0 mm 2 ) a 142,2 mm 2 (114,0 -160,0 mm 2 ) entre a 20 a e 33 a semanas, respectivamente. O comprimento e a área do corpo caloso foram fortemente correlacionados com a idade gestacional (R 2 = 0,7 e 0,7, respectivamente) e com o diâmetro biparietal (R 2 = 0,7 e 0,6, respectivamente). A variabilidade intraobservador foi adequada com CCI = 0,9 e 0,9 para o comprimento e área, respectivamente. CONCLUSÕES: valores de referência para o comprimento e área do corpo caloso fetal entre a 20 a e 33 a semanas foram determinados. A variabilidade intraobservador foi adequada.Abstract PURPOSE: to establish reference values for the length and area of the fetal corpus callosum between the 20 th and 33 rd weeks of gestation using three-dimensional ultrasound (3DUS). METHODS: this cross-sectional study involved 70 normal pregnancies with gestational age between 20 and 33 weeks. An Accuvix XQ instrument with a convex volumetric transducer (3 to 5 MHz) was used. To assess the corpus callosum, a transfrontal plane was obtained using the metopic suture as an acoustic window. Length was obtained by measuring the distance between the proximal and distal extremities of the corpus callosum. Area was obtained by manual tracing of the external corpus callosum surface. The means, medians, standard deviations, and maximum and minimum values were calculated for the corpus callosum length and area. Scatter graphs were created to analyze the correlation between corpus callosum length and area and gestational age and biparietal diameter, the quality adjustments was verified according to the determination coefficient (R...

O diagnóstico das lesões mamárias não palpáveis tem sido cada vez mais freqüente, a partir do aprimoramento dos métodos de diagnóstico por imagem desenvolvidos nas últimas três décadas e mais recentemente com as técnicas de biópsia por agulha (core biopsy). Apresentamos um estudo de 197 casos submetidos à biópsia por agulha, guiadas por ultra-sonografia e por mamografia, com ênfase na correlação entre os achados morfológicos dos exames de diagnóstico por imagem e a histopatologia. Em 40 casos o diagnóstico foi de carcinoma. Houve concordância significativa (p<0,001) entre a classificação conhecida com BIRADS™ e os diagnósticos histopatológicos.

Poster abstracts increase chances of survival of the second twin. We report the case of a 27-year old primigravida presenting at 19 + 5 weeks of gestation with bulging membranes of the first dichoric twin. Due to the large prolapse an emergency cerclage proposed by the couple, was denied and conservative treatment with combined antibiotics and bed rest was proposed. The couple was informed about the poor prognosis. Two days after admission, rupture of membranes led to abortion of the first twin. Immediately after birth of the fetus, contractions ceased spontaneously. Within an interval of 12 hours, vaginal ultrasound revealed a cervical length of 40 mm with the umbilical cord passing through it. Within a few days paraclinical signs of infection normalised. At 20 + 6 gestational weeks abdominal ultrasound revealed opening of the cervical os to 1 cm. A cerclage and resection of the umbilical cord was performed. At 22 + 4 weeks of gestation the patient developed severe chorioamnionitis with increase of c-reactive protein and uterine contractions. Antibiotics could not control symptoms which led to abortion of the second twin at 22 + 5 gestational weeks. Conclusion: Due to universal accesibility of information via the internet, patients are aware of most, even experimental or anecdotal, therapeutical options. Extensive discussion of external evidence and individual examination results are necessary to meet the patients need for information. To accomplish this, clinical experience and knowledge of psychosomatic counselling are essential. Close monitoring by ultrasound is needed to detect complications.